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- Strukturbereich Kognitionswissenschaften (222) (remove)
This study compares the duration and first two formants (F1 and F2) of 11 nominal monophthongs and five nominal diphthongs in Standard Southern British English (SSBE) and a Northern English dialect. F1 and F2 trajectories were fitted with parametric curves using the discrete cosine transform (DCT) and the zeroth DCT coefficient represented formant trajectory means and the first DCT coefficient represented the magnitude and direction of formant trajectory change to characterize vowel inherent spectral change (VISC). Cross-dialectal comparisons involving these measures revealed significant differences for the phonologically back monophthongs /D, , , u:/ and also /3z:/ and the diphthongs /eI, e, aI, I/. Most cross-dialectal differences are in zeroth DCT coefficients, suggesting formant trajectory means tend to characterize such differences, while first DCT coefficient differences were more numerous for diphthongs. With respect to VISC, the most striking differences are that /u:/is considerably more diphthongized in the Northern dialect and that the F2 trajectory of /e/proceeds in opposite directions in the two dialects. Cross-dialectal differences were found to be largely unaffected by the consonantal context in which the vowels were produced. The implications of the results are discussed in relation to VISC, consonantal context effects and speech perception. (c) 2014 Acoustical Society of America.
Background: Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome.
Methods: From February 2009 to June 2010 1253 patients (70.9 +/- 7.0 years, 78.1% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation.
Results: The majority of patients (61.1%) were referred for rehabilitation after cardiac surgery, 38.9% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale).
Conclusion: The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.
Introduction: Cardiac rehabilitation is designed for patients suffering from cardiovascular diseases or functional disabilities. The aim of a cardiac rehabilitation is to improve overall physical health, psychological well-being, physical function, the ability to participate in social life and help patients to change their habits. Regarding the heterogeneity of these aims measuring of the effect of cardiac rehabilitation is still a challenge. This study recommends a concept to assess the effects of cardiac rehabilitation regarding the individual change of relevant quality indicators.
Methods: With EVA-Reha; cardiac rehabilitation the Medical Advisory Service of Statutory Health Insurance Funds in Rhineland-Palatinate, Alzey (MDK Rheinland-Pfalz) developed a software to collect data set including sociodemographic and diagnostic data and also the results of specific assessments. The project was funded by the Techniker Krankenkasse, Hamburg, and supported by participating rehabilitation centers. From 01. July 2010 to 30. June 2011 1309 patients (age 71.5 years, 76.1% men) from 13 rehabilitation centers were consecutively enrolled. 13 quality indicators in 3 scales were developed for evaluation of cardiac rehabilitation: 1) cardiovascular risk factors (blood pressure, LDL cholesterol, triglycerides), 2) exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure [NYHA classification], and angina pectoris [CCS classification]) and 3) subjective health (IRES-24: pain, somatic health, psychological wellbeing and depression as well as anxiety on the HADS). The study was prospective; data of patients were assessed at entry and discharge of rehabilitation. To measure the success of rehabilitation each parameter was graded in severity classes at entry and discharge. For each of the 13 quality indicators changes of severity class were rated in a rating matrix. For indicators without a requirement for medical care neither at entry nor at discharge no rating was performed.
Results: The grading into severity classes as well as the minimal important differences were given for the 13 quality indicators. The result of rehabilitation can be demonstrated in suitable form by means of rating of the 13 quality indicators according to a clinical population. The rating model differs well between clinically changed and unchanged patients for the quality indicators.
Conclusion: The result of cardiac rehabilitation can be assessed with 13 quality indicators measured at entry and discharge of the rehabilitation program. If a change into a more favorable category at the end of rehabilitation could be achieved it was counted as a success. The 13 quality indicators can be used to assess the individual result as well as the result of a population - e.g. all patients of a clinic in a specific time period. In addition, the assessment and rating of relevant quality indicators can be used for comparisons of rehabilitation centers.
Background: Travel-related conditions have impact on the quality of oral anticoagulation therapy (OAT) with vitamin K-antagonists. No predictors for travel activity and for travel-associated haemorrhage or thromboembolic complications of patients on OAT are known.
Methods: A standardised questionnaire was sent to 2500 patients on long-term OAT in Austria, Switzerland and Germany. 997 questionnaires were received (responder rate 39.9%). Ordinal or logistic regression models with travel activity before and after onset of OAT or travel-associated haemorrhages and thromboembolic complications as outcome measures were applied.
Results: 43.4% changed travel habits since onset of OAT with 24.9% and 18.5% reporting decreased or increased travel activity, respectively. Long-distance worldwide before OAT or having suffered from thromboembolic complications was associated with reduced travel activity. Increased travel activity was associated with more intensive travel experience, increased duration of OAT, higher education, or performing patient self-management (PSM). Travel-associated haemorrhages or thromboennbolic complications were reported by 6.5% and 0.9% of the patients, respectively. Former thromboennbolic complications, former bleedings and PSM were significant predictors of travel-associated complications.
Conclusions: OAT also increases travel intensity. Specific medical advice prior travelling to prevent complications should be given especially to patients with former bleedings or thromboennbolic complications and to those performing PSM. (C) 2014 Elsevier Ltd. All rights reserved.
Background: Chronic kidney disease (CKD) is a frequent comorbidity among elderly patients and those with cardiovascular disease. CKD carries prognostic relevance. We aimed to describe patient characteristics, risk factor management and control status of patients in cardiac rehabilitation (CR), differentiated by presence or absence of CKD.
Design and methods: Data from 92,071 inpatients with adequate information to calculate glomerular filtration rate (GFR) based on the Cockcroft-Gault formula were analyzed at the beginning and the end of a 3-week CR stay. CKD was defined as estimated GFR <60 ml/min/1.73 m(2).
Results: Compared with non-CKD patients, CKD patients were significantly older (72.0 versus 58.0 years) and more often had diabetes mellitus, arterial hypertension, and atherothrombotic manifestations (previous stroke, peripheral arterial disease), but fewer were current or previous smokers had a CHD family history. Exercise capacity was much lower in CKD (59 vs. 92Watts). Fewer patients with CKD were treated with percutaneous coronary intervention (PCI), but more had coronary artery bypass graft (CABG) surgery. Patients with CKD compared with non-CKD less frequently received statins, acetylsalicylic acid (ASA), clopidogrel, beta blockers, and angiotensin converting enzyme (ACE) inhibitors, and more frequently received angiotensin receptor blockers, insulin and oral anticoagulants. In CKD, mean low density lipoprotein cholesterol (LDL-C), total cholesterol, and high density lipoprotein cholesterol (HDL-C) were slightly higher at baseline, while triglycerides were substantially lower. This lipid pattern did not change at the discharge visit, but overall control rates for all described parameters (with the exception of HDL-C) were improved substantially. At discharge, systolic blood pressure (BP) was higher in CKD (124 versus 121 mmHg) and diastolic BP was lower (72 versus 74 mmHg). At discharge, 68.7% of CKD versus 71.9% of non-CKD patients had LDL-C <100 mg/dl. Physical fitness on exercise testing improved substantially in both groups. When the Modification of Diet in Renal Disease (MDRD) formula was used for CKD classification, there was no clinically relevant change in these results.
Conclusion: Within a short period of 3-4 weeks, CR led to substantial improvements in key risk factors such as lipid profile, blood pressure, and physical fitness for all patients, even if CKD was present.
In this article we report on early rhythmic discrimination performance of children who participated in a longitudinal study following children from birth to their 6th year of life. Thirty-four children including 8 children with a family risk for developmental language impairment were tested on the discrimination of trochaic and iambic disyllabic sequences when they were 4 months old. At 5 years of age, standardized measures on language performance (SETK3-5) and nonverbal intelligence (SON-R) were obtained. Overall, evidence of discrimination of the rhythmic patterns was found only for children without a family risk. The performance in early rhythmic discrimination correlated with the later outcomes in SETK3-5 subtests on sentence comprehension and morphological skills, but not with subtests related to memory performance nor with nonverbal intelligence. Our results suggest that indicators of language development can be discovered as early as 4 months of age, and seem to correlate with later outcomes in rather specific language skills.
Numerical cognitions such as spatial-numerical associations have been observed to be influenced by grounded, embodied and situated factors. For the case of finger counting, grounded and embodied influences have been reported. However, situated influences, e.g., that reported counting habits change with perception and action within a given situation, have not been systematically examined. To pursue the issue of situatedness of reported finger-counting habits, 458 participants were tested in three separate groups: (1) spontaneous condition: counting with both hands available, (2) perceptual condition: counting with horizontal (left-to-right) perceptual arrangement of fingers (3) perceptual and proprioceptive condition: counting with horizontal (left-to-right) perceptual arrangement of fingers and with busy dominant hand. Report of typical counting habits differed strongly between the three conditions. 28 % reported to start counting with the left hand in the spontaneous counting condition (1), 54 % in the perceptual condition (2) and 62 % in the perceptual and proprioceptive condition (3). Additionally, all participants in the spontaneous counting group showed a symmetry-based counting pattern (with the thumb as number 6), while in the two other groups, a considerable number of participants exhibited a spatially continuous counting pattern (with the pinkie as number 6). Taken together, the study shows that reported finger-counting habits depend on the perceptual and proprioceptive situation and thus are strongly influenced by situated cognition. We suggest that this account reconciles apparently contradictory previous findings of different counting preferences regarding the starting hand in different examination situations.
Computer aided dosage management of phenprocoumon anticoagulation therapy Clinical validation
(2014)
A recently developed multiparameter computer-aided expert system (TheMa) for guiding anticoagulation with phenprocoumon (PPC) was validated by a prospective investigation in 22 patients. The PPC-INR-response curve resulting from physician guided dosage was compared to INR values calculated by "twin calculation" from TheMa recommended dosage. Additionally, TheMa was used to predict the optimal time to perform surgery or invasive procedures after interruption of anticogulation therapy. Results: Comparison of physician and TheMa guided anticoagulation showed almost identical accuracy by three quantitative measures: Polygon integration method (area around INR target) 616.17 vs. 607.86, INR hits in the target range 166 vs. 161, and TTR (time in therapeutic range) 63.91 vs. 62.40 %. After discontinuation of anticoagulation therapy, calculating the INR phase-out curve with TheMa INR prognosis of 1.8 was possible with a standard deviation of 0.50 +/- 0.59 days. Conclusion: Guiding anticoagulation with TheMa was as accurate as Physician guided therapy. After interruption of anticoagulant therapy, TheMa may be used for calculating the optimal time performing operations or initiating bridging therapy.
Working memory load-dependent brain response predicts behavioral training gains in older adults
(2014)
In the domain of working memory (WM), a sigmoid-shaped relationship between WM load and brain activation patterns has been demonstrated in younger adults. It has been suggested that age-related alterations of this pattern are associated with changes in neural efficiency and capacity. At the same time, WM training studies have shown that some older adults are able to increase their WM performance through training. In this study, functional magnetic resonance imaging during an n-back WM task at different WM load levels was applied to compare blood oxygen level-dependent (BOLD) responses between younger and older participants and to predict gains in WM performance after a subsequent 12-session WM training procedure in older adults. We show that increased neural efficiency and capacity, as reflected by more "youth-like" brain response patterns in regions of interest of the frontoparietal WM network, were associated with better behavioral training outcome beyond the effects of age, sex, education, gray matter volume, and baseline WM performance. Furthermore, at low difficulty levels, decreases in BOLD response were found after WM training. Results indicate that both neural efficiency (i. e., decreased activation at comparable performance levels) and capacity (i. e., increasing activation with increasing WM load) of a WM-related network predict plasticity of the WM system, whereas WM training may specifically increase neural efficiency in older adults.
Processing of reward is the basis of adaptive behavior of the human being. Neural correlates of reward processing seem to be influenced by developmental changes from adolescence to late adulthood. The aim of this study is to uncover these neural correlates during a slot machine gambling task across the lifespan. Therefore, we used functional magnetic resonance imaging to investigate 102 volunteers in three different age groups: 34 adolescents, 34 younger adults, and 34 older adults. We focused on the core reward areas ventral striatum (VS) and ventromedial prefrontal cortex (VMPFC), the valence processing associated areas, anterior cingulate cortex (ACC) and insula, as well as information integration associated areas, dorsolateral prefrontal cortex (DLPFC), and inferior parietal lobule (IPL). Results showed that VS and VMPFC were characterized by a hyperactivation in adolescents compared with younger adults. Furthermore, the ACC and insula were characterized by a U-shape pattern (hypoactivation in younger adults compared with adolescents and older adults), whereas the DLPFC and IPL were characterized by a J-shaped form (hyperactivation in older adults compared with younger groups). Furthermore, a functional connectivity analysis revealed an elevated negative functional coupling between the inhibition-related area rIFG and VS in younger adults compared with adolescents. Results indicate that lifespan-related changes during reward anticipation are characterized by different trajectories in different reward network modules and support the hypothesis of an imbalance in maturation of striatal and prefrontal cortex in adolescents. Furthermore, these results suggest compensatory age-specific effects in fronto-parietal regions. Hum Brain Mapp 35:5153-5165, 2014. (c) 2014 Wiley Periodicals, Inc.
The purpose of this study was to compare static balance performance and muscle activity during one-leg standing on the dominant and nondominant leg under various sensory conditions with increased levels of task difficulty. Thirty healthy young adults (age: 23 +/- 2 years) performed one-leg standing tests for 30 s under three sensory conditions (ie, eyes open/firm ground; eyes open/foam ground [elastic pad on top of the balance plate]; eyes closed/firm ground). Center of pressure displacements and activity of four lower leg muscles (ie, m. tibialis anterior [TA], m. soleus [SOL], m. gastrocnemius medialis [GAS], m. peroneus longus [PER]) were analyzed. An increase in sensory task difficulty resulted in deteriorated balance performance (P < .001, effect size [ES] = .57-2.54) and increased muscle activity (P < .001, ES = .50-1.11) for all but two muscles (ie, GAS, PER). However, regardless of the sensory condition, one-leg standing on the dominant as compared with the nondominant limb did not produce statistically significant differences in various balance (P > .05, ES = .06-.22) and electromyographic (P > .05, ES = .03-.13) measures. This indicates that the dominant and the nondominant leg can be used interchangeably during static one-leg balance testing in healthy young adults.
The proportion of elderly people in societies of western industrialized countries is continuously rising. Biologic aging induces deficits in balance and muscle strength/power in old age, which is responsible for an increased prevalence of falls. Therefore, nationwide and easy-to-administer fall prevention programs have to be developed in order to contribute to the autonomy and quality of life in old age and to help reduce the financial burden on the public health care system due to the treatment of fall-related injuries. This narrative (qualitative) literature review deals with a) the reasons for an increased prevalence of falls in old age, b) important clinical tests for fall-risk assessment, and c) evidence-based intervention/training programs for fall prevention in old age. The findings of this literature review are based on a cost-free practice guide that is available to the public (via the internet) and that was created by an expert panel (i.e., geriatricians, exercise scientists, physiotherapists, geriatric therapists). The present review provides the scientific foundation of the practice guide.
