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- Strukturbereich Kognitionswissenschaften (221) (remove)
Background: A prominent model of semantic processing in modern cognitive psychology proposes that semantic memory originates in everyday life experience with concrete objects such as plants, animals, and tools (Martin Chao, 2001). When the meaning of a concrete content word is being acquired, the learner is confronted with stimuli of various modalities related to the word's meaning. This comes to be stored as sensory knowledge about the object. It is further postulated that there is a conceptual domain remote from the mechanisms of perception, which is often referred to as functional knowledge or verbal semantics. There is a large body of neuropsychological literature trying to establish how much sensory and functional semantics is needed to access a name, and whether the relative contribution of these types of knowledge is the same for all categories of objects. Another controversial issue is whether naming requires access to semantic knowledge, or whether object names can be accessed directly from vision without the intervention of semantics, as is generally accepted for written word naming. Some support for this assumption seems to come from cases of so-called non-optic aphasia, a condition in which patients can name from visual presentation only but not from any other modality of presentation such as auditory, verbal, tactile, etc. In optic aphasia, a condition far better established, naming is possible from all modalities except vision. Aims: The aim of this paper is to draw attention to the first case description of non-optic or negative optic aphasia described by Wolff (1897, 1904). Methods Procedures: The case describes the results of a re-examination of Voit, who was seen by several neurologists in the course of a decade in classical aphasiology. The patient demonstrated anomia in oral but not in written naming of objects in view. Wolff's examination involves extensive testing of semantic processing in several modalities, especially with respect to the status of functional and sensory semantic features Outcomes Results: The re-examination of patient Voit by Wolff in 1897 with new procedures revealed a specific impairment in processing sensory knowledge, while functional knowledge of objects was relatively preserved. This led to a naming impairment in all modalities of presentation except the visual one. Using more refined tasks, Wolff also demonstrated receptive impairments, in contrast to previous researchers who had concluded that the impairment was restricted to oral production. Conclusions: Although Wolff's (1904) case of negative optic aphasia has been almost completely forgotten (but see Bartels Wallesch, 1996), it is astonishingly modern in its conceptual approach and in the central questions it addresses on the mechanisms involved in the process of naming and on the structure of the semantic system. As is usual in classical cases, the methodology may appear less stringent than in most contemporary work, but the approach was brilliant.
We investigated the mental rehearsal of complex action instructions by recording spontaneous eye movements of healthy adults as they looked at objects on a monitor. Participants heard consecutive instructions, each of the form "move [object] to [location]''. Instructions were only to be executed after a go signal, by manipulating all objects successively with a mouse. Participants re-inspected previously mentioned objects already while listening to further instructions. This rehearsal behavior broke down after 4 instructions, coincident with participants' instruction span, as determined from subsequent execution accuracy. These results suggest that spontaneous eye movements while listening to instructions predict their successful execution.
Current models of eye movement control are derived from theories assuming serial processing of single items or from theories based on parallel processing of multiple items at a time. This issue has persisted because most investigated paradigms generated data compatible with both serial and parallel models. Here, we study eye movements in a sequential scanning task, where stimulus n indicates the position of the next stimulus n + 1. We investigate whether eye movements are controlled by sequential attention shifts when the task requires serial order of processing. Our measures of distributed processing in the form of parafoveal-on-foveal effects, long-range modulations of target selection, and skipping saccades provide evidence against models strictly based on serial attention shifts. We conclude that our results lend support to parallel processing as a strategy for eye movement control.
Inhalt: Introduction Developments in creating corpora dlexDB, subtitles, and tabloid newspapers Rating corpus emotionality Current study Method Materials Corpora Results Type-token ratio Validity: Effects of task difficulty Emotionality of a corpus Validity: Effects of emotionality Discussion Outlook References
Tracheotomierte Patienten, die sowohl eine Dysphagie als auch respiratorische Defizite aufweisen, haben nach der Dekanülierung häufig Probleme, sich an die translaryngeale Atmung anzupassen. Wir entwickelten ein Dekanülierungsprotokoll für diese Patientengruppe, das optional in unser bestehendes Trachealkanülenmanagement integriert werden kann. Erfüllt ein Patient die hierfür definierten Kriterien, so erfolgt unter laryngoskopischer Kontrolle die Einlage eines Platzhalters, der bis zu 3 Tage in situ verbleibt. Während dieser Probedekanülierungsphase werden die respiratorischen Funktionen und das Speichelmanagement engmaschig überwacht. Auf der Grundlage dieser Evaluation wird dann die Entscheidung für oder gegen eine endgültige Dekanülierung getroffen. Wir stellen den Ablauf, die Kriterienkataloge und die Evaluationsparameter für diese Probedekanülierungsphase vor und illustrieren den Ablauf anhand von 2 Fallbeispielen.