This study investigated associations between variables of trunk muscle strength (TMS), spinal mobility, and balance in seniors. Thirty-four seniors (sex: 18 female, 16 male; age: 70 +/- 4 years; activity level: 13 +/- 7 hr/week) were tested for maximal isometric strength (MIS) of the trunk extensors, flexors, lateral flexors, rotators, spinal mobility, and steady-state, reactive, and proactive balance. Significant correlations were detected between all measures of TMS and static steady-state balance (r = .43.57, p < .05). Significant correlations were observed between specific measures of TMS and dynamic steady-state balance (r = .42.55, p < .05). No significant correlations were found between all variables of TMS and reactive/proactive balance and between all variables of spinal mobility and balance. Regression analyses revealed that TMS explains between 1-33% of total variance of the respective balance parameters. Findings indicate that TMS is related to measures of steady-state balance which may imply that TMS promoting exercises should be integrated in strength training for seniors.
Background: Interoceptive awareness, the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying interoceptive awareness (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst healthy participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
The processing of nonverbal auditory stimuli has not yet been sufficiently investigated in patients with aphasia. On the basis of a duration discrimination task, we examined whether patients with left-sided cerebrovascular lesions were able to perceive time differences in the scale of approximately 150ms. Further linguistic and memory-related tasks were used to characterize more exactly the relationships in the performances between auditory nonverbal task and selective linguistic or mnemonic disturbances. All examined conduction aphasics showed increased thresholds in the duration discrimination task. The low thresholds on this task were in a strong correlative relation to the reduced performances in repetition and working memory task. This was interpreted as an indication of a pronounced disturbance in integrating auditory verbal information into a long-term window (sampling disturbance) resulting in an additional load of working memory. In order to determine the lesion topography of patients with sampling disturbances, the anatomical and psychophysical data were correlated on the basis of a voxelwise statistical approach. It was found that tissue damage extending through the insula, the posterior superior temporal gyrus, and the supramarginal gyrus causes impairments in sequencing of time-sensitive information.
Finger-based numerical representations have gained increasing research interest. However, their description and assessment often refer to different numerical principles of ordinality, cardinality and 1-to-1 correspondence. Our aim was to investigate similarities and differences between these principles in finger-based numerical representations. Sixty-eight healthy adults performed ordinal finger counting, cardinal finger montring (showing the number of gestures) and finger-to-number mapping with twisted arms and fingers. We found that counting gestures and montring postures were identical for Number 10 but differed to varying degrees for other numbers. Interestingly, there was no systematic relation between finger-to-number mapping and ordinal finger counting habits. These data question the assumption of a unitary embodied finger-based numerical representation, but suggest that different finger-based representations co-exist and can be recruited flexibly depending on the numerical aspects to be conveyed.
This paper reports the results of a production experiment that explores the prosodic realization of focus in Hungarian, a language that is characterized by obligatory syntactic focus marking. Our study investigates narrow focus in sentences in which focus is unambiguously marked by syntactic means, comparing it to broad focus sentences. Potential independent effects of the salience (textual givenness) of the background of the narrow focus and the contrastiveness of the focus are controlled for and are also examined.
The results show that both continuous phonetic measures and categorical factors such as the distribution of contour types are affected by the focus-related factors, despite the presence of syntactic focus marking. The phonetic effects found are mostly parallel to those of typical prosodic focus marking languages like English. The prosodic prominence required of focus is realized through changes to the scaling and slope of F0 targets and contours. The asymmetric prominence relation between the focus and the background can be expressed not only by the phonetic marking of the prominence of the focused element, but also by the phonetic marking of the reduced prominence of the background. Furthermore, contrastiveness of focus and (textual) givenness of the background show independent phonetic effects, both of them affecting the realization of the background. These results are argued to shed light on alternative approaches to the information structural notion of contrastive focus and the relation between the notions of focus and givenness. (C) 2014 Elsevier B.V. All rights reserved.
Accentual preferences and predictability: An acceptability study on split intransitivity in German
(2015)
The difference in the default prosodic realization of simple sentences with unergative vs. unaccusative/passive verbs (assigning early nuclear accent with unaccusative/passive verbs but late nuclear accent with unergative verbs) is often related to the syntactic distinction of their nominative arguments as starting off in different hierarchical positions. Alternative accounts try to trace this prosodic variation back to asymmetries in the semantic or pragmatic contribution of the verb to an utterance. The present article investigates the interaction of the assignment of default nuclear accent with the predictability of the verb. In an experimental study testing the acceptability of nuclear accent assignment, we confirmed that the predictability of the verb influences accentual preferences (such that highly predictable verbs are preferably not accented). However, the experiment also reveals that the unaccusativity distinction cannot be accounted for by means of pragmatic phenomena of this type: the two verb classes are associated with distinct accentual patterns in the baseline condition, that is, without the predictability manipulation. (C) 2014 Elsevier B.V. All rights reserved.
Objective. We evaluated the long-term effect of a smoking intervention embedded in an adherence program in patients with an increased risk for cardiovascular disease.
Method. Secondary analysis of a randomized controlled trial: In 2002-2004,8108 patients with hypercholesterolemia were enrolled from general practices in Germany. Patients received a 12-month adherence program and statin medication (intervention) or statin medication only (control). The program aimed to improve adherence to medication and lifestyle by educational material, mailings, and phone calls. Smoking was self-reported at baseline and every 6 months during the 3-year follow-up.
Results. In total, 7640 patients were analyzed. At baseline, smoking prevalence was 21.7% in the intervention and 21.5% in the control group. Prevalence decreased in both groups to 16.6% vs. 19.5%, 153% vs. 16.8%, and 14.2% vs. 15.6% at the 12-, 24-, and 36-month follow-up. The intervention had a beneficial effect on smoking differing over time (group x time: P = 0.005). The effect was largest after 6 and 12 months [odds ratios (95% confidence intervals): 0.67 (0.54-0.82) and 0.63 (0.51-0.78)]. The effect decreased until the 18-month follow-up [0.72 (0.58-0.90)] and was not significant after 24 months.
Conclusion. A low-intensity smoking intervention embedded in an adherence program can contribute to smoking cessation although the intervention effect diminished over time. (C) 2015 Elsevier Inc. All rights reserved.
Number processing evokes spatial biases, both when dealing with single digits and in more complex mental calculations. Here we investigated whether these two biases have a common origin, by examining their flexibility. Participants pointed to the locations of arithmetic results on a visually presented line with an inverted, right-to-left number arrangement. We found directionally opposite spatial biases for mental arithmetic and for a parity task administered both before and after the arithmetic task. We discuss implications of this dissociation in our results for the task-dependent cognitive representation of numbers.
Background: Evidence that home telemonitoring for patients with chronic heart failure (CHF) offers clinical benefit over usual care is controversial as is evidence of a health economic advantage.
Methods: Between January 2010 and June 2013, patients with a confirmed diagnosis of CHF were enrolled and randomly assigned to 2 study groups comprising usual care with and without an interactive bi-directional remote monitoring system (Motiva (R)). The primary endpoint in CardioBBEAT is the Incremental Cost-Effectiveness Ratio (ICER) established by the groups' difference in total cost and in the combined clinical endpoint "days alive and not in hospital nor inpatient care per potential days in study" within the follow-up of 12 months.
Results: A total of 621 predominantly male patients were enrolled, whereof 302 patients were assigned to the intervention group and 319 to the control group. Ischemic cardiomyopathy was the leading cause of heart failure. Despite randomization, subjects of the control group were more often in NYHA functional class III-IV, and exhibited peripheral edema and renal dysfunction more often. Additionally, the control and intervention groups differed in heart rhythm disorders. No differences existed regarding risk factor profile, comorbidities, echocardiographic parameters, especially left ventricular and diastolic diameter and ejection fraction, as well as functional test results, medication and quality of life. While the observed baseline differences may well be a play of chance, they are of clinical relevance. Therefore, the statistical analysis plan was extended to include adjusted analyses with respect to the baseline imbalances.
Conclusions: CardioBBEAT provides prospective outcome data on both, clinical and health economic impact of home telemonitoring in CHF. The study differs by the use of a high evidence level randomized controlled trial (RCT) design along with actual cost data obtained from health insurance companies. Its results are conducive to informed political and economic decision-making with regard to home telemonitoring solutions as an option for health care. Overall, it contributes to developing advanced health economic evaluation instruments to be deployed within the specific context of the German Health Care System.
Cytochrome P450 17A1 (CYP17A1) catalyses the formation and metabolism of steroid hormones. They are involved in blood pressure (BP) regulation and in the pathogenesis of left ventricular hypertrophy. Therefore, altered function of CYP17A1 due to genetic variants may influence BP and left ventricular mass. Notably, genome wide association studies supported the role of this enzyme in BP control. Against this background, we investigated associations between single nucleotide polymorphisms (SNPs) in or nearby the CYP17A1 gene with BP and left ventricular mass in patients with arterial hypertension and associated cardiovascular organ damage treated according to guidelines. Patients (n = 1007, mean age 58.0 +/- 9.8 years, 83% men) with arterial hypertension and cardiac left ventricular ejection fraction (LVEF) 40% were enrolled in the study. Cardiac parameters of left ventricular mass, geometry and function were determined by echocardiography. The cohort comprised patients with coronary heart disease (n = 823; 81.7%) and myocardial infarction (n = 545; 54.1%) with a mean LVEF of 59.9% +/- 9.3%. The mean left ventricular mass index (LVMI) was 52.1 +/- 21.2 g/m(2.7) and 485 (48.2%) patients had left ventricular hypertrophy. There was no significant association of any investigated SNP (rs619824, rs743572, rs1004467, rs11191548, rs17115100) with mean 24 h systolic or diastolic BP. However, carriers of the rs11191548 C allele demonstrated a 7% increase in LVMI (95% CI: 1%-12%, p = 0.017) compared to non-carriers. The CYP17A1 polymorphism rs11191548 demonstrated a significant association with LVMI in patients with arterial hypertension and preserved LVEF. Thus, CYP17A1 may contribute to cardiac hypertrophy in this clinical condition.
The direction of object enumeration reflects children's enculturation but previous work on the development of such spatial preferences has been inconsistent. Therefore, we documented directional preferences in finger counting, object counting, and picture naming for children (4 groups from 3 to 6 years, N = 104) and adults (N = 56). We found a right-side preference for finger counting in 3- to 6-year-olds and a left-side preference for counting objects and naming pictures by 6 years of age. Children were consistent in their special preferences when comparing object counting and picture naming, but not in other task pairings. Finally, spatial preferences were not related to cardinality comprehension. These results, together with other recent work, suggest a gradual development of spatial-numerical associations from early non-directional mappings into culturally constrained directional mappings.
There is evidence of substantial benefit of cardiac rehabilitation (CR) for patients with low exercise capacity at admission. Nevertheless, some patients are not able to perform an initial exercise stress test (EST). We aimed to describe this group using data of 1094 consecutive patients after a cardiac event (71 +/- 7 years, 78% men) enrolled in nine centres for inpatient CR. We analysed sociodemographic and clinical variables (e.g. cardiovascular risk factors, comorbidities, complications at admission), amount of therapy (e.g. exercise training, nursing care) and the results of the initial and the final 6-min walking test (6MWT) with respect to the application of an EST. Fifteen per cent of patients did not undergo an EST (non-EST group). In multivariable analysis, the probability of obtaining an EST was higher for men [odds ratio (OR) 1.89, P=0.01], a 6MWT (per 10 m, OR 1.07, P<0.01) and lower for patients with diabetes mellitus (OR 0.48, P<0.01), NYHA-class III/IV (OR 0.27, P<0.01), osteoarthritis (OR 0.39, P<0.01) and a longer hospital stay (per 5 days, OR 0.87, P=0.02). The non-EST group received fewer therapy units of exercise training, but more units of nursing care and physiotherapy than the EST group. However, there were no significant differences between both groups in the increase of the 6MWT during CR (123 vs. 108 m, P=0.122). The present study confirms the feasibility of an EST at the start of CR as an indicator of disease severity. Nevertheless, patients without EST benefit from CR even if exercising less. Thus, there is a justified need for individualized, comprehensive and interdisciplinary CR.
Referential Coding Does Not Rely on Location Features: Evidence for a Nonspatial Joint Simon Effect
(2015)
The joint Simon effect (JSE) shows that the presence of another agent can change one's representation of one's task and/or action. According to the spatial response coding approach, this is because another person in one's peri-personal space automatically induces the spatial coding of one's own action, which in turn invites spatial stimulus-response priming. According to the referential coding approach, the presence of another person or event creates response conflict, which the actor is assumed to solve by emphasizing response features that discriminate between one's own response and that of the other. The 2 approaches often make the same predictions, but the spatial response coding approach considers spatial location as the only dimension that can drive response coding, whereas the referential coding approach allows for other dimensions as well. To compare these approaches, the authors ran 2 experiments to see whether a nonspatial JSE can be demonstrated. Participants responded to the geometrical shape of a central colored stimulus by pressing a left or right button, while wearing gloves of the same or different color as the stimuli. Participants performed the task individually, either by responding to either stimulus shapes (Experiment 1) or by responding to only 1 of the 2 shapes (Experiment 2), and in the presence of a coactor. Congruence between stimulus and glove color affected performance in the 2-choice and the joint tasks but not in the individual go/no-go task. This demonstration of a nonspatial JSE is inconsistent with the spatial response coding approach but supports the referential coding approach.
Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully.
Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis
(2015)
Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics.
Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status.
Results: After one year of follow-up, nearly 60% of patients continued drug treatment. Donezepil (HR: 0.88; 95% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline.
Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.
The interruption of learning processes by breaks filled with diverse activities is common in everyday life. This study investigated the effects of active computer gaming and passive relaxation (rest and music) breaks on auditory versus visual memory performance. Young adults were exposed to breaks involving (a) open eyes resting, (b) listening to music, and (c) playing a video game, immediately after memorizing auditory versus visual stimuli. To assess learning performance, words were recalled directly after the break (an 8:30 minute delay) and were recalled and recognized again after 7 days. Based on linear mixed-effects modeling, it was found that playing the Angry Birds video game during a short learning break impaired long-term retrieval in auditory learning but enhanced long-term retrieval in visual learning compared with the music and rest conditions. These differential effects of video games on visual versus auditory learning suggest specific interference of common break activities on learning.