We examined how the frequency of the fixated word influences the spatiotemporal distribution of covert attention during reading. Participants discriminated gaze-contingent probes that occurred with different spatial and temporal offsets from randomly chosen fixation points during reading. We found that attention was initially focused at fixation and that subsequent defocusing was slower when the fixated word was lower in frequency. Later in a fixation, attention oriented more towards the next saccadic target for high- than for low-frequency words. These results constitute the first report of the time course of the effect of load on attentional engagement and orienting in reading. They are discussed in the context of serial and parallel models of reading.
What features of a poem make it captivating, and which cognitive mechanisms are sensitive to these features? We addressed these questions experimentally by measuring pupillary responses of 40 participants who listened to a series of Limericks. The Limericks ended with either a semantic, syntactic, rhyme or metric violation. Compared to a control condition without violations, only the rhyme violation condition induced a reliable pupillary response. An anomaly-rating study on the same stimuli showed that all violations were reliably detectable relative to the control condition, but the anomaly induced by rhyme violations was perceived as most severe. Together, our data suggest that rhyme violations in Limericks may induce an emotional response beyond mere anomaly detection.
Stress-levels experienced by school-aged elite athletes are pronounced, but data on their mental health status are widely lacking. In our study, we examined self-reported psychological symptoms and chronic mood. Data from a representative sample of 866 elite student-athletes (aged 12-15 years), enrolled in high-performance sport programming in German Elite Schools of Sport, were compared with data from 80 student-athletes from the same schools who have just been deselected from elite sport promotion, and from 432 age-and sex-matched non-sport students from regular schools (without such programming). Anxiety symptoms were least prevalent in female elite student-athletes. In male elite student-athletes, only symptoms of posttraumatic stress were less prevalent than in the other groups. Somatoform symptoms were generally more frequent in athletes, a trend that was significantly pronounced in deselected athletes. Deselected athletes showed an increased risk for psychological symptoms compared with both other groups. Regarding chronic mood, again deselected athletes showed less positive scores. While there was a trend toward high-performance sport being associated with better psychological health at least in girls, preventative programs should take into account that deselection from elite sport programming may be associated with specific risks for mental disorders.
Background: Melatonin exerts multiple biological effects with potential impact on human diseases. This is underscored by genetic studies that demonstrated associations between melatonin receptor type 2 gene (MTNR1B) polymorphisms and characteristics of type 2 diabetes. We set out to test the hypothesis whether genetic variants at MTNR1B are also relevant for other disease phenotypes within the cardiovascular continuum. We thus investigated single nucleotide polymorphisms (SNPs) of MTNR1B in relation to blood pressure (BP) and cardiac parameters in hypertensive patients.
Methods: Patients (n = 605, mean age 56.2 +/- 9.4 years, 82.3% male) with arterial hypertension and cardiac ejection fraction (EF) >= 40% were studied. Cardiac parameters were assessed by echocardiography.
Results: The cohort comprised subjects with coronary heart disease (73.1%) and myocardial infarction (48.1%) with a mean EF of 63.7 +/- 8.9%. Analysis of SNPs rs10830962, rs4753426, rs12804291, rs10830963, and rs3781638 revealed two haplotypes 1 and 2 with frequencies of 0.402 and 0.277, respectively. Carriers with haplotype 1 (CTCCC) showed compared to non-carriers a higher mean 24-hour systolic BP (difference BP: 2.4 mm Hg, 95% confidence interval (CI): 0.3 to 4.5 mm Hg, p = 0.023). Haplotype 2 (GCCGA) was significantly related to EF with an absolute increase of 1.8% (CI: 0.45 to 3.14%) in carriers versus non-carriers (p = 0.009).
Conclusion: Genetics of MTNR1B point to impact of the melatonin signalling pathway for BP and left ventricular function. This may support the importance of the melatonin system as a potential therapeutic target.
Background: The contractile history of a muscle or a muscle group can result in an acute enhancement of subsequent muscle force output. This phenomenon is referred to as postactivation potentiation (PAP) and it was frequently substantiated in original research manuscripts, systematic literature reviews, and meta-analyses. However, there is a lack in the literature regarding precise dose-response relations. This literature review describes the main determinants of PAP effects and additionally presents the state of the art regarding the acute effects of PAP protocols on measures of strength, power, and speed in subelite and elite athletes of different sport disciplines. Furthermore, an attempt is made to demonstrate evidence-based information concerning the design of effective PAP protocols.