The interruption of learning processes by breaks filled with diverse activities is common in everyday life. We investigated the effects of active computer gaming and passive relaxation (rest and music) breaks on working memory performance. Young adults were exposed to breaks involving (i) eyes-open resting, (ii) listening to music and (iii) playing the video game “Angry Birds” before performing the n-back working memory task. Based on linear mixed-effects modeling, we found that playing the “Angry Birds” video game during a short learning break led to a decline in task performance over the course of the task as compared to eyes-open resting and listening to music, although overall task performance was not impaired. This effect was associated with high levels of daily mind wandering and low self-reported ability to concentrate. These findings indicate that video games can negatively affect working memory performance over time when played in between learning tasks. We suggest further investigation of these effects because of their relevance to everyday activity.
Various behavioural studies show that semantic typicality (TYP) and age of acquisition (AOA) of a specific word influence processing time and accuracy during the performance of lexical-semantic tasks. This study examines the influence of TYP and AOA on semantic processing at behavioural (response times and accuracy data) and electrophysiological levels using an auditory category-member-verification task. Reaction time data reveal independent TYP and AOA effects, while in the accuracy data and the event-related potentials predominantly effects of TYP can be found. The present study thus confirms previous findings and extends evidence found in the visual modality to the auditory modality. A modality-independent influence on semantic word processing is manifested. However, with regard to the influence of AOA, the diverging results raise questions on the origin of AOA effects as well as on the interpretation of offline and online data. Hence, results will be discussed against the background of recent theories on N400 correlates in semantic processing. In addition, an argument in favour of a complementary use of research techniques will be made. (C) 2015 Elsevier Ltd. All rights reserved.
There is a wealth of evidence showing that increasing the distance between an argument and its head leads to more processing effort, namely, locality effects; these are usually associated with constraints in working memory (DLT: Gibson, 2000; activation-based model: Lewis and Vasishth, 2005). In SOV languages, however, the opposite effect has been found: antilocality (see discussion in Levy et al., 2013). Antilocality effects can be explained by the expectation-based approach as proposed by Levy (2008) or by the activation-based model of sentence processing as proposed by Lewis and Vasishth (2005). We report an eye-tracking and a self-paced reading study with sentences in Spanish together with measures of individual differences to examine the distinction between expectation- and memory-based accounts, and within memory-based accounts the further distinction between DLT and the activation-based model. The experiments show that (i) antilocality effects as predicted by the expectation account appear only for high-capacity readers; (ii) increasing dependency length by interposing material that modifies the head of the dependency (the verb) produces stronger facilitation than increasing dependency length with material that does not modify the head; this is in agreement with the activation-based model but not with the expectation account; and (iii) a possible outcome of memory load on low-capacity readers is the increase in regressive saccades (locality effects as predicted by memory-based accounts) or, surprisingly, a speedup in the self-paced reading task; the latter consistent with good-enough parsing (Ferreira et al., 2002). In sum, the study suggests that individual differences in working memory capacity play a role in dependency resolution, and that some of the aspects of dependency resolution can be best explained with the activation-based model together with a prediction component.
Objective: Alexithymia relates to difficulties recognizing and describing emotions. It has been linked to subjectively increased interoceptive awareness (IA) and to psychiatric illnesses such as major depressive disorder (MDD) and somatization. MDD in turn is characterized by aberrant emotion processing and IA on the subjective as well as on the neural level. However, a link between neural activity in response to IA and alexithymic traits in health and depression remains unclear.
Methods: A well-established fMRI task was used to investigate neural activity during IA (heartbeat counting) and exteroceptive awareness (tone counting) in non-psychiatric controls (NC) and MDD. Firstly, comparing MDD and NC, a linear relationship between IA-related activity and scores of the Toronto Alexithymia Scale (TAS) was investigated through whole-brain regression. Secondly, NC were divided by median-split of TAS scores into groups showing low (NC-low) or high (NC-high) alexithymia. MDD and NC-high showed equally high TAS scores. Subsequently, IA-related neural activity was compared on a whole-brain level between the three independent samples (MDD, NC-low, NC-high).
Results: Whole-brain regressions between MDD and NC revealed neural differences during IA as a function of TAS-DD (subscale difficulty describing feelings) in the supragenual anterior cingulate cortex (sACC; BA 24/32), which were due to negative associations between TAS-DD and IA-related activity in NC. Contrasting NC subgroups after median-split on a whole-brain level, high TAS scores were associated with decreased neural activity during IA in the sACC and increased insula activity. Though having equally high alexithymia scores, NC-high showed increased insula activity during IA compared to MDD, whilst both groups showed decreased activity in the sACC.
Conclusions: Within the context of decreased sACC activity during IA in alexithymia (NC-high and MDD), increased insula activity might mirror a compensatory mechanism in NC-high, which is disrupted in MDD.
Background: Interoceptive awareness (iA), the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored.
Methods: A well-established fMRI paradigm for studying (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups.
Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences.
Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst non-psychiatric participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.
The neurophysiological and behavioral correlates of action-related language processing have been debated for long time. A precursor in this field was the study by Buccino et al. (2005) combining transcranial magnetic stimulation (TMS) and behavioral measures (reaction times, RTs) to study the effect of listening to hand- and foot-related sentences. In the TMS experiment, the authors showed a decrease of motor evoked potentials (MEPs) recorded from hand muscles when processing hand-related verbs as compared to foot-related verbs. Similarly, MEPs recorded from leg muscles decreased when participants processed foot-related as compared to hand-related verbs. In the behavioral experiment, using the same stimuli and a semantic decision task the authors found slower RTs when the participants used the body effector (hand or foot) involved in the actual execution of the action expressed by the presented verb to give their motor responses. These findings were interpreted as an interference effect due to a simultaneous involvement of the motor system in both a language and a motor task. Our replication aimed to enlarge the sample size and replicate the findings with higher statistical power. The TMS experiment showed a significant modulation of hand MEPs, but in the sense of a motor facilitation when processing hand-related verbs. On the contrary, the behavioral experiment did not show significant results. The results are discussed within the general debate on the time-course of the modulation of motor cortex during implicit and explicit language processing and in relation to the studies on action observation/understanding.
Validation of two accelerometers to determine mechanical loading of physical activities in children
(2015)
The purpose of this study was to assess the validity of accelerometers using force plates (i.e., ground reaction force (GRF)) during the performance of different tasks of daily physical activity in children. Thirteen children (10.1 (range 5.4-15.7)years, 3 girls) wore two accelerometers (ActiGraph GT3X+ (ACT), GENEA (GEN)) at the hip that provide raw acceleration signals at 100Hz. Participants completed different tasks (walking, jogging, running, landings from boxes of different height, rope skipping, dancing) on a force plate. GRF was collected for one step per trial (10 trials) for ambulatory movements and for all landings (10 trials), rope skips and dance procedures. Accelerometer outputs as peak loading (g) per activity were averaged. ANOVA, correlation analyses and Bland-Altman plots were computed to determine validity of accelerometers using GRF. There was a main effect of task with increasing acceleration values in tasks with increasing locomotion speed and landing height (P<0.001). Data from ACT and GEN correlated with GRF (r=0.90 and 0.89, respectively) and between each other (r=0.98), but both accelerometers consistently overestimated GRF. The new generation of accelerometer models that allow raw signal detection are reasonably accurate to measure impact loading of bone in children, although they systematically overestimate GRF.
The purpose of this study was to investigate the effects of back extensor fatigue on performance measures and electromyographic (EMG) activity of leg and trunk muscles during jumping on stable and unstable surfaces.
Before and after a modified Biering-Sorensen fatigue protocol for the back extensors, countermovement (CMJ) and lateral jumps (LJ) were performed on a force plate under stable and unstable (balance pad on the force plate) conditions. Performance measures for LJ (contact time) and CMJ height and leg and trunk muscles EMG activity were tested in 14 male experienced jumpers during 2 time intervals for CMJ (braking phase, push-off phase) and 5 intervals for LJ (-30 to 0, 0-30, 30-60, 60-90, and 90-120 ms) in non-fatigued and fatigued conditions.
A significant main effect of test (fatigue) (p = 0.007, f = 0.57) was observed for CMJ height. EMG analysis showed a significant fatigue-induced decrease in biceps femoris and gastrocnemius activity with CMJ (p = 0.008, f = 0.58 andp = 0.04, f = 0.422, respectively). LJ contact time was not affected by fatigue or surface interaction. EMG activity was significantly lower in the tibialis anterior with LJ following fatigue (p = 0.05, f = 0.405). A test x surface (p = 0.04, f = 0.438) interaction revealed that the non-fatigued unstable CMJ gastrocnemius EMG activity was lower than the non-fatigued stable condition during the onset-of-force phase.
The findings revealed that fatiguing the trunk negatively impacts CMJ height and muscle activity during the performance of CMJs. However, skilled jumpers are not additionally affected by a moderately unstable surface as compared to a stable surface.
The term “bilateral deficit” (BLD) has been used to describe a reduction in performance during bilateral contractions when compared to the sum of identical unilateral contractions. In old age, maximal isometric force production (MIF) decreases and BLD increases indicating the need for training interventions to mitigate this impact in seniors. In a cross-sectional approach, we examined age-related differences in MIF and BLD in young (age: 20–30 years) and old adults (age: >65 years). In addition, a randomized-controlled trial was conducted to investigate training-specific effects of resistance vs. balance training on MIF and BLD of the leg extensors in old adults. Subjects were randomly assigned to resistance training (n = 19), balance training (n = 14), or a control group (n = 20). Bilateral heavy-resistance training for the lower extremities was performed for 13 weeks (3 × / week) at 80% of the one repetition maximum. Balance training was conducted using predominately unilateral exercises on wobble boards, soft mats, and uneven surfaces for the same duration. Pre- and post-tests included uni- and bilateral measurements of maximal isometric leg extension force. At baseline, young subjects outperformed older adults in uni- and bilateral MIF (all p < .001; d = 2.61–3.37) and in measures of BLD (p < .001; d = 2.04). We also found significant increases in uni- and bilateral MIF after resistance training (all p < .001, d = 1.8-5.7) and balance training (all p < .05, d = 1.3-3.2). In addition, BLD decreased following resistance (p < .001, d = 3.4) and balance training (p < .001, d = 2.6). It can be concluded that both training regimens resulted in increased MIF and decreased BLD of the leg extensors (HRT-group more than BAL-group), almost reaching the levels of young adults.
Two experiments examined how individuals respond to a restriction presented within an approach versus an avoidance frame. In Study 1, working on a problem-solving task, participants were initially free to choose their strategy, but for a second task were told to change their strategy. The message to change was embedded in either an approach or avoidance frame. When confronted with an avoidance compared to an approach frame, the participants’ reactance toward the request was greater and, in turn, led to impaired performance. The role of reactance as a response to threat to freedom was explicitly examined in Study 2, in which participants evaluated a potential change in policy affecting their program of study herein explicitly varying whether a restriction was present or absent and whether the message was embedded in an approach versus avoidance frame. When communicated with an avoidance frame and as a restriction, participants showed the highest resistance in terms of reactance, message agreement and evaluation of the communicator. The difference in agreement with the change was mediated by reactance only when a restriction was present. Overall, avoidance goal frames were associated with more resistance to change on different levels of experience (reactance, performance, and person perception). Reactance mediated the effect of goal frame on other outcomes only when a restriction was present.
Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)
(2016)
Background
Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting.
Methods
Five hundred twenty-three parents and their 7–13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses.
Results
Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child’s quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant.
Conclusions
The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.
Background
Doping presents a potential health risk for young athletes. Prevention programs are intended to prevent doping by educating athletes about banned substances. However, such programs have their limitations in practice. This led Germany to introduce the National Doping Prevention Plan (NDPP), in hopes of ameliorating the situation among young elite athletes. Two studies examined 1) the degree to which the NDPP led to improved prevention efforts in elite sport schools, and 2) the extent to which newly developed prevention activities of the national anti-doping agency (NADA) based on the NDPP have improved knowledge among young athletes within elite sports schools.
Methods
The first objective was investigated in a longitudinal study (Study I: t0 = baseline, t1 = follow-up 4 years after NDPP introduction) with N = 22 teachers engaged in doping prevention in elite sports schools. The second objective was evaluated in a cross-sectional comparison study (Study II) in N = 213 elite sports school students (54.5 % male, 45.5 % female, age M = 16.7 ± 1.3 years (all students had received the improved NDDP measure in school; one student group had received additionally NADA anti-doping activities and a control group did not). Descriptive statistics were calculated, followed by McNemar tests, Wilcoxon tests and Analysis of Covariance (ANCOVA).
Results
Results indicate that 4 years after the introduction of the NDPP there have been limited structural changes with regard to the frequency, type, and scope of doping prevention in elite sport schools. On the other hand, in study II, elite sport school students who received further NADA anti-doping activities performed better on an anti-doping knowledge test than students who did not take part (F(1, 207) = 33.99, p <0.001), although this difference was small.
Conclusion
The integration of doping-prevention in elite sport schools as part of the NDPP was only partially successful. The results of the evaluation indicate that the introduction of the NDPP has contributed more to a change in the content of doping prevention activities than to a structural transformation in anti-doping education in elite sport schools. Moreover, while students who did receive additional education in the form of the NDPP“booster sessions” had significantly more knowledge about doping than students who did not receive such education, this difference was only small and may not translate to actual behavior.
Exploring generalisation following treatment of language deficits in aphasia can provide insights into the functional relation of the cognitive processing systems involved. In the present study, we first review treatment outcomes of interventions targeting sentence processing deficits and, second report a treatment study examining the occurrence of practice effects and generalisation in sentence comprehension and production. In order to explore the potential linkage between processing systems involved in comprehending and producing sentences, we investigated whether improvements generalise within (i.e., uni-modal generalisation in comprehension or in production) and/or across modalities (i.e., cross-modal generalisation from comprehension to production or vice versa). Two individuals with aphasia displaying co-occurring deficits in sentence comprehension and production were trained on complex, non-canonical sentences in both modalities. Two evidence-based treatment protocols were applied in a crossover intervention study with sequence of treatment phases being randomly allocated. Both participants benefited significantly from treatment, leading to uni-modal generalisation in both comprehension and production. However, cross-modal generalisation did not occur. The magnitude of uni-modal generalisation in sentence production was related to participants’ sentence comprehension performance prior to treatment. These findings support the assumption of modality-specific sub-systems for sentence comprehension and production, being linked uni-directionally from comprehension to production.
Recent research has indicated that university students sometimes use caffeine pills for neuroenhancement (NE; non-medical use of psychoactive substances or technology to produce a subjective enhancement in psychological functioning and experience), especially during exam preparation. In our factorial survey experiment, we manipulated the evidence participants were given about the prevalence of NE amongst peers and measured the resulting effects on the psychological predictors included in the Prototype-Willingness Model of risk behavior. Two hundred and thirty-one university students were randomized to a high prevalence condition (read faked research results overstating usage of caffeine pills amongst peers by a factor of 5; 50%), low prevalence condition (half the estimated prevalence; 5%) or control condition (no information about peer prevalence). Structural equation modeling confirmed that our participants’ willingness and intention to use caffeine pills in the next exam period could be explained by their past use of neuroenhancers, attitude to NE and subjective norm about use of caffeine pills whilst image of the typical user was a much less important factor. Provision of inaccurate information about prevalence reduced the predictive power of attitude with respect to willingness by 40-45%. This may be because receiving information about peer prevalence which does not fit with their perception of the social norm causes people to question their attitude. Prevalence information might exert a deterrent effect on NE via the attitude-willingness association. We argue that research into NE and deterrence of associated risk behaviors should be informed by psychological theory.
Children’s interpretations of sentences containing focus particles do not seem adult-like until school age. This study investigates how German 4-year-old children comprehend sentences with the focus particle ‘nur’ (only) by using different tasks and controlling for the impact of general cognitive abilities on performance measures. Two sentence types with ‘only’ in either pre-subject or pre-object position were presented. Eye gaze data and verbal responses were collected via the visual world paradigm combined with a sentence-picture verification task. While the eye tracking data revealed an adult-like pattern of focus particle processing, the sentence-picture verification replicated previous findings of poor comprehension, especially for ‘only’ in pre-subject position. A second study focused on the impact of general cognitive abilities on the outcomes of the verification task. Working memory was related to children’s performance in both sentence types whereas inhibitory control was selectively related to the number of errors for sentences with ‘only’ in pre-subject position. These results suggest that children at the age of 4 years have the linguistic competence to correctly interpret sentences with focus particles, which–depending on specific task demands–may be masked by immature general cognitive abilities.
Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and
their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited
working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.
Dependency Resolution Difficulty Increases with Distance in Persian Separable Complex Predicates
(2016)
Delaying the appearance of a verb in a noun-verb dependency tends to increase processing difficulty at the verb; one explanation for this locality effect is decay and/or interference of the noun in working memory. Surprisal, an expectation-based account, predicts that delaying the appearance of a verb either renders it no more predictable or more predictable, leading respectively to a prediction of no effect of distance or a facilitation. Recently, Husain et al. (2014) suggested that when the exact identity of the upcoming verb is predictable (strong predictability), increasing argument-verb distance leads to facilitation effects, which is consistent with surprisal; but when the exact identity of the upcoming verb is not predictable (weak predictability), locality effects are seen. We investigated Husain et al.'s proposal using Persian complex predicates (CPs), which consist of a non-verbal element—a noun in the current study—and a verb. In CPs, once the noun has been read, the exact identity of the verb is highly predictable (strong predictability); this was confirmed using a sentence completion study. In two self-paced reading (SPR) and two eye-tracking (ET) experiments, we delayed the appearance of the verb by interposing a relative clause (Experiments 1 and 3) or a long PP (Experiments 2 and 4). We also included a simple Noun-Verb predicate configuration with the same distance manipulation; here, the exact identity of the verb was not predictable (weak predictability). Thus, the design crossed Predictability Strength and Distance. We found that, consistent with surprisal, the verb in the strong predictability conditions was read faster than in the weak predictability conditions. Furthermore, greater verb-argument distance led to slower reading times; strong predictability did not neutralize or attenuate the locality effects. As regards the effect of distance on dependency resolution difficulty, these four experiments present evidence in favor of working memory accounts of argument-verb dependency resolution, and against the surprisal-based expectation account of Levy (2008). However, another expectation-based measure, entropy, which was computed using the offline sentence completion data, predicts reading times in Experiment 1 but not in the other experiments. Because participants tend to produce more ungrammatical continuations in the long-distance condition in Experiment 1, we suggest that forgetting due to memory overload leads to greater entropy at the verb.
We examined the effects of argument-head distance in SVO and SOV languages (Spanish and German), while taking into account readers' working memory capacity and controlling for expectation (Levy, 2008) and other factors. We predicted only locality effects, that is, a slowdown produced by increased dependency distance (Gibson, 2000; Lewis and Vasishth, 2005). Furthermore, we expected stronger locality effects for readers with low working memory capacity. Contrary to our predictions, low-capacity readers showed faster reading with increased distance, while high-capacity readers showed locality effects. We suggest that while the locality effects are compatible with memory-based explanations, the speedup of low-capacity readers can be explained by an increased probability of retrieval failure. We present a computational model based on ACT-R built under the previous assumptions, which is able to give a qualitative account for the present data and can be tested in future research. Our results suggest that in some cases, interpreting longer RTs as indexing increased processing difficulty and shorter RTs as facilitation may be too simplistic: The same increase in processing difficulty may lead to slowdowns in high-capacity readers and speedups in low-capacity ones. Ignoring individual level capacity differences when investigating locality effects may lead to misleading conclusions.
Postural control is important to cope with demands of everyday life. It has been shown that both attentional demand (i.e., cognitive processing) and fatigue affect postural control in young adults. However, their combined effect is still unresolved. Therefore, we investigated the effects of fatigue on single- (ST) and dual-task (DT) postural control. Twenty young subjects (age: 23.7 ± 2.7) performed an all-out incremental treadmill protocol. After each completed stage, one-legged-stance performance on a force platform under ST (i.e., one-legged-stance only) and DT conditions (i.e., one-legged-stance while subtracting serial 3s) was registered. On a second test day, subjects conducted the same balance tasks for the control condition (i.e., non-fatigued). Results showed that heart rate, lactate, and ventilation increased following fatigue (all p < 0.001; d = 4.2–21). Postural sway and sway velocity increased during DT compared to ST (all p < 0.001; d = 1.9–2.0) and fatigued compared to non-fatigued condition (all p < 0.001; d = 3.3–4.2). In addition, postural control deteriorated with each completed stage during the treadmill protocol (all p < 0.01; d = 1.9–3.3). The addition of an attention-demanding interference task did not further impede one-legged-stance performance. Although both additional attentional demand and physical fatigue affected postural control in healthy young adults, there was no evidence for an overadditive effect (i.e., fatigue-related performance decrements in postural control were similar under ST and DT conditions). Thus, attentional resources were sufficient to cope with the DT situations in the fatigue condition of this experiment.
Walking while concurrently performing cognitive and/or motor interference tasks is the norm rather than the exception during everyday life and there is evidence from behavioral studies that it negatively affects human locomotion. However, there is hardly any information available regarding the underlying neural correlates of single- and dual-task walking. We had 12 young adults (23.8 ± 2.8 years) walk while concurrently performing a cognitive interference (CI) or a motor interference (MI) task. Simultaneously, neural activation in frontal, central, and parietal brain areas was registered using a mobile EEG system. Results showed that the MI task but not the CI task affected walking performance in terms of significantly decreased gait velocity and stride length and significantly increased stride time and tempo-spatial variability. Average activity in alpha and beta frequencies was significantly modulated during both CI and MI walking conditions in frontal and central brain regions, indicating an increased cognitive load during dual-task walking. Our results suggest that impaired motor performance during dual-task walking is mirrored in neural activation patterns of the brain. This finding is in line with established cognitive theories arguing that dual-task situations overstrain cognitive capabilities resulting in motor performance decrements.
Hauptziel Adipositas ist eine der Hauptindikationen in der Kinder- und Jugend-Rehabilitation. Für ältere Jugendliche und junge Erwachsene fehlen altersspezifische Therapieangebote fast vollständig. Ziel war es die Wünsche bezüglich der Inhalte und Methoden einer „perfekten Therapie“ im Rahmen eines Rehabilitationsaufenthalts zu untersuchen.
Methode Im Rahmen der YOUTH-Studie wurden 147 adipöse Jugendliche und junge Erwachsene beiderlei Geschlechts (zwischen 15 und 21 Jahren) mithilfe eines standardisierten Fragebogens befragt.
Ergebnis Insgesamt zeigten sich relativ wenige alters- und geschlechtsspezifische Unterschiede. Interdisziplinär geleitete, koedukative Gruppen mit Elterneinbindung wurden gewünscht. Wichtige Themen waren gesunde Ernährung sowie psychosoziale Aspekte. Auch der Prävention von Rückfällen wurde eine hohe Relevanz zugeschrieben.
Schlussfolgerung Psychosoziale Aspekte und die Vorbereitung auf mögliche Rückfallsituationen sollten integraler Bestandteil der Therapie sein.
Mental arithmetic exhibits various biases. Among those is a tendency to overestimate addition and to underestimate subtraction outcomes. Does such “operational momentum” (OM) also affect multiplication and division? Twenty-six adults produced lines whose lengths corresponded to the correct outcomes of multiplication and division problems shown in symbolic format. We found a reliable tendency to over-estimate division outcomes, i.e., reverse OM. We suggest that anchoring on the first operand (a tendency to use this number as a reference for further quantitative reasoning) contributes to cognitive biases in mental arithmetic.
Background
Foot orthoses are usually assumed to be effective by optimizing mechanically dynamic rearfoot configuration. However, the effect from a foot orthosis on kinematics that has been demonstrated scientifically has only been marginal. The aim of this study was to examine the effect of different heights in medial arch-supported foot orthoses on rear foot motion during gait.
Methods
Nineteen asymptomatic runners (36±11years, 180±5cm, 79±10kg; 41±22km/week) participated in the study. Trials were recorded at 3.1 mph (5 km/h) on a treadmill. Athletes walked barefoot and with 4 different not customized medial arch-supported foot orthoses of various arch heights (N:0 mm, M:30 mm, H:35 mm, E:40mm). Six infrared cameras and the `Oxford Foot Model´ were used to capture motion. The average stride in each condition was calculated from 50 gait cycles per condition. Eversion excursion and internal tibia rotation were analyzed. Descriptive statistics included calculating the mean ± SD and 95% CIs. Group differences by condition were analyzed by one factor (foot orthoses) repeated measures ANOVA (α = 0.05).
Results
Eversion excursion revealed the lowest values for N and highest for H (B:4.6°±2.2°; 95% CI [3.1;6.2]/N:4.0°±1.7°; [2.9;5.2]/M:5.2°±2.6°; [3.6;6.8]/H:6.2°±3.3°; [4.0;8.5]/E:5.1°±3.5°; [2.8;7.5]) (p>0.05). Range of internal tibia rotation was lowest with orthosis H and highest with E (B:13.3°±3.2°; 95% CI [11.0;15.6]/N:14.5°±7.2°; [9.2;19.6]/M:13.8°±5.0°; [10.8;16.8]/H:12.3°±4.3°; [9.0;15.6]/E:14.9°±5.0°; [11.5;18.3]) (p>0.05). Differences between conditions were small and the intrasubject variation high.
Conclusion
Our results indicate that different arch support heights have no systematic effect on eversion excursion or the range of internal tibia rotation and therefore might not exert a crucial influence on rear foot alignment during gait.
In the context of back pain, great emphasis has been placed on the importance of trunk stability, especially in situations requiring compensation of repetitive, intense loading induced during high-performance activities, e.g., jumping or landing. This study aims to evaluate trunk muscle activity during drop jump in adolescent athletes with back pain (BP) compared to athletes without back pain (NBP). Eleven adolescent athletes suffering back pain (BP: m/f: n = 4/7; 15.9 ± 1.3 y; 176 ± 11 cm; 68 ± 11 kg; 12.4 ± 10.5 h/we training) and 11 matched athletes without back pain (NBP: m/f: n = 4/7; 15.5 ± 1.3 y; 174 ± 7 cm; 67 ± 8 kg; 14.9 ± 9.5 h/we training) were evaluated. Subjects conducted 3 drop jumps onto a force plate (ground reaction force). Bilateral 12-lead SEMG (surface Electromyography) was applied to assess trunk muscle activity. Ground contact time [ms], maximum vertical jump force [N], jump time [ms] and the jump performance index [m/s] were calculated for drop jumps. SEMG amplitudes (RMS: root mean square [%]) for all 12 single muscles were normalized to MIVC (maximum isometric voluntary contraction) and analyzed in 4 time windows (100 ms pre- and 200 ms post-initial ground contact, 100 ms pre- and 200 ms post-landing) as outcome variables. In addition, muscles were grouped and analyzed in ventral and dorsal muscles, as well as straight and transverse trunk muscles. Drop jump ground reaction force variables did not differ between NBP and BP (p > 0.05). Mm obliquus externus and internus abdominis presented higher SEMG amplitudes (1.3–1.9-fold) for BP (p < 0.05). Mm rectus abdominis, erector spinae thoracic/lumbar and latissimus dorsi did not differ (p > 0.05). The muscle group analysis over the whole jumping cycle showed statistically significantly higher SEMG amplitudes for BP in the ventral (p = 0.031) and transverse muscles (p = 0.020) compared to NBP. Higher activity of transverse, but not straight, trunk muscles might indicate a specific compensation strategy to support trunk stability in athletes with back pain during drop jumps. Therefore, exercises favoring the transverse trunk muscles could be recommended for back pain treatment.
Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic–pituitary–adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.
Objectives: Chronic back pain (CBP) can lead to disability and burden. In addition to its medical causes, its development is influenced by psychosocial risk factors, the so-called flag factors, which are categorized and integrated into many treatment guidelines. Currently, most studies investigate single flag factors, which limit the estimation of individual factor significance in the development of chronic pain. Furthermore, factors concerning patients’ lifestyle, biography and treatment history are often neglected. Therefore, the objectives of the present study are to identify commonly neglected factors of CBP and integrate them into an analysis model comparing their significance with established flag factors.
Methods: A total of 24 patients and therapists were cross-sectionally interviewed to identify commonly neglected factors of CBP. Subsequently, the impact of these factors was surveyed in a longitudinal study. In two rehabilitation clinics, CBP patients (n = 145) were examined before and 6 months after a 3-week inpatient rehabilitation. Outcome variables, chronification factor pain experience (CF-PE) and chronification factor disability (CF-D), were ascertained with confirmatory factor analysis (CFA) of standardized questionnaires. Predictors were evaluated using stepwise calculations of simple and multiple regression models.
Results: Through interviews, medical history, iatrogenic factors, poor compliance, critical life events (LEs), social support (SS) type and effort–reward were identified as commonly neglected factors. However, only the final three held significance in comparison to established factors such as depression and pain-related cognitions. Longitudinally, lifestyle factors found to influence future pain were initial pain, physically demanding work, nicotine consumption, gender and rehabilitation clinic. LEs were unexpectedly found to be a strong predictor of future pain, as were the protective factors, reward at work and perceived SS.
Discussion: These findings shed insight regarding often overlooked factors in the development of CBP, suggesting that more detailed operationalization and superordinate frameworks would be beneficial to further research.
Conclusion: In particular, LEs should be taken into account in future research. Protective factors should be integrated in therapeutic settings.
Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation
(2017)
Background: In the last decade, transcatheter aortic valve implantation has become a promising treatment modality for patients with aortic stenosis and a high surgical risk. Little is known about influencing factors of function and quality of life during multicomponent cardiac rehabilitation. Methods: From October 2013 to July 2015, patients with elective transcatheter aortic valve implantation and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. Frailty-Index (including cognition, nutrition, autonomy and mobility), Short Form-12 (SF-12), six-minute walk distance (6MWD) and maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. The relation between patient characteristics and improvements in 6MWD, maximum work load or SF-12 scales were studied univariately and multivariately using regression models. Results: One hundred and thirty-six patients (80.6 +/- 5.0 years, 47.8% male) were enrolled. 6MWD and maximum work load increased by 56.3 +/- 65.3 m (p < 0.001) and 8.0 +/- 14.9 watts (p < 0.001), respectively. An improvement in SF-12 (physical 2.5 +/- 8.7, p = 0.001, mental 3.4 +/- 10.2, p = 0.003) could be observed. In multivariate analysis, age and higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Higher cognition, nutrition and autonomy positively influenced the physical scale of SF-12. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions: Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after transcatheter aortic valve implantation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life.
The predictions of two contrasting approaches to the acquisition of transitive relative clauses were tested within the same groups of German-speaking participants aged from 3 to 5 years old. The input frequency approach predicts that object relative clauses with inanimate heads (e.g., the pullover that the man is scratching) are comprehended earlier and more accurately than those with an animate head (e.g., the man that the boy is scratching). In contrast, the structural intervention approach predicts that object relative clauses with two full NP arguments mismatching in number (e.g., the man that the boys are scratching) are comprehended earlier and more accurately than those with number-matching NPs (e.g., the man that the boy is scratching). These approaches were tested in two steps. First, we ran a corpus analysis to ensure that object relative clauses with number-mismatching NPs are not more frequent than object relative clauses with number-matching NPs in child directed speech. Next, the comprehension of these structures was tested experimentally in 3-, 4-, and 5-year-olds respectively by means of a color naming task. By comparing the predictions of the two approaches within the same participant groups, we were able to uncover that the effects predicted by the input frequency and by the structural intervention approaches co-exist and that they both influence the performance of children on transitive relative clauses, but in a manner that is modulated by age. These results reveal a sensitivity to animacy mismatch already being demonstrated by 3-year-olds and show that animacy is initially deployed more reliably than number to interpret relative clauses correctly. In all age groups, the animacy mismatch appears to explain the performance of children, thus, showing that the comprehension of frequent object relative clauses is enhanced compared to the other conditions. Starting with 4-year-olds but especially in 5-year-olds, the number mismatch supported comprehension—a facilitation that is unlikely to be driven by input frequency. Once children fine-tune their sensitivity to verb agreement information around the age of four, they are also able to deploy number marking to overcome the intervention effects. This study highlights the importance of testing experimentally contrasting theoretical approaches in order to characterize the multifaceted, developmental nature of language acquisition.
Meaning-making in the brain has become one of the most intensely discussed topics in cognitive science. Traditional theories on cognition that emphasize abstract symbol manipulations often face a dead end: The symbol grounding problem. The embodiment idea tries to overcome this barrier by assuming that the mind is grounded in sensorimotor experiences. A recent surge in behavioral and brain-imaging studies has therefore focused on the role of the motor cortex in language processing. Concrete, action-related words have received convincing evidence to rely on sensorimotor activation. Abstract concepts, however, still pose a distinct challenge for embodied theories on cognition. Fully embodied abstraction mechanisms were formulated but sensorimotor activation alone seems unlikely to close the explanatory gap. In this respect, the idea of integration areas, such as convergence zones or the ‘hub and spoke’ model, do not only appear like the most promising candidates to account for the discrepancies between concrete and abstract concepts but could also help to unite the field of cognitive science again. The current review identifies milestones in cognitive science research and recent achievements that highlight fundamental challenges, key questions and directions for future research.
As an emerging sub-field of music information retrieval (MIR), music imagery information retrieval (MIIR) aims to retrieve information from brain activity recorded during music cognition–such as listening to or imagining music pieces. This is a highly inter-disciplinary endeavor that requires expertise in MIR as well as cognitive neuroscience and psychology. The OpenMIIR initiative strives to foster collaborations between these fields to advance the state of the art in MIIR. As a first step, electroencephalography (EEG) recordings of music perception and imagination have been made publicly available, enabling MIR researchers to easily test and adapt their existing approaches for music analysis like fingerprinting, beat tracking or tempo estimation on this new kind of data. This paper reports on first results of MIIR experiments using these OpenMIIR datasets and points out how these findings could drive new research in cognitive neuroscience.
Introduction: Chronic low back pain (LBP) is a major cause of disability; early diagnosis and stratification of care remain challenges.
Objectives: This article describes the development of a screening tool for the 1-year prognosis of patients with high chronic LBP risk (risk stratification index) and for treatment allocation according to treatment-modifiable yellow flag indicators (risk prevention indices, RPI-S).
Methods: Screening tools were derived from a multicentre longitudinal study (n = 1071, age >18, intermittent LBP). The greatest prognostic predictors of 4 flag domains ("pain," "distress," "social-environment," "medical care-environment") were determined using least absolute shrinkage and selection operator regression analysis. Internal validity and prognosis error were evaluated after 1-year follow-up. Receiver operating characteristic curves for discrimination (area under the curve) and cutoff values were determined.
Results: The risk stratification index identified persons with increased risk of chronic LBP and accurately estimated expected pain intensity and disability on the Pain Grade Questionnaire (0-100 points) up to 1 year later with an average prognosis error of 15 points. In addition, 3-risk classes were discerned with an accuracy of area under the curve = 0.74 (95% confidence interval 0.63-0.85). The RPI-S also distinguished persons with potentially modifiable prognostic indicators from 4 flag domains and stratified allocation to biopsychosocial treatments accordingly.
Conclusion: The screening tools, developed in compliance with the PROGRESS and TRIPOD statements, revealed good validation and prognostic strength. These tools improve on existing screening tools because of their utility for secondary preventions, incorporation of exercise effect modifiers, exact pain estimations, and personalized allocation to multimodal treatments.
Increased Achilles (AT) and Patellar tendon (PT) thickness in adolescent athletes compared to non-athletes could be shown. However, it is unclear, if changes are of pathological or physiological origin due to training. The aim of this study was to determine physiological AT and PT thickness adaptation in adolescent elite athletes compared to non-athletes, considering sex and sport. In a longitudinal study design with two measurement days (M1/M2) within an interval of 3.2 ± 0.8 years, 131 healthy adolescent elite athletes (m/f: 90/41) out of 13 different sports and 24 recreationally active controls (m/f: 6/18) were included. Both ATs and PTs were measured at standardized reference points. Athletes were divided into 4 sport categories [ball (B), combat (C), endurance (E) and explosive strength sports (S)]. Descriptive analysis (mean ± SD) and statistical testing for group differences was performed (α = 0.05). AT thickness did not differ significantly between measurement days, neither in athletes (5.6 ± 0.7 mm/5.6 ± 0.7 mm) nor in controls (4.8 ± 0.4 mm/4.9 ± 0.5 mm, p > 0.05). For PTs, athletes presented increased thickness at M2 (M1: 3.5 ± 0.5 mm, M2: 3.8 ± 0.5 mm, p < 0.001). In general, males had thicker ATs and PTs than females (p < 0.05). Considering sex and sports, only male athletes from B, C, and S showed significant higher PT-thickness at M2 compared to controls (p ≤ 0.01). Sport-specific adaptation regarding tendon thickness in adolescent elite athletes can be detected in PTs among male athletes participating in certain sports with high repetitive jumping and strength components. Sonographic microstructural analysis might provide an enhanced insight into tendon material properties enabling the differentiation of sex and influence of different sports.
Working memory (WM) performance declines with age. However, several studies have shown that WM training may lead to performance increases not only in the trained task, but also in untrained cognitive transfer tasks. It has been suggested that transfer effects occur if training task and transfer task share specific processing components that are supposedly processed in the same brain areas. In the current study, we investigated whether single-task WM training and training-related alterations in neural activity might support performance in a dual-task setting, thus assessing transfer effects to higher-order control processes in the context of dual-task coordination. A sample of older adults (age 60–72) was assigned to either a training or control group. The training group participated in 12 sessions of an adaptive n-back training. At pre and post-measurement, a multimodal dual-task was performed in all participants to assess transfer effects. This task consisted of two simultaneous delayed match to sample WM tasks using two different stimulus modalities (visual and auditory) that were performed either in isolation (single-task) or in conjunction (dual-task). A subgroup also participated in functional magnetic resonance imaging (fMRI) during the performance of the n-back task before and after training. While no transfer to single-task performance was found, dual-task costs in both the visual modality (p < 0.05) and the auditory modality (p < 0.05) decreased at post-measurement in the training but not in the control group. In the fMRI subgroup of the training participants, neural activity changes in left dorsolateral prefrontal cortex (DLPFC) during one-back predicted post-training auditory dual-task costs, while neural activity changes in right DLPFC during three-back predicted visual dual-task costs. Results might indicate an improvement in central executive processing that could facilitate both WM and dual-task coordination.
The term Adaptive Force (AF) describes the capability of adaptation of the nerve-muscle-system to externally applied forces during isometric and eccentric muscle action. This ability plays an important role in real life motions as well as in sports. The focus of this paper is on the specific measurement method of this neuromuscular action, which can be seen as innovative. A measuring system based on the use of compressed air was constructed and evaluated for this neuromuscular function. It depends on the physical conditions of the subject, at which force level it deviates from the quasi isometric position and merges into eccentric muscle action. The device enables – in contrast to the isokinetic systems – a measure of strength without forced motion. Evaluation of the scientific quality criteria of the devices was done by measurements regarding the intra- and interrater-, the test-retest-reliability and fatiguing measurements. Comparisons of the pneumatic device with a dynamometer were also done. Looking at the mechanical evaluation, the results show a high level of consistency (r²=0.94 to 0.96). The parallel test reliability delivers a very high and significant correlation (ρ=0.976; p=0.000). Including the biological system, the concordance of three different raters is very high (p=0.001, Cronbachs alpha α=0.987). The test retest with 4 subjects over five weeks speaks for the reliability of the device in showing no statistically significant differences. These evaluations indicate that the scientific evaluation criteria are fulfilled. The specific feature of this system is that an isometric position can be maintained while the externally impacting force rises. Moreover, the device can capture concentric, static and eccentric strength values. Fields of application are performance diagnostics in sports and medicine.
Background
In isometric muscle function, there are subjectively two different modes of performance: one can either hold isometrically – thus resist an impacting force – or push isometrically – therefore work against a stable resistance. The purpose of this study is to investigate whether or not two different isometric muscle actions – the holding vs. pushing one (HIMA vs PIMA) – can be distinguished by objective parameters.
Methods
Ten subjects performed two different measuring modes at 80% of MVC realized by a special pneumatic system. During HIMA the subject had to resist the defined impacting force of the pneumatic system in an isometric position, whereby the force of the cylinder works in direction of elbow flexion against the subject. During PIMA the subject worked isometrically in direction of elbow extension against a stable position of the system. The signals of pressure, force, acceleration and mechanomyography/-tendography (MMG/MTG) of the elbow extensor (MMGtri/MTGtri) and the abdominal muscle (MMGobl) were recorded and evaluated concerning the duration of maintaining the force level (force endurance) and the characteristics of MMG-/MTG-signals. Statistical group differences comparing HIMA vs. PIMA were estimated using SPSS.
Results
Significant differences between HIMA and PIMA were especially apparent regarding the force endurance: During HIMA the subjects showed a decisively shorter time of stable isometric position (19 ± 8 s) in comparison with PIMA (41 ± 24 s; p = .005). In addition, during PIMA the longest isometric plateau amounted to 59.4% of the overall duration time of isometric measuring, during HIMA it lasted 31.6% (p = .000). The frequency of MMG/MTG did not show significant differences. The power in the frequency ranges of 8–15 Hz and 10–29 Hz was significantly higher in the MTGtri performing HIMA compared to PIMA (but not for the MMGs). The amplitude of MMG/MTG did not show any significant difference considering the whole measurement. However, looking only at the last 10% of duration time (exhaustion), the MMGtri showed significantly higher amplitudes during PIMA.
Conclusion
The results suggest that under holding isometric conditions muscles exhaust earlier. That means that there are probably two forms of isometric muscle action. We hypothesize two potential reasons for faster yielding during HIMA: (1) earlier metabolic fatigue of the muscle fibers and (2) the complexity of neural control strategies.
Background
Total hip or knee replacement is one of the most frequently performed surgical procedures. Physical rehabilitation following total hip or knee replacement is an essential part of the therapy to improve functional outcomes and quality of life. After discharge from inpatient rehabilitation, a subsequent postoperative exercise therapy is needed to maintain functional mobility. Telerehabilitation may be a potential innovative treatment approach. We aim to investigate the superiority of an interactive telerehabilitation intervention for patients after total hip or knee replacement, in comparison to usual care, regarding physical performance, functional mobility, quality of life and pain.
Methods/design
This is an open, randomized controlled, multicenter superiority study with two prospective arms. One hundred and ten eligible and consenting participants with total knee or hip replacement will be recruited at admission to subsequent inpatient rehabilitation. After comprehensive, 3-week, inpatient rehabilitation, the intervention group performs a 3-month, interactive, home-based exercise training with a telerehabilitation system. For this purpose, the physiotherapist creates an individual training plan out of 38 different strength and balance exercises which were implemented in the system. Data about the quality and frequency of training are transmitted to the physiotherapist for further adjustment. Communication between patient and physiotherapist is possible with the system. The control group receives voluntary, usual aftercare programs. Baseline assessments are investigated after discharge from rehabilitation; final assessments 3 months later. The primary outcome is the difference in improvement between intervention and control group in 6-minute walk distance after 3 months. Secondary outcomes include differences in the Timed Up and Go Test, the Five-Times-Sit-to-Stand Test, the Stair Ascend Test, the Short-Form 36, the Western Ontario and McMaster Universities Osteoarthritis Index, the International Physical Activity Questionnaire, and postural control as well as gait and kinematic parameters of the lower limbs. Baseline-adjusted analysis of covariance models will be used to test for group differences in the primary and secondary endpoints.
Discussion
We expect the intervention group to benefit from the interactive, home-based exercise training in many respects represented by the study endpoints. If successful, this approach could be used to enhance the access to aftercare programs, especially in structurally weak areas.