Methods: Our literature search included the electronic databases Pubmed, SportDiscus, and Google Scholar (1995 - March 2013). In total, 23 studies met the inclusionary criteria for review.
Results: Findings from our literature review indicate that various conditioning activities produce acute PAP effects in subelite and particularly elite athletes. More specifically, conditioning activities that are characterised by multiple sets, moderate to high intensities (60 - 84 % of the one repetition maximum), and rest intervals of 7 - 10 min. following the conditioning activity have the potential to induce short-term improvements in muscle force output and sports performance.
Conclusion: It is recommended that subelite and particularly elite athletes from strength, power, and speed disciplines apply specifically tailored conditioning activities during the acute preparation process for competition to induce performance enhancing PAP effects.
Background: Therapeutic climbing exercises are employed for the treatment of shoulder-and knee-joint injuries. However, there is a void in the literature regarding muscle activation levels during the performance of these exercises. Thus, the purpose of this study was to investigate differences in muscle activation during therapeutic climbing exercises depending on the degree of task difficulty.
Participants/Material and Methods: A sample of 10 healthy subjects (sex: 4 females, 6 males; age: 27 +/- 3 years; climbing experience: 5 +/- 3 years) performed three shoulder girdle (i.e., wide shoulder pull, narrow shoulder pull, shoulder row) and two leg extensor (i.e., ascending frontal, ascending sidewards) exercises. Electromyographic (EMG) data were recorded on the right side for eleven muscles and then normalised using the maximum voluntary contractions for each muscle.
Results: With increasing task difficulty, muscle activity in all but one muscle (i.e., m. trapezius ascendens) increased significantly for the three shoulder girdle exercises. For the two leg extensor exercises, an increase in task difficulty produced a tendency towards yet not significantly higher muscle activity.
Conclusion: Shoulder row was the most effective therapeutic climbing exercise in the ability to activate muscles while showing the highest EMG signals. The absence of significant differences in muscle activity between the two leg extensor exercises indicates their equivalent use for muscle activation during therapy.
Muehlbauer, T, Gollhofer, A, and Granacher, U. Association of balance, strength, and power measures in young adults. J Strength Cond Res 27(3): 582-589, 2013-The purpose of this study was to investigate the relationship between variables of static/dynamic balance, isometric strength, and power. Twenty-seven young healthy adults (mean age: 23 6 4 years) performed measurements of static (unperturbed)/dynamic (perturbed) balance, isometric strength (i.e., maximal isometric torque [MIT]; rate of torque development [RTD] of the plantar flexor), and power (i.e., countermovement jump [CMJ] height and power). No significant associations were found between variables of static and dynamic balance (r = -0.090 to + 0.329, p > 0.05) and between measures of static/dynamic balance and isometric strength (r = +0.041 to +0.387, p > 0.05) and static/dynamic balance and power (r = -0.076 to + 0.218, p > 0.05). Significant positive correlations (r) were detected between variables of power and isometric strength ranging from +0.458 to +0.689 (p, 0.05). Furthermore, simple regression analyses revealed that a 10% increase in mean CMJ height (4.1 cm) was associated with 22.9 N.m and 128.4 N.m.s(-1) better MIT and RTD, respectively. The nonsignificant correlation between static and dynamic balance measures and between static/dynamic balance, isometric strength, and power variables implies that these capacities may be independent of each other and may have to be tested and trained complementarily.
Background: With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested.
Methods/Design: Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale -International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version (` 3 times 3') that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period.
Discussion: It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose-response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention.
Recent research showed that past events are associated with the back and left side, whereas future events are associated with the front and right side of space. These spatial-temporal associations have an impact on our sensorimotor system: thinking about one's past and future leads to subtle body sways in the sagittal dimension of space (Miles, Nind, & Macrae, 2010). In this study we investigated whether mental time travel leads to sensorimotor correlates in the horizontal dimension of space. Participants were asked to mentally displace themselves into the past or future while measuring their spontaneous eye movements on a blank screen. Eye gaze was directed more rightward and upward when thinking about the future than when thinking about the past. Our results provide further insight into the spatial nature of temporal thoughts, and show that not only body, but also eye movements follow a (diagonal) "time line" during mental time travel. (C) 2014 Elsevier Inc. All rights reserved.
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 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.
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.
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.