Introduction: Several sports demand an early start into long-term athlete development (LTAD) because peak performances are achieved at a relatively young age (e.g., gymnastics). However, the challenging combination of high training volumes and academic demands may impede youth athletes' cognitive and academic performances. Thus, the aims of this study were to examine the effects of a 1-year sport-specific training and/or physical education on physical fitness, body composition, cognitive and academic performances in youth athletes and their non-athletic peers. Methods: Overall, 45 prepubertal fourth graders from a German elite sport school were enrolled in this study. Participating children were either youth athletes from an elite sports class (n = 20, age 9.5 ± 0.5 years) or age-matched peers from a regular class (n = 25, age 9.6 ± 0.6 years). Over the 1-year intervention period, the elite sports class conducted physical education and sport-specific training (i.e., gymnastics, swimming, soccer, bicycle motocross [BMX]) during school time while the regular class attended physical education only. Of note, BMX is a specialized form of cycling that is performed on motocross tracks and affords high technical skills. Before and after intervention, tests were performed for the assessment of physical fitness (speed [20-m sprint], agility [star agility run], muscle power [standing long jump], flexibility [stand-and-reach], endurance [6-min-run], balance [single-leg stance]), body composition (e.g., muscle mass), cognitive (d2-test) and academic performance (reading [ELFE 1–6], writing [HSP 4–5], calculating [DEMAT 4]). In addition, grades in German, English, Mathematics, and physical education were documented. Results: At baseline, youth athletes showed better physical fitness performances (p < 0.05; d = 0.70–2.16), less relative body fat mass, more relative skeletal muscle mass (p < 0.01; d = 1.62–1.84), and similar cognitive and academic achievements compared to their non-athletic peers. Athletes' training volume amounted to 620 min/week over the 1-year period while their peers performed 155 min/week. After the intervention, significant differences were found in 6 out of 7 physical fitness tests (p < 0.05; d = 0.75–1.40) and in the physical education grades (p < 0.01; d = 2.36) in favor of the elite sports class. No significant between-group differences were found after the intervention in measures of body composition (p > 0.05; d = 0.66–0.67), cognition and academics (p > 0.05; d = 0.40–0.64). Our findings revealed no significant between-group differences in growth rate (deltas of pre-post-changes in body height and leg length). Discussion: Our results revealed that a school-based 1-year sport-specific training in combination with physical education improved physical fitness but did not negatively affect cognitive and academic performances of youth athletes compared to their non-athletic peers. It is concluded that sport-specific training in combination with physical education promotes youth athletes' physical fitness development during LTAD and does not impede their cognitive and academic development.
Age-related decline in executive functions and postural control due to degenerative processes in the central nervous system have been related to increased fall-risk in old age. Many studies have shown cognitive-postural dual-task interference in old adults, but research on the role of specific executive functions in this context has just begun. In this study, we addressed the question whether postural control is impaired depending on the coordination of concurrent response-selection processes related to the compatibility of input and output modality mappings as compared to impairments related to working-memory load in the comparison of cognitive dual and single tasks. Specifically, we measured total center of pressure (CoP) displacements in healthy female participants aged 19–30 and 66–84 years while they performed different versions of a spatial one-back working memory task during semi-tandem stance on an unstable surface (i.e., balance pad) while standing on a force plate. The specific working-memory tasks comprised: (i) modality compatible single tasks (i.e., visual-manual or auditory-vocal tasks), (ii) modality compatible dual tasks (i.e., visual-manual and auditory-vocal tasks), (iii) modality incompatible single tasks (i.e., visual-vocal or auditory-manual tasks), and (iv) modality incompatible dual tasks (i.e., visual-vocal and auditory-manual tasks). In addition, participants performed the same tasks while sitting. As expected from previous research, old adults showed generally impaired performance under high working-memory load (i.e., dual vs. single one-back task). In addition, modality compatibility affected one-back performance in dual-task but not in single-task conditions with strikingly pronounced impairments in old adults. Notably, the modality incompatible dual task also resulted in a selective increase in total CoP displacements compared to the modality compatible dual task in the old but not in the young participants. These results suggest that in addition to effects of working-memory load, processes related to simultaneously overcoming special linkages between input- and output modalities interfere with postural control in old but not in young female adults. Our preliminary data provide further evidence for the involvement of cognitive control processes in postural tasks.
Introduction
Varus knee alignment has been identified as a risk factor for the progression of medial knee osteoarthritis. However, the underlying mechanisms have not been elucidated yet in children. Thus, the aims of the present study were to examine differences in ground reaction forces, loading rate, impulses, and free moment values during running in children with and without genu varus.
Methods
Thirty-six boys aged 9–14 volunteered to participate in this study. They were divided in two age-matched groups (genu varus versus healthy controls). Body weight adjusted three dimensional kinetic data (Fx, Fy, Fz) were collected during running at preferred speed using two Kistler force plates for the dominant and non-dominant limb.
Results
Individuals with knee genu varus produced significantly higher (p = .01; d = 1.09; 95%) body weight adjusted ground reaction forces in the lateral direction (Fx) of the dominant limb compared to controls. On the non-dominant limb, genu varus patients showed significantly higher body weight adjusted ground reaction forces values in the lateral (p = .01; d = 1.08; 86%) and medial (p < .001; d = 1.55; 102%) directions (Fx). Further, genu varus patients demonstrated 55% and 36% greater body weight adjusted loading rates in the dominant (p < .001; d = 2.09) and non-dominant (p < .001; d = 1.02) leg, respectively. No significant between-group differences were observed for adjusted free moment values (p>.05).
Discussion
Higher mediolateral ground reaction forces and vertical loading rate amplitudes in boys with genu varus during running at preferred running speed may accelerate the development of progressive joint degeneration in terms of the age at knee osteoarthritis onset. Therefore, practitioners and therapists are advised to conduct balance and strength training programs to improve lower limb alignment and mediolateral control during dynamic movements.
Introduction: The goal of the present study was to identify the prospective relations between weight/shape and muscularity concerns and emotional problems in adolescents. Methods: Self-report data of 966 German male and female adolescents were analyzed in a cross lagged panel design. Results: Analyses of latent means revealed significant correlations between weight/shape concern and emotional problems as well as between muscularity concern and emotional problems in both genders. Moreover, weight/shape concern predicted emotional problems prospectively, but only in girls. Regarding muscularity concern, we could not find any prospective relation with emotional problems In boys or girls from the general population. Conclusions: It is assumed that as appearance is highly relevant for the self-concept in girls, concerns about the look might promote emotional problems. Thus, weight/shape concern should be addressed in the prevention of emotional problems in adolescent girls, whereas further research is necessary investigating the contribution of muscularity concern in this context.
Background
This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents’ utilisation of psychological health care for symptoms of anxiety or depression.
Methods/design
In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session.
Discussion
This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood.
Conceptualisation is the first step of speech production and describes the process by which we map our thoughts onto spoken language. Recent studies suggest that some people with language impairments have conceptualisation deficits manifested by information selection and sequencing difficulties. In this study, we examined conceptualisation in the complex picture descriptions of individuals with and without aphasia. We analysed the number and the order of main concepts (ideas produced by >= 60% of unimpaired speakers) and non-main concepts (e.g. irrelevant details). Half of the individuals with aphasia showed a reduced number of main concepts that could not be fully accounted for by their language production deficits. Moreover, individuals with aphasia produced both a larger amount of marginally relevant information, as well as having greater variability in the order of main concepts. Both findings provide support for the idea that conceptualisation deficits are a relatively common impairment in people with aphasia.
We report two corpus analyses to examine the impact of animacy, definiteness, givenness and type of referring expression on the ordering of double objects in the spontaneous speech of German-speaking two- to four-year-old children and the child-directed speech of their mothers. The first corpus analysis revealed that definiteness, givenness and type of referring expression influenced word order variation in child language and child-directed speech when the type of referring expression distinguished between pronouns and lexical noun phrases. These results correspond to previous child language studies in English (e.g., de Marneffe et al. 2012). Extending the scope of previous studies, our second corpus analysis examined the role of different pronoun types on word order. It revealed that word order in child language and child-directed speech was predictable from the types of pronouns used. Different types of pronouns were associated with different sentence positions but also showed a strong correlation to givenness and definiteness. Yet, the distinction between pronoun types diminished the effects of givenness so that givenness had an independent impact on word order only in child-directed speech but not in child language. Our results support a multi-factorial approach to word order in German. Moreover, they underline the strong impact of the type of referring expression on word order and suggest that it plays a crucial role in the acquisition of the factors influencing word order variation.
Degenerative disc disease is associated with increased expression of pro-inflammatory cytokines in the intervertebral disc (IVD). However, it is not completely clear how inflammation arises in the IVD and which cellular compartments are involved in this process. Recently, the endoplasmic reticulum (ER) has emerged as a possible modulator of inflammation in age-related disorders. In addition, ER stress has been associated with the microenvironment of degenerated IVDs. Therefore, the aim of this study was to analyze the effects of ER stress on inflammatory responses in degenerated human IVDs and associated molecular mechanisms. Gene expression of ER stress marker GRP78 and pro-inflammatory cytokines IL-6, IL-8, IL-1 beta, and TNF-alpha was analyzed in human surgical IVD samples (n = 51, Pfirrmann grade 2-5). The expression of GRP78 positively correlated with the degeneration grade in lumbar IVDs and IL-6, but not with IL-1 beta and TNF-alpha. Another set of human surgical IVD samples (n = 25) was used to prepare primary cell cultures. ER stress inducer thapsigargin (Tg, 100 and 500 nM) activated gene and protein expression of IL-6 and induced phosphorylation of p38 MAPK. Both inhibition of p38 MAPK by SB203580 (10 mu M) and knockdown of ER stress effector CCAAT-enhancer-binding protein homologous protein (CHOP) reduced gene and protein expression of IL-6 in Tg-treated cells. Furthermore, the effects of an inflammatory microenvironment on ER stress were tested. TNF-alpha (5 and 10 ng/mL) did not activate ER stress, while IL-1 beta (5 and 10 ng/mL) activated gene and protein expression of GRP78, but did not influence [Ca2+](i) flux and expression of CHOP, indicating that pro-inflammatory cytokines alone may not induce ER stress in vivo. This study showed that IL-6 release in the IVD can be initiated following ER stress and that ER stress mediates IL-6 release through p38 MAPK and CHOP. Therapeutic targeting of ER stress response may reduce the consequences of the harsh microenvironment in degenerated IVD.
Ziel ist die Überprüfung der kurz- und mittelfristigen Wirksamkeit einer vorschulischen Förderung des Mengen- und Zahlenverständnisses bei Kindern mit einem Risiko für die Entwicklung einer Rechenstörung. Es wurden 32 Risikokinder mit einer Kombination aus den Förderprogrammen Mathematik im Vorschulalter und Mengen, zählen, Zahlen im letzten Kindergartenjahr von den Erzieherinnen trainiert und mit 38 untrainierten Risikokindern verglichen. Hinsichtlich der kurzfristigen Wirksamkeit zeigten sich positive Trainingseffekte auf die numerischen Leistungen im letzten Kindergartenjahr. Es ließen sich keine signifikanten mittelfristigen Trainingseffekte auf die Rechenleistungen im zweiten Halbjahr der 1. Klasse finden. Das eingesetzte vorschulische Präventionsprogramm leistete danach einen wichtigen Beitrag zur kurzfristigen Verbesserung der mathematischen Basiskompetenzen.
This study aimed to determine the specific physical and basic gymnastics skills considered critical in gymnastics talent identification and selection as well as in promoting men's artistic gymnastics performances. Fifty-one boys from a provincial gymnastics team (age 11.03 ± 0.95 years; height 1.33 ± 0.05 m; body mass 30.01 ± 5.53 kg; body mass index [BMI] 16.89 ± 3.93 kg/m²) regularly competing at national level voluntarily participated in this study. Anthropometric measures as well as the men's artistic gymnastics physical test battery (i.e., International Gymnastics Federation [FIG] age group development programme) were used to assess the somatic and physical fitness profile of participants, respectively. The physical characteristics assessed were: muscle strength, flexibility, speed, endurance, and muscle power. Test outcomes were subjected to a principal components analysis to identify the most representative factors. The main findings revealed that power speed, isometric and explosive strength, strength endurance, and dynamic and static flexibility are the most determinant physical fitness aspects of the talent selection process in young male artistic gymnasts. These findings are of utmost importance for talent identification, selection, and development.
Recent research has suggested that all types of size-related information are linked by a generalised system that codes for domain-independent magnitudes. This generalized system is further suggested to be acquired through everyday sensorimotor experiences with contingencies of size-related information in the real world. The aim of the present study was to investigate the existence of this common representation and its impact on the coupling of perception and action in early childhood. According to an embodied view on magnitude representation, an association between perceived magnitude information and size-related motor features, such as applied motor force, should emerge as soon as motor control is sufficiently developed. This hypothesis was tested in 2.5- to 3-year-old toddlers by engaging them in a computer game-like experimental task in which they were required to move objects placed on a platform upwards by pressing a button. The amount of objects was varied systematically (small amount: 3 vs. large amount: 15) and the force children applied on the button while moving the objects was recorded. Importantly, the amount of applied force was not relevant for successfully playing the game. The analysis of the peak force revealed that motor responses were executed more forcefully when children were presented with a large amount of objects compared to a small amount, irrespective of the toddler’s motor abilities which were evaluated by two additional measures (force control and general fine motor skills). This general effect of perceived magnitude information on the task-irrelevant applied motor force confirms our notion that a link between perceptual and motor magnitudes exists already in early childhood and provides new evidence for a sensorimotor grounding of magnitude concepts.
Introduction
Annually, 2 million sports-related injuries are reported in Germany of which athletes contribute to a large proportion. Multiple sport injury prevention programs designed to decrease acute and overuse injuries in athletes have been proven effective. Yet, the programs’ components, general or sports-specific, that led to these positive effects are uncertain. Despite not knowing about the superiority of sports-specific injury prevention programs, coaches and athletes alike prefer more specialized rather than generalized exercise programs. Therefore, this systematic review aimed to present the available evidence on how general and sports-specific prevention programs affect injury rates in athletes.
Methods
PubMed and Web of Science were electronically searched throughout April 2018. The inclusion criteria were publication dates Jan 2006–Dec 2017, athletes (11–45 years), exercise-based injury prevention programs and injury incidence. The methodological quality was assessed with the Cochrane Collaboration assessment tools.
Results
Of the initial 6619 findings, 15 studies met the inclusion criteria. In addition, 13 studies were added from reference lists and external sources making a total of 28 studies. Of which, one used sports-specific, seven general and 20 mixed prevention strategies. Twenty-four studies revealed reduced injury rates. Of the four ineffective programs, one was general and three mixed.
Conclusion
The general and mixed programs positively affect injury rates. Sports-specific programs are uninvestigated and despite wide discussion regarding the definition, no consensus was reached. Defining such terminology and investigating the true effectiveness of such IPPs is a potential avenue for future research.
Language and Arithmetic
(2018)
We examined cross-domain semantic priming effects between arithmetic and language. We paired subtractions with their linguistic equivalent, exception phrases (EPs) with positive quantifiers (e.g., “everybody except John”) while pairing additions with their own linguistic equivalent, EPs with negative quantifiers (e.g., “nobody except John”; Moltmann, 1995). We hypothesized that EPs with positive quantifiers prime subtractions and inhibit additions while EPs with negative quantifiers prime additions and inhibit subtractions. Furthermore, we expected similar priming and inhibition effects from arithmetic into semantics. Our design allowed for a bidirectional analysis by using one trial's target as the prime for the next trial. Two experiments failed to show significant priming effects in either direction. Implications and possible shortcomings are explored in the general discussion.
Introduction: We conducted a case study to examine the feasibility and safety of high-intensity interval training (HIIT) with increased inspired oxygen content in a colon cancer patient undergoing chemotherapy. A secondary purpose was to investigate the effects of such training regimen on physical functioning.
Case presentation: A female patient (51 years; 49.1 kg; 1.65 m; tumor stage: pT3, pN2a (5/29), pM1a (HEP), L0, V0, R0) performed 8 sessions of HIIT (5 × 3 minutes at 90% of Wmax, separated by 2 minutes at 45% Wmax) with an increased inspired oxygen fraction of 30%. Patient safety, training adherence, cardiorespiratory fitness (peak oxygen uptake and maximal power output during an incremental cycle ergometer test), autonomous nervous function (i.e., heart rate variability during an orthostatic test) as well as questionnaire-assessed quality of life (EORTC QLQ-C30) were evaluated before and after the intervention.
No adverse events were reported throughout the training intervention and a 3 months follow-up. While the patient attended all sessions, adherence to total training time was only 51% (102 of 200 minutes; mean training time per session 12:44 min:sec). VO2peak and Wmax increased by 13% (from 23.0 to 26.1 mL min kg−1) and 21% (from 83 to 100 W), respectively. Heart rate variability represented by the root mean squares of successive differences both in supine and upright positions were increased after the training by 143 and 100%, respectively. The EORTC QLQ-C30 score for physical functioning (7.5%) as well as the global health score (10.7%) improved, while social function decreased (17%).
Conclusions: Our results show that a already short period of HIIT with concomitant hyperoxia was safe and feasible for a patient undergoing chemotherapy for colon cancer. Furthermore, the low overall training adherence of only 51% and an overall low training time per session (∼13 minutes) was sufficient to induce clinically meaningful improvements in physical functioning. However, this case also underlines that intensity and/or length of the HIIT-bouts might need further adjustments to increase training compliance.
Although middle childhood is an important period for the development of hot and cool executive functions (EFs), longitudinal studies investigating trajectories of childhood EF development are still limited and little is known about predictors for individual developmental trajectories. The current study examined the development of two typical facets of cool and hot EFs over a 3-year period during middle childhood, comparing a younger cohort (6- and 7-year-olds at the first wave [T1]; n = 621) and an older cohort (8- and 9-year olds at T1; n = 975) of children. "Cool" working memory updating (WM) was assessed using a backward digit span task, and "hot" decision making (DM) was assessed using a child variant of the Iowa Gambling Task. Linear latent growth curve analyses revealed evidence for developmental growth as well as interindividual variance in the initial level and rate of change in both EF facets. Initial level of WM was positively associated with age (both between and within cohorts), socioeconomic status, verbal ability, and processing speed, whereas initial levels of DM were, in addition to a (potentially age-related) cohort effect, exclusively predicted by gender, with boys outperforming girls. None of the variables predicted the rate of change, that is, the developmental trajectories. However, younger children, as compared with older children, had slightly steeper WM growth curves over time, hinting at a leveling off in the development of WM during middle childhood. In sum, these data add important evidence to the understanding of hot and cool EF development during middle childhood. (C) 2018 Elsevier Inc. All rights reserved.
In the first years of life, children differ greatly from adults in the temporal organization of their speech gestures in fluent language production. However, dissent remains as to the maturational direction of such organization. The present study sheds new light on this process by tracking the development of anticipatory vowel-to-vowel coarticulation in a cross-sectional investigation of 62 German children (from 3.5 to 7 years of age) and 13 adults. It focuses on gestures of the tongue, a complex organ whose spatiotemporal control is indispensable for speech production. The goal of the study was threefold: 1) investigate whether children as well as adults initiate the articulation for a target vowel in advance of its acoustic onset, 2) test if the identity of the intervocalic consonant matters and finally, 3) describe age-related developments of these lingual coarticulatory patterns. To achieve this goal, ultrasound tongue imaging was used to record lingual movements and quantify changes in coarticulation degree as a function of consonantal context and age. Results from linear mixed effects models indicate that like adults, children initiate vowels' lingual gestures well ahead of their acoustic onset. Second, while the identity of the intervocalic consonant affects the degree of vocalic anticipation in adults, it does not in children at any age. Finally, the degree of vowelto-vowel coarticulation is significantly higher in all cohorts of children than in adults. However, among children, a developmental decrease of vocalic coarticulation is only found for sequences including the alveolar stop /d/ which requires finer spatiotemporal coordination of the tongue's subparts compared to labial and velar stops. Altogether, results suggest greater gestural overlap in child than in adult speech and support the view of a non-uniform and protracted maturation of lingual coarticulation calling for thorough considerations of the articulatory intricacies from which subtle developmental differences may originate.
In a self-paced reading study on German sluicing, Paape (Paape, 2016) found that reading times were shorter at the ellipsis site when the antecedent was a temporarily ambiguous garden-path structure. As a post-hoc explanation of this finding, Paape assumed that the antecedent’s memory representation was reactivated during syntactic reanalysis, making it easier to retrieve. In two eye tracking experiments, we subjected the reactivation hypothesis to further empirical scrutiny. Experiment 1, carried out in French, showed no evidence in favor in the reactivation hypothesis. Instead, results for one out of the three types of garden-path sentences that were tested suggest that subjects sometimes failed to resolve the temporary ambiguity in the antecedent clause, and subsequently failed to resolve the ellipsis. The results of Experiment 2, a conceptual replication of Paape’s (Paape, 2016) original study carried out in German, are compatible with the reactivation hypothesis, but leave open the possibility that the observed speedup for ambiguous antecedents may be due to occasional retrievals of an incorrect structure.
Previous research has indicated that executive function (EF) is negatively associated with aggressive behavior in childhood. However, there is a lack of longitudinal studies that have examined the effect of deficits in EF on aggression over time and taken into account different forms and functions of aggression at the same time. Furthermore, only few studies have analyzed the role of underlying variables that may explain the association between EF and aggression. The present study examined the prospective paths between EF and different forms (physical and relational) and functions (reactive and proactive) of aggression. The habitual experience of anger was examined as a potential underlying mechanism of the link between EF and aggression, because the tendency to get angry easily has been found to be both a consequence of deficits in EF and a predictor of aggression. The study included 1,652 children (between 6 and 11 years old at the first time point), who were followed over three time points (T1, T2, and T3) covering 3 years. At T1, a latent factor of EF comprised measures of planning, rated via teacher reports, as well as inhibition, set shifting, and working-memory updating, assessed experimentally. Habitual anger experience was assessed via parent reports at T1 and T2. The forms and functions of aggression were measured via teacher reports at all three time points. Structural equation modeling revealed that EF at T1 predicted physical, relational, and reactive aggression at T3, but was unrelated to proactive aggression at T3. Furthermore, EF at T1 was indirectly linked to physical aggression at T3, mediated through habitual anger experience at T2. The results indicate that deficits in EF influence the later occurrence of aggression in middle childhood, and the tendency to get angry easily mediates this relation.
Previous research has shown that electrical muscle activity is able to synchronize between muscles of one subject. The ability to synchronize the mechanical muscle oscillations measured by Mechanomyography (MMG) is not described sufficiently. Likewise, the behavior of myofascial oscillations was not considered yet during muscular interaction of two human subjects. The purpose of this study is to investigate the myofascial oscillations intra- and interpersonally. For this the mechanical muscle oscillations of the triceps and the abdominal external oblique muscles were measured by MMG and the triceps tendon was measured by mechanotendography (MTG) during isometric interaction of two subjects (n = 20) performed at 80% of the MVC using their arm extensors. The coherence of MMG/MTG-signals was analyzed with coherence wavelet transform and was compared with randomly matched signal pairs. Each signal pairing shows significant coherent behavior. Averagely, the coherent phases of n = 485 real pairings last over 82 ± 39 % of the total duration time of the isometric interaction. Coherent phases of randomly matched signal pairs take 21 ± 12 % of the total duration time (n = 39). The difference between real vs. randomly matched pairs is significant (U = 113.0, p = 0.000, r = 0.73). The results show that the neuromuscular system seems to be able to synchronize to another neuromuscular system during muscular interaction and generate a coherent behavior of the mechanical muscular oscillations. Potential explanatory approaches are discussed.
Background
Due to inconclusive evidence on the effects of foot orthoses treatment on lower limb kinematics and kinetics in children, studies are needed that particularly evaluate the long-term use of foot orthoses on lower limb alignment during walking. Thus, the main objective of this study was to evaluate the effects of long-term treatment with arch support foot orthoses versus a sham condition on lower extremity kinematics and kinetics during walking in children with flexible flat feet.
Methods
Thirty boys aged 8–12 years with flexible flat feet participated in this study. While the experimental group (n = 15) used medial arch support foot orthoses during everyday activities over a period of four months, the control group (n = 15) received flat 2-mm-thick insoles (i.e., sham condition) for the same time period. Before and after the intervention period, walking kinematics and ground reaction forces were collected.
Results
Significant group by time interactions were observed during walking at preferred gait speed for maximum ankle eversion, maximum ankle internal rotation angle, minimum knee abduction angle, maximum knee abduction angle, maximum knee external rotation angle, maximum knee internal rotation angle, maximum hip extension angle, and maximum hip external rotation angle in favor of the foot orthoses group. In addition, statistically significant group by time interactions were detected for maximum posterior, and vertical ground reaction forces in favor of the foot orthoses group.
Conclusions
The long-term use of arch support foot orthoses proved to be feasible and effective in boys with flexible flat feet to improve lower limb alignment during walking.
Introduction: Studies that combined balance and resistance training induced larger performance improvements compared with single mode training. Agility exercises contain more dynamic and sport-specific movements compared with balance training. Thus, the purpose of this study was to contrast the effects of combined balance and plyometric training with combined agility and plyometric training and an active control on physical fitness in youth.
Methods: Fifty-seven male soccer players aged 10–12 years participated in an 8-week training program (2 × week). They were randomly assigned to a balance-plyometric (BPT: n = 21), agility-plyometric (APT: n = 20) or control group (n = 16). Measures included proxies of muscle power [countermovement jump (CMJ), triple-hop-test (THT)], muscle strength [reactive strength index (RSI), maximum voluntary isometric contraction (MVIC) of handgrip, back extensors, knee extensors], agility [4-m × 9-m shuttle run, Illinois change of direction test (ICODT) with and without the ball], balance (Standing Stork, Y-Balance), and speed (10–30 m sprints).
Results: Significant time × group interactions were found for CMJ, hand grip MVIC force, ICODT without a ball, agility (4 m × 9 m), standing stork balance, Y-balance, 10 and 30-m sprint. The APT pre- to post-test measures displayed large ES improvements for hand grip MVIC force, ICODT without a ball, agility test, CMJ, standing stork balance test, Y-balance test but only moderate ES improvements with the 10 and 30 m sprints. The BPT group showed small (30 m sprint), moderate (hand grip MVIC, ICODTwithout a ball) and large ES [agility (4 m × 9 m) test, CMJ, standing stork balance test, Y-balance] improvements, respectively.
Conclusion: In conclusion, both training groups provided significant improvements in all measures. It is recommended that youth incorporate balance exercises into their training and progress to agility with their strength and power training.
Combining training of muscle strength and cardiorespiratory fitness within a training cycle could increase athletic performance more than single-mode training. However, the physiological effects produced by each training modality could also interfere with each other, improving athletic performance less than single-mode training. Because anthropometric, physiological, and biomechanical differences between young and adult athletes can affect the responses to exercise training, young athletes might respond differently to concurrent training (CT) compared with adults. Thus, the aim of the present systematic review with meta-analysis was to determine the effects of concurrent strength and endurance training on selected physical fitness components and athletic performance in youth. A systematic literature search of PubMed and Web of Science identified 886 records. The studies included in the analyses examined children (girls age 6–11 years, boys age 6–13 years) or adolescents (girls age 12–18 years, boys age 14–18 years), compared CT with single-mode endurance (ET) or strength training (ST), and reported at least one strength/power—(e.g., jump height), endurance—(e.g., peak V°O2, exercise economy), or performance-related (e.g., time trial) outcome. We calculated weighted standardized mean differences (SMDs). CT compared to ET produced small effects in favor of CT on athletic performance (n = 11 studies, SMD = 0.41, p = 0.04) and trivial effects on cardiorespiratory endurance (n = 4 studies, SMD = 0.04, p = 0.86) and exercise economy (n = 5 studies, SMD = 0.16, p = 0.49) in young athletes. A sub-analysis of chronological age revealed a trend toward larger effects of CT vs. ET on athletic performance in adolescents (SMD = 0.52) compared with children (SMD = 0.17). CT compared with ST had small effects in favor of CT on muscle power (n = 4 studies, SMD = 0.23, p = 0.04). In conclusion, CT is more effective than single-mode ET or ST in improving selected measures of physical fitness and athletic performance in youth. Specifically, CT compared with ET improved athletic performance in children and particularly adolescents. Finally, CT was more effective than ST in improving muscle power in youth.
It is well-documented that strength training (ST) improves measures of muscle strength in young athletes. Less is known on transfer effects of ST on proxies of muscle power and the underlying dose-response relationships. The objectives of this meta-analysis were to quantify the effects of ST on lower limb muscle power in young athletes and to provide dose-response relationships for ST modalities such as frequency, intensity, and volume. A systematic literature search of electronic databases identified 895 records. Studies were eligible for inclusion if (i) healthy trained children (girls aged 6–11 y, boys aged 6–13 y) or adolescents (girls aged 12–18 y, boys aged 14–18 y) were examined, (ii) ST was compared with an active control, and (iii) at least one proxy of muscle power [squat jump (SJ) and countermovement jump height (CMJ)] was reported. Weighted mean standardized mean differences (SMDwm) between subjects were calculated. Based on the findings from 15 statistically aggregated studies, ST produced significant but small effects on CMJ height (SMDwm = 0.65; 95% CI 0.34–0.96) and moderate effects on SJ height (SMDwm = 0.80; 95% CI 0.23–1.37). The sub-analyses revealed that the moderating variable expertise level (CMJ height: p = 0.06; SJ height: N/A) did not significantly influence ST-related effects on proxies of muscle power. “Age” and “sex” moderated ST effects on SJ (p = 0.005) and CMJ height (p = 0.03), respectively. With regard to the dose-response relationships, findings from the meta-regression showed that none of the included training modalities predicted ST effects on CMJ height. For SJ height, the meta-regression indicated that the training modality “training duration” significantly predicted the observed gains (p = 0.02), with longer training durations (>8 weeks) showing larger improvements. This meta-analysis clearly proved the general effectiveness of ST on lower-limb muscle power in young athletes, irrespective of the moderating variables. Dose-response analyses revealed that longer training durations (>8 weeks) are more effective to improve SJ height. No such training modalities were found for CMJ height. Thus, there appear to be other training modalities besides the ones that were included in our analyses that may have an effect on SJ and particularly CMJ height. ST monitoring through rating of perceived exertion, movement velocity or force-velocity profile could be promising monitoring tools for lower-limb muscle power development in young athletes.
Power training programs have proved to be effective in improving components of physical fitness such as speed. According to the concept of training specificity, it was postulated that exercises must attempt to closely mimic the demands of the respective activity. When transferring this idea to speed development, the purpose of the present study was to examine the effects of resisted sprint (RST) vs. traditional power training (TPT) on physical fitness in healthy young adults. Thirty-five healthy, physically active adults were randomly assigned to a RST (n = 10, 23 ± 3 years), a TPT (n = 9, 23 ± 3 years), or a passive control group (n = 16, 23 ± 2 years). RST and TPT exercised for 6 weeks with three training sessions/week each lasting 45–60 min. RST comprised frontal and lateral sprint exercises using an expander system with increasing levels of resistance that was attached to a treadmill (h/p/cosmos). TPT included ballistic strength training at 40% of the one-repetition-maximum for the lower limbs (e.g., leg press, knee extensions). Before and after training, sprint (20-m sprint), change-of-direction speed (T-agility test), jump (drop, countermovement jump), and balance performances (Y balance test) were assessed. ANCOVA statistics revealed large main effects of group for 20-m sprint velocity and ground contact time (0.81 ≤ d ≤ 1.00). Post-hoc tests showed higher sprint velocity following RST and TPT (0.69 ≤ d ≤ 0.82) when compared to the control group, but no difference between RST and TPT. Pre-to-post changes amounted to 4.5% for RST [90%CI: (−1.1%;10.1%), d = 1.23] and 2.6% for TPT [90%CI: (0.4%;4.8%), d = 1.59]. Additionally, ground contact times during sprinting were shorter following RST and TPT (0.68 ≤ d ≤ 1.09) compared to the control group, but no difference between RST and TPT. Pre-to-post changes amounted to −6.3% for RST [90%CI: (−11.4%;−1.1%), d = 1.45) and −2.7% for TPT [90%CI: (−4.2%;−1.2%), d = 2.36]. Finally, effects for change-of-direction speed, jump, and balance performance varied from small-to-large. The present findings indicate that 6 weeks of RST and TPT produced similar effects on 20-m sprint performance compared with a passive control in healthy and physically active, young adults. However, no training-related effects were found for change-of-direction speed, jump and balance performance. We conclude that both training regimes can be applied for speed development.
Plyometric jump training (PJT) is a frequently used and effective means to improve amateur and elite soccer players' physical fitness. However, it is unresolved how different PJT frequencies per week with equal overall training volume may affect training-induced adaptations. Therefore, the aim of this study was to compare the effects of an in-season 8 week PJT with one session vs. two sessions per week and equal training volume on components of physical fitness in amateur female soccer players. A single-blind randomized controlled trial was conducted. Participants (N = 23; age, 21.4 ± 3.2 years) were randomly assigned to a one session PJT per-week (PJT-1, n = 8), two sessions PJT per-week (PJT-2, n = 8) or an active control group (CON, n = 7). Before and after training, participants performed countermovement jumps (CMJ), drop-jumps from a 20-cm drop-height (DJ20), a maximal kicking velocity test (MKV), the 15-m linear sprint-time test, the Meylan test for the assessment of change of direction ability (CoDA), and the Yo-Yo intermittent recovery endurance test (Yo-YoIR1). Results revealed significant main effects of time for the CMJ, DJ20, MKV, 15-m sprint, CoDA, and the Yo-YoIR1 (all p < 0.001; d = 0.57–0.83). Significant group × time interactions were observed for the CMJ, DJ20, MKV, 15-m sprint, CoDA, and the Yo-YoIR1 (all p < 0.05; d = 0.36–0.51). Post-hoc analyses showed similar improvements for PJT-1 and PJT-2 groups in CMJ (Δ10.6%, d = 0.37; and Δ10.1%, d = 0.51, respectively), DJ20 (Δ12.9%, d = 0.47; and Δ13.1%, d = 0.54, respectively), MKV (Δ8.6%, d = 0.52; and Δ9.1%, d = 0.47, respectively), 15-m sprint (Δ8.3%, d = 2.25; and Δ9.5%, d = 2.67, respectively), CoDA (Δ7.5%, d = 1.68; and Δ7.4%, d = 1.16, respectively), and YoYoIR1 (Δ10.3%, d = 0.22; and Δ9.9%, d = 0.26, respectively). No significant pre-post changes were found for CON (all p > 0.05; Δ0.5–4.2%, d = 0.03–0.2). In conclusion, higher PJT exposure in terms of session frequency has no extra effects on female soccer players' physical fitness development when jump volume is equated during a short-term (i.e., 8 weeks) training program. From this, it follows that one PJT session per week combined with regular soccer-specific training appears to be sufficient to induce physical fitness improvements in amateur female soccer players.
Background: Telerehabilitation can contribute to the maintenance of successful rehabilitation regardless of location and time. The aim of this study was to investigate a specific three-month interactive telerehabilitation routine regarding its effectiveness in assisting patients with physical functionality and with returning to work compared to typical aftercare.
Objective: The aim of the study was to investigate a specific three-month interactive telerehabilitation with regard to effectiveness in functioning and return to work compared to usual aftercare.
Methods: From August 2016 to December 2017, 111 patients (mean 54.9 years old; SD 6.8; 54.3% female) with hip or knee replacement were enrolled in the randomized controlled trial. At discharge from inpatient rehabilitation and after three months, their distance in the 6-minute walk test was assessed as the primary endpoint. Other functional parameters, including health related quality of life, pain, and time to return to work, were secondary endpoints.
Results: Patients in the intervention group performed telerehabilitation for an average of 55.0 minutes (SD 9.2) per week. Adherence was high, at over 75%, until the 7th week of the three-month intervention phase. Almost all the patients and therapists used the communication options. Both the intervention group (average difference 88.3 m; SD 57.7; P=.95) and the control group (average difference 79.6 m; SD 48.7; P=.95) increased their distance in the 6-minute-walk-test. Improvements in other functional parameters, as well as in quality of life and pain, were achieved in both groups. The higher proportion of working patients in the intervention group (64.6%; P=.01) versus the control group (46.2%) is of note.
Conclusions: The effect of the investigated telerehabilitation therapy in patients following knee or hip replacement was equivalent to the usual aftercare in terms of functional testing, quality of life, and pain. Since a significantly higher return-to-work rate could be achieved, this therapy might be a promising supplement to established aftercare.
Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR).
Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR. Further, sociodemographic data (eg, age, sex, and education level), diagnoses, functional data (eg, exercise stress test and 6-min walking test [6MWT]), the Hospital Anxiety and Depression Scale (HADS) and self-assessment of the occupational prognosis (negative expectations and/or unemployment, Würzburger screening) at admission to CR were considered.
Results: A negative occupational prognosis was detected in 384 patients (43%). Out of these, 368 (96%) expected not to return to work after CR and/or were unemployed before CR at 29% (n=113). Affected patients showed a reduced exercise capacity (bicycle stress test: 100 W vs 118 W, P<0.01; 6MWT: 380 m vs 421 m, P<0.01) and were more likely to receive a depression diagnosis (12% vs 3%, P<0.01), as well as higher levels on the HADS. At discharge from CR, 21% of this group (n=81) were fit for work (vs 35% of patients with a normal occupational prognosis (n=175, P<0.01)). Sick leave before the cardiac event (OR 0.4, 95% CI 0.2–0.6, P<0.01), negative occupational expectations (OR 0.4, 95% CI 0.3–0.7, P<0.01) and depression (OR 0.3, 95% CI 0.1–0.8, P=0.01) reduced the likelihood of achieving work capacity upon discharge. In contrast, higher exercise capacity was positively associated.
Conclusion: Patients with a negative occupational prognosis often revealed a reduced physical performance and suffered from a high psychosocial burden. In addition, patients’ occupational expectations were a predictor of work capacity at discharge from CR. Affected patients should be identified at admission to allow for targeted psychosocial care.
Aim: The aim of the study was to identify common orthopedic sports injury profiles in adolescent elite athletes with respect to age, sex, and anthropometrics.
Methods: A retrospective data analysis of 718 orthopedic presentations among 381 adolescent elite athletes from 16 different sports to a sports medical department was performed. Recorded data of history and clinical examination included area, cause and structure of acute and overuse injuries. Injury-events were analyzed in the whole cohort and stratified by age (11–14/15–17 years) and sex. Group differences were tested by chi-squared-tests. Logistic regression analysis was applied examining the influence of factors age, sex, and body mass index (BMI) on the outcome variables area and structure (a = 0.05).
Results: Higher proportions of injury-events were reported for females (60%) and athletes of the older age group (66%) than males and younger athletes. The most frequently injured area was the lower extremity (47%) followed by the spine (30.5%) and the upper extremity (12.5%). Acute injuries were mainly located at the lower extremity (74.5%), while overuse injuries were predominantly observed at the lower extremity (41%) as well as the spine (36.5%). Joints (34%), muscles (22%), and tendons (21.5%) were found to be the most often affected structures. The injured structures were different between the age groups (p = 0.022), with the older age group presenting three times more frequent with ligament pathology events (5.5%/2%) and less frequent with bony problems (11%/20.5%) than athletes of the younger age group. The injured area differed between the sexes (p = 0.005), with males having fewer spine injury-events (25.5%/34%) but more upper extremity injuries (18%/9%) than females. Regression analysis showed statistically significant influence for BMI (p = 0.002) and age (p = 0.015) on structure, whereas the area was significantly influenced by sex (p = 0.005).
Conclusion: Events of soft-tissue overuse injuries are the most common reasons resulting in orthopedic presentations of adolescent elite athletes. Mostly, the lower extremity and the spine are affected, while sex and age characteristics on affected area and structure must be considered. Therefore, prevention strategies addressing the injury-event profiles should already be implemented in early adolescence taking age, sex as well as injury entity into account.
Sentence comprehension requires the assignment of thematic relations between the verb and its noun arguments in order to determine who is doing what to whom. In some languages, such as English, word order is the primary syntactic cue. In other languages, such as German, case-marking is additionally used to assign thematic roles. During development children have to acquire the thematic relevance of these syntactic cues and weigh them against semantic cues. Here we investigated the processing of syntactic cues and semantic cues in 2- and 3-year-old children by analyzing their behavioral and neurophysiological responses. Case-marked subject-first and object-first sentences (syntactic cue) including animate and inanimate nouns (semantic cue) were presented auditorily. The semantic animacy cue either conflicted with or supported the thematic roles assigned by syntactic case-marking. In contrast to adults, for whom semantics did not interfere with case-marking, children attended to both syntactic and to semantic cues with a stronger reliance on semantic cues in early development. Children’s event-related brain potentials indicated sensitivity to syntactic information but increased processing costs when case-marking and animacy assigned conflicting thematic roles. These results demonstrate an early developmental sensitivity and ongoing shift towards the use of syntactic cues during sentence comprehension.
It is a common finding across languages that young children have problems in understanding patient-initial sentences. We used Tagalog, a verb-initial language with a reliable voice-marking system and highly frequent patient voice constructions, to test the predictions of several accounts that have been proposed to explain this difficulty: the frequency account, the Competition Model, and the incremental processing account. Study 1 presents an analysis of Tagalog child-directed speech, which showed that the dominant argument order is agent-before-patient and that morphosyntactic markers are highly valid cues to thematic role assignment. In Study 2, we used a combined self-paced listening and picture verification task to test how Tagalog-speaking adults and 5- and 7-year-old children process reversible transitive sentences. Results showed that adults performed well in all conditions, while children’s accuracy and listening times for the first noun phrase indicated more difficulty in interpreting patient-initial sentences in the agent voice compared to the patient voice. The patient voice advantage is partly explained by both the frequency account and incremental processing account.
We aimed at unveiling the role of executive functions (EFs) and language-related skills in spelling for mono- versus multilingual primary school children. We focused on EF and language-related skills, in particular lexicon size and phonological awareness (PA), because these factors were found to predict spelling in studies predominantly conducted with monolinguals, and because multilingualism can modulate these factors. There is evidence for (a) a bilingual advantage in EF due to constant high cognitive demands through language control, (b) a smaller mental lexicon in German and (c) possibly better PA. Multilinguals in Germany show on average poorer German language proficiency, what can influence performance on language-based tasks negatively. Thus, we included two spelling tasks to tease apart spelling based on lexical knowledge (i.e., word spelling) from spelling based on non-lexical strategies (i.e., non-word spelling). Our sample consisted of heterogeneous third graders from Germany: 69 monolinguals (age: M = 108 months) and 57 multilinguals (age: M = 111 months). On less language-dependent tasks (e.g., non-word spelling, PA, intelligence, short-term memory (STM) and three EF tasks testing switching, inhibition, and working memory) performance of both groups did not differ significantly. However, multilinguals performed significantly more poorly on tasks measuring German lexicon size and word spelling than monolinguals. Regression analyses revealed that for multilinguals, inhibition was related to spelling, whereas switching was the only EF component to influence word spelling in monolinguals and non-word spelling performance in both groups. By adding lexicon size and other language-related factors to the regression models, the influence of switching was reduced to insignificant effects, but inhibition remained significant for multilinguals. Language-related skills best predicted spelling and both language groups shared those variables: PA for word spelling, and STM for non-word spelling. Additionally, multilinguals’ word spelling performance was also predicted by their German lexicon size, and non-word spelling performance by PA. This study offers an in-depth look at spelling acquisition at a certain point of literacy development. Mono- and multilinguals have the predominant factors for spelling in common, but probably due to superior language knowledge, monolinguals were already able to make use of EF during spelling. For multilinguals, German lexicon size was more important for spelling than EF. For multilinguals’ spelling these functions might come into play only at a later stage.
Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach.