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Models of ring current electron dynamics unavoidably contain uncertainties in boundary conditions, electric and magnetic fields, electron scattering rates, and plasmapause location. Model errors can accumulate with time and result in significant deviations of model predictions from observations. Data assimilation offers useful tools which can combine physics-based models and measurements to improve model predictions. In this study, we systematically analyze performance of the Kalman filter applied to a log-transformed convection model of ring current electrons and Van Allen Probe data. We consider long-term dynamics of mu = 2.3 MeV/G and K = 0.3 G(1/2) R-E electrons from 1 February 2013 to 16 June 2013. By using synthetic data, we show that the Kalman filter is capable of correcting errors in model predictions associated with uncertainties in electron lifetimes, boundary conditions, and convection electric fields. We demonstrate that reanalysis retains features which cannot be fully reproduced by the convection model such as storm-time earthward propagation of the electrons down to 2.5 R-E. The Kalman filter can adjust model predictions to satellite measurements even in regions where data are not available. We show that the Kalman filter can adjust model predictions in accordance with observations for mu = 0.1, 2.3, and 9.9 MeV/G and constant K = 0.3 G(1/2) R-E electrons. The results of this study demonstrate that data assimilation can improve performance of ring current models, better quantify model uncertainties, and help deeper understand the physics of the ring current particles.
Statistical Analysis of Hiss Waves in Plasmaspheric Plumes Using Van Allen Probe Observations
(2019)
Plasmaspheric hiss waves commonly observed in high‐density regions in the Earth's magnetosphere are known to be one of the main contributors to the loss of radiation belt electrons. There has been a lot of effort to investigate the distributions of hiss waves in the plasmasphere, while relatively little attention has been given to those in the plasmaspheric plume. In this study, we present for the first time a statistical analysis of the occurrence and the spatial distribution of wave amplitudes and wave normal angles for hiss waves in plumes using Van Allen Probes observations during the period of October 2012 to December 2016. Statistical results show that a wide range of hiss wave amplitudes in plumes from a few picotesla to >100 pT is observed, but a modest (<20 pT) wave amplitude is more commonly observed regardless of geomagnetic activity in both the midnight‐to‐dawn and dusk sector. By contrast, stronger amplitude hiss occurs preferentially during geomagnetically active times in the dusk sector. The wave normal angles are distributed over a broad range from 0° to 90° with a bimodal distribution: a quasi‐field‐aligned population (<20°) with an occurrence rate of <60% and an oblique one (>50°) with a relative low occurrence rate of ≲20%. Therefore, from a statistical point of view, we confirm that the hiss intensity (a few tens of picotesla) and field‐aligned hiss wave adopted in previous simulation studies are a reasonable assumption but stress that the activity dependence of the wave amplitude should be considered.
In this study, rapid loss of relativistic radiation belt electrons at low L* values (2.4-3.2) during a strong geomagnetic storm on 22 June 2015 is investigated along with five possible loss mechanisms. Both the particle and wave data are obtained from the Van Allen Probes. Duskside H+ band electromagnetic ion cyclotron (EMIC) waves were observed during a rapid decrease of relativistic electrons with energy above 5.2 MeV occurring outside the plasma sphere during extreme magnetopause compression. Lower He+ composition and enriched O+ composition are found compared to typical values assumed in other studies of cyclotron resonant scattering of relativistic electrons by EMIC waves. Quantitative analysis demonstrates that even with the existence of He+ band EMIC waves, it is the H+ band EMIC waves that are likely to cause the depletion at small pitch angles and strong gradients in pitch angle distributions of relativistic electrons with energy above 5.2 MeV at low L values for this event. Very low frequency wave activity at other magnetic local time can be favorable for the loss of relativistic electrons at higher pitch angles. An illustrative calculation that combines the nominal pitch angle scattering rate due to whistler mode chorus at high pitch angles with the H+ band EMIC wave loss rate at low pitch angles produces loss on time scale observed at L = 2.4-3.2. At high L values and lower energies, radial loss to the magnetopause is a viable explanation.
Plain Language Summary Radiation belts of the Earth, which are the zones of charged energetic particles trapped by the geomagnetic field, comprise enormous and dynamic systems. While the inner radiation belt, composed mainly of high-energy protons, is relatively stable, the outer belt, filled with energetic electrons, is highly variable and depends substantially on solar activity. Hence, extended reliable observations and the improved models of the electron intensities in the outer belt depending on solar wind parameters are necessary for prediction of their dynamics. The Cluster mission has been measuring electron flux intensities in the radiation belts since its launch in 2000, thus providing a huge dataset that can be used for radiation belts analysis. Using 16 years of electron measurements by the Cluster mission corrected for background contamination, we derived a uniform linear-logarithmic dependence of electron fluxes in the outer belt on the solar wind dynamic pressure.
Space radiation is one of the main concerns for human space flights. The prediction of the radiation dose for the actual spacecraft geometry is very important for the planning of long-duration missions. We present a numerical method for the fast calculation of the radiation dose rate during a space flight. We demonstrate its application for dose calculations during the first and the second sessions of the MATROSHKA-R space experiment with a spherical tissue-equivalent phantom. The main advantage of the method is the short simulation time, so it can be applied for urgent radiation dose calculations for low-Earth orbit space missions. The method uses depth-dose curve and shield-and-composition distribution functions to calculate a radiation dose at the point of interest. The spacecraft geometry is processed into a shield-and-composition distribution function using a ray-tracing method. Depth-dose curves are calculated using the GEANT4 Monte-Carlo code (version 10.00.P02) for a double-layer aluminum-water shielding. Aluminum-water shielding is a good approximation of the real geometry, as water is a good equivalent for biological tissues, and aluminum is the major material of spacecraft bodies.
In this paper we report a rare and fortunate event of fast magnetosonic (MS, also called equatorial noise) waves modulated by compressional ultralow frequency (ULF) waves measured by Van Allen Probes. The characteristics of MS waves, ULF waves, proton distribution, and their potential correlations are analyzed. The results show that ULF waves can modulate the energetic ring proton distribution and in turn modulate the MS generation. Furthermore, the variation of MS intensities is attributed to not only ULF wave activities but also the variation of background parameters, for example, number density. The results confirm the opinion that MS waves are generated by proton ring distribution and propose a new modulation phenomenon.
Data assimilation aims to blend incomplete and inaccurate data with physics-based dynamical models. In the Earth's radiation belts, it is used to reconstruct electron phase space density, and it has become an increasingly important tool in validating our current understanding of radiation belt dynamics, identifying new physical processes, and predicting the near-Earth hazardous radiation environment. In this study, we perform reanalysis of the sparse measurements from four spacecraft using the three-dimensional Versatile Electron Radiation Belt diffusion model and a split-operator Kalman filter over a 6-month period from 1 October 2012 to 1 April 2013. In comparison to previous works, our 3-D model accounts for more physical processes, namely, mixed pitch angle-energy diffusion, scattering by Electromagnetic Ion Cyclotron waves, and magnetopause shadowing. We describe how data assimilation, by means of the innovation vector, can be used to account for missing physics in the model. We use this method to identify the radial distances from the Earth and the geomagnetic conditions where our model is inconsistent with the measured phase space density for different values of the invariants mu and K. As a result, the Kalman filter adjusts the predictions in order to match the observations, and we interpret this as evidence of where and when additional source or loss processes are active. The current work demonstrates that 3-D data assimilation provides a comprehensive picture of the radiation belt electrons and is a crucial step toward performing reanalysis using measurements from ongoing and future missions.
Solar wind observations show that geomagnetic storms are mainly driven by interplanetary coronal mass ejections (ICMEs) and corotating or stream interaction regions (C/SIRs). We present a binary classifier that assigns one of these drivers to 7,546 storms between 1930 and 2015 using ground‐based geomagnetic field observations only. The input data consists of the long‐term stable Hourly Magnetospheric Currents index alongside the corresponding midlatitude geomagnetic observatory time series. This data set provides comprehensive information on the global storm time magnetic disturbance field, particularly its spatial variability, over eight solar cycles. For the first time, we use this information statistically with regard to an automated storm driver identification. Our supervised classification model significantly outperforms unskilled baseline models (78% accuracy with 26[19]% misidentified interplanetary coronal mass ejections [corotating or stream interaction regions]) and delivers plausible driver occurrences with regard to storm intensity and solar cycle phase. Our results can readily be used to advance related studies fundamental to space weather research, for example, studies connecting galactic cosmic ray modulation and geomagnetic disturbances. They are fully reproducible by means of the underlying open‐source software (Pick, 2019, http://doi.org/10.5880/GFZ.2.3.2019.003)
Ring current electrons (1–100 keV) have received significant attention in recent decades, but many questions regarding their major transport and loss mechanisms remain open. In this study, we use the four‐dimensional Versatile Electron Radiation Belt code to model the enhancement of phase space density that occurred during the 17 March 2013 storm. Our model includes global convection, radial diffusion, and scattering into the Earth's atmosphere driven by whistler‐mode hiss and chorus waves. We study the sensitivity of the model to the boundary conditions, global electric field, the electric field associated with subauroral polarization streams, electron loss rates, and radial diffusion coefficients. The results of the code are almost insensitive to the model parameters above 4.5 RERE, which indicates that the general dynamics of the electrons between 4.5 RE and the geostationary orbit can be explained by global convection. We found that the major discrepancies between the model and data can stem from the inaccurate electric field model and uncertainties in lifetimes. We show that additional mechanisms that are responsible for radial transport are required to explain the dynamics of ≥40‐keV electrons, and the inclusion of the radial diffusion rates that are typically assumed in radiation belt studies leads to a better agreement with the data. The overall effect of subauroral polarization streams on the electron phase space density profiles seems to be smaller than the uncertainties in other input parameters. This study is an initial step toward understanding the dynamics of these particles inside the geostationary orbit.
For the layered transition metal dichalcogenide 1T-TaS2, we establish through a unique experimental approach and density functional theory, how ultrafast charge transfer in 1T-TaS2 takes on isotropic three-dimensional character or anisotropic two-dimensional character, depending on the commensurability of the charge density wave phases of 1T-TaS2. The X-ray spectroscopic core-hole-clock method prepares selectively in-and out-of-plane polarized sulfur 3p orbital occupation with respect to the 1T-TaS2 planes and monitors sub-femtosecond wave packet delocalization. Despite being a prototypical two-dimensional material, isotropic three-dimensional charge transfer is found in the commensurate charge density wave phase (CCDW), indicating strong coupling between layers. In contrast, anisotropic two-dimensional charge transfer occurs for the nearly commensurate phase (NCDW). In direct comparison, theory shows that interlayer interaction in the CCDW phase - not layer stacking variations - causes isotropic three-dimensional charge transfer. This is presumably a general mechanism for phase transitions and tailored properties of dichalcogenides with charge density waves.
Electromagnetic ion cyclotron waves have long been recognized to play a crucial role in the dynamic loss of ring current protons. While the field-aligned propagation approximation of electromagnetic ion cyclotron waves was widely used to quantify the scattering loss of ring current protons, in this study, we find that the wave normal distribution strongly affects the pitch angle scattering efficiency of protons. Increase of peak normal angle or angular width can considerably reduce the scattering rates of <= 10 keV protons. For >10 keV protons, the field-aligned propagation approximation results in a pronounced underestimate of the scattering of intermediate equatorial pitch angle protons and overestimates the scattering of high equatorial pitch angle protons by orders of magnitude. Our results suggest that the wave normal distribution of electromagnetic ion cyclotron waves plays an important role in the pitch angle evolution and scattering loss of ring current protons and should be incorporated in future global modeling of ring current dynamics.
Chorus waves play an important role in the dynamic evolution of energetic electrons in the Earth's radiation belts and ring current. Using more than 5 years of Van Allen Probe data, we developed a new analytical model for upper‐band chorus (UBC; 0.5fce < f < fce) and lower‐band chorus (LBC; 0.05fce < f < 0.5fce) waves, where fce is the equatorial electron gyrofrequency. By applying polynomial fits to chorus wave root mean square amplitudes, we developed regression models for LBC and UBC as a function of geomagnetic activity (Kp), L, magnetic latitude (λ), and magnetic local time (MLT). Dependence on Kp is separated from the dependence on λ, L, and MLT as Kp‐scaling law to simplify the calculation of diffusion coefficients and inclusion into particle tracing codes. Frequency models for UBC and LBC are also developed, which depends on MLT and magnetic latitude. This empirical model is valid in all MLTs, magnetic latitude up to 20°, Kp ≤ 6, L‐shell range from 3.5 to 6 for LBC and from 4 to 6 for UBC. The dependence of root mean square amplitudes on L are different for different bands, which implies different energy sources for different wave bands. This analytical chorus wave model is convenient for inclusion in quasi‐linear diffusion calculations of electron scattering rates and particle simulations in the inner magnetosphere, especially for the newly developed four‐dimensional codes, which require significantly improved wave parameterizations.
Simulations of the inner magnetospheric energetic electrons using the IMPTAM-VERB coupled model
(2019)
In this study, we present initial results of the coupling between the Inner Magnetospheric Particle Transport and Acceleration Model (IMPTAM) and the Versatile Electron Radiation Belt (VERB-3D) code. IMPTAM traces electrons of 10-100 keV energies from the plasma sheet (L = 9 Re) to inner L-shell regions. The flux evolution modeled by IMPTAM is used at the low energy and outer L* computational boundaries of the VERB code (assuming a dipole approximation) to perform radiation belt simulations of energetic electrons. The model was tested on the March 17th, 2013 storm, for a six-day period. Four different simulations were performed and their results compared to satellites observations from Van Allen probes and GOES. The coupled IMPTAM-VERB model reproduces evolution and storm-time features of electron fluxes throughout the studied storm in agreement with the satellite data (within similar to 0.5 orders of magnitude). Including dynamics of the low energy population at L* = 6.6 increases fluxes closer to the heart of the belt and has a strong impact in the VERB simulations at all energies. However, inclusion of magnetopause losses leads to drastic flux decreases even below L* = 3. The dynamics of low energy electrons (max. 10s of keV) do not affect electron fluxes at energies >= 900 keV. Since the IMPTAM-VERB coupled model is only driven by solar wind parameters and the Dst and Kp indexes, it is suitable as a forecasting tool. In this study, we demonstrate that the estimation of electron dynamics with satellite-data-independent models is possible and very accurate.
Electron acceleration at Saturn due to whistler mode chorus waves has previously been assumed to be ineffective; new data closer to the planet show it can be very rapid (factor of 104 flux increase at 1 MeV in 10 days compared to factor of 2). A full survey of chorus waves at Saturn is combined with an improved plasma density model to show that where the plasma frequency falls below the gyrofrequency additional strong resonances are observed favoring electron acceleration. This results in strong chorus acceleration between approximately 2.5 R-S and 5.5 R-S outside which adiabatic transport may dominate. Strong pitch angle dependence results in butterfly pitch angle distributions that flatten over a few days at 100s keV, tens of days at MeV energies which may explain observations of butterfly distributions of MeV electrons near L = 3. Including cross terms in the simulations increases the tendency toward butterfly distributions. Plain Language Summary Radiation belts are hazardous regions found around several of the planets in our Solar System. They consist of very hot, electrically charged particles trapped in the magnetic field of the planet. At Saturn the most important way to heat these particles has for many years been thought to involve the particles drifting closer toward the planet. This paper adds to the emerging idea at Saturn that a different way to heat the particles is also possible where the heating is done by waves, in a similar way to what we find at the Earth. We use recent information from the Cassini spacecraft on the number and location of particles and also of the waves strength and location combined with computer simulations to show that a particular wave called chorus is excellent at heating the particles where the surrounding number of cold particles is low.
The morphology of marine and lacustrine terraces has been largely used to measure past sea- and lake-level positions and estimate vertical deformation in a wealth of studies focused on climate and tectonic processes. To obtain accurate morphometric assessments of terrace morphology we present TerraceM-2, an improved version of our MatlabR (R) graphic-user interface that provides new methodologies for morphometric analyses as well as landscape evolution and fault-dislocation modeling. The new version includes novel routines to map the elevation and spatial distribution of terraces, to model their formation and evolution, and to estimate fault-slip rates from terrace deformation patterns. TerraceM-2 has significantly improves its processing speed and mapping capabilities, and includes separate functions for developing customized workflows beyond the graphic-user interface. We illustrate these new mapping and modeling capabilities with three examples: mapping lacustrine shorelines in the Dead Sea to estimate deformation across the Dead Sea Fault, landscape evolution modeling to estimate a history of uplift rates in southern Peru, and dislocation modeling of deformed marine terraces in California. These examples also illustrate the need to use topographic data of different resolutions. The new modeling and mapping routines of TerraceM-2 highlight the advantages of an integrated joint mapping and modeling approach to improve the efficiency and precision of coastal terrace metrics in both marine and lacustrine environments.
Pitch Angle Scattering of Sub-MeV Relativistic Electrons by Electromagnetic Ion Cyclotron Waves
(2019)
Electromagnetic ion cyclotron (EMIC) waves have long been considered to be a significant loss mechanism for relativistic electrons. This has most often been attributed to resonant interactions with the highest amplitude waves. But recent observations have suggested that the dominant energy of electrons precipitated to the atmosphere may often be relatively low, less than 1 MeV, whereas the minimum resonant energy of the highest amplitude waves is often greater than 2 MeV. Here we use relativistic electron test particle simulations in the wavefields of a hybrid code simulation of EMIC waves in dipole geometry in order to show that significant pitch angle scattering can occur due to interaction with low-amplitude short-wavelength EMIC waves. In the case we examined, these waves are in the H band (at frequencies above the He+ gyrofrequency), even though the highest amplitude waves were in the He band frequency range (below the He+ gyrofrequency). We also present wave power distributions for 29 EMIC simulations in straight magnetic field line geometry that show that the high wave number portion of the spectrum is in every case mostly due to the H band waves. Though He band waves are often associated with relativistic electron precipitation, it is possible that the He band waves do not directly scatter the sub-megaelectron volts (sub-MeV) electrons, but that the presence of He band waves is associated with high plasma density which lowers the minimum resonant energy so that these electrons can more easily resonate with the H band waves.
Pump-probe photoelectron spectroscopy (PES) is a versatile tool to investigate the dynamics of transient states of excited matter. Vacuum space-charge effects can mask these dynamics and complicate the interpretation of electron spectra. Here we report on space-charge effects in Au 4f photoemission from a polycrystalline gold surface, excited with moderately intense 90 ps (FWHM) soft x-ray probe pulses, under the influence of the Coulomb forces exerted by a pump electron cloud, which was produced by intense 40 fs laser pulses. The experimentally observed kinetic energy shift and spectral broadening of the Au 4f lines, measured with highly-efficient time-of-flight spectroscopy, are in good agreement with simulations utilizing a mean-field model of the electrostatic pump electron potential. This confirms that the line broadening is predominantly caused by variations in the take-off time of the probe electrons without appreciable influence of local scattering events. Our findings might be of general interest for pump-probe PES with picosecond-pulse-length sources.
Current algorithms for the real-time prediction of the Kp index use a combination of models empirically driven by solar wind measurements at the L1 Lagrange point and historical values of the index. In this study, we explore the limitations of this approach, examining the forecast for short and long lead times using measurements at L1 and Kp time series as input to artificial neural networks. We explore the relative efficiency of the solar wind-based predictions, predictions based on recurrence, and predictions based on persistence. Our modeling results show that for short-term forecasts of approximately half a day, the addition of the historical values of Kp to the measured solar wind values provides a barely noticeable improvement. For a longer-term forecast of more than 2 days, predictions can be made using recurrence only, while solar wind measurements provide very little improvement for a forecast with long horizon times. We also examine predictions for disturbed and quiet geomagnetic activity conditions. Our results show that the paucity of historical measurements of the solar wind for high Kp results in a lower accuracy of predictions during disturbed conditions. Rebalancing of input data can help tailor the predictions for more disturbed conditions.
The Kp index is a measure of the midlatitude global geomagnetic activity and represents short-term magnetic variations driven by solar wind plasma and interplanetary magnetic field. The Kp index is one of the most widely used indicators for space weather alerts and serves as input to various models, such as for the thermosphere and the radiation belts. It is therefore crucial to predict the Kp index accurately. Previous work in this area has mostly employed artificial neural networks to nowcast Kp, based their inferences on the recent history of Kp and on solar wind measurements at L1. In this study, we systematically test how different machine learning techniques perform on the task of nowcasting and forecasting Kp for prediction horizons of up to 12 hr. Additionally, we investigate different methods of machine learning and information theory for selecting the optimal inputs to a predictive model. We illustrate how these methods can be applied to select the most important inputs to a predictive model of Kp and to significantly reduce input dimensionality. We compare our best performing models based on a reduced set of optimal inputs with the existing models of Kp, using different test intervals, and show how this selection can affect model performance.
Storm Time Depletions of Multi-MeV Radiation Belt Electrons Observed at Different Pitch Angles
(2019)
During geomagnetic storms, the rapid depletion of the high-energy (several MeV) outer radiation belt electrons is the result of loss to the interplanetary medium through the magnetopause, outward radial diffusion, and loss to the atmosphere due to wave-particle interactions. We have performed a statistical study of 110 storms using pitch angle resolved electron flux measurements from the Van Allen Probes mission and found that inside of the radiation belt (L* = 3 - 5) the number of storms that result in depletion of electrons with equatorial pitch angle alpha(eq) = 30 degrees is higher than number of storms that result in depletion of electrons with equatorial pitch angle alpha(eq) = 75 degrees. We conclude that this result is consistent with electron scattering by whistler and electromagnetic ion cyclotron waves. At the outer edge of the radiation belt (L* >= 5.2) the number of storms that result in depletion is also large (similar to 40-50%), emphasizing the significance of the magnetopause shadowing effect and outward radial transport.
Encroachment of shrubs into the unique pastoral grassland ecosystems of the Tibetan Plateau has significant impact on ecosystem services, especially forage production. We developed a process-based ecohydrological model to identify the relative importance of the main drivers of shrub encroachment for the alpine meadows within the Qinghai province. Specifically, we explored the effects of summer livestock grazing (intensity and type of livestock) together with the effects of climate warming, including interactions between herbaceous and woody vegetation and feedback loops between soil, water and vegetation. Under current climatic conditions and a traditional herd composition, an increasing grazing intensity above a threshold value of 0.32 +/- 0.10 large stock units (LSU) ha(-1) day(-1) changes the vegetation composition from herbaceous towards a woody and bare soil dominated system. Very high grazing intensity (above 0.8 LSU ha(-1) day(-1)) leads to a complete loss of any vegetation. Under warmer conditions, the vegetation showed a higher resilience against livestock farming. This resilience is enhanced when the herd has a higher browser : grazer ratio. A cooler climate has a shrub encroaching effect, whereas warmer conditions increase the cover of the herbaceous vegetation. This effect was primarily due to season length and an accompanied competitive loss of slower growing shrubs, rather than evaporative water loss leading to less soil water in deeper soil layers for deeper rooting shrubs. If climate warming is driving current shrub encroachment, we conclude it is only indirectly so. It would be manifest by an advancing shrubline and could be regarded as a climatic escape of specific shrub species such as Potentilla fruticosa. Under the recent high intensity of grazing, only herding by more browsing animals can potentially prevent both shrub encroachment and the complete loss of herbaceous vegetation.
Forest structure is a crucial component in the assessment of whether a forest is likely to act as a carbon sink under changing climate. Detailed 3D structural information about the tundra–taiga ecotone of Siberia is mostly missing and still underrepresented in current research due to the remoteness and restricted accessibility. Field based, high-resolution remote sensing can provide important knowledge for the understanding of vegetation properties and dynamics. In this study, we test the applicability of consumer-grade Unmanned Aerial Vehicles (UAVs) for rapid calculation of stand metrics in treeline forests. We reconstructed high-resolution photogrammetric point clouds and derived canopy height models for 10 study sites from NE Chukotka and SW Yakutia. Subsequently, we detected individual tree tops using a variable-window size local maximum filter and applied a marker-controlled watershed segmentation for the delineation of tree crowns. With this, we successfully detected 67.1% of the validation individuals. Simple linear regressions of observed and detected metrics show a better correlation (R2) and lower relative root mean square percentage error (RMSE%) for tree heights (mean R2 = 0.77, mean RMSE% = 18.46%) than for crown diameters (mean R2 = 0.46, mean RMSE% = 24.9%). The comparison between detected and observed tree height distributions revealed that our tree detection method was unable to representatively identify trees <2 m. Our results show that plot sizes for vegetation surveys in the tundra–taiga ecotone should be adapted to the forest structure and have a radius of >15–20 m to capture homogeneous and representative forest stands. Additionally, we identify sources of omission and commission errors and give recommendations for their mitigation. In summary, the efficiency of the used method depends on the complexity of the forest’s stand structure.
Continuous insight into biological processes has led to the development of large-scale, mechanistic systems biology models of pharmacologically relevant networks. While these models are typically designed to study the impact of diverse stimuli or perturbations on multiple system variables, the focus in pharmacological research is often on a specific input, e.g., the dose of a drug, and a specific output related to the drug effect or response in terms of some surrogate marker.
To study a chosen input-output pair, the complexity of the interactions as well as the size of the models hinders easy access and understanding of the details of the input-output relationship.
The objective of this thesis is the development of a mathematical approach, in specific a model reduction technique, that allows (i) to quantify the importance of the different state variables for a given input-output relationship, and (ii) to reduce the dynamics to its essential features -- allowing for a physiological interpretation of state variables as well as parameter estimation in the statistical analysis of clinical data. We develop a model reduction technique using a control theoretic setting by first defining a novel type of time-limited controllability and observability gramians for nonlinear systems. We then show the superiority of the time-limited generalised gramians for nonlinear systems in the context of balanced truncation for a benchmark system from control theory.
The concept of time-limited controllability and observability gramians is subsequently used to introduce a state and time-dependent quantity called the input-response (ir) index that quantifies the importance of state variables for a given input-response relationship at a particular time.
We subsequently link our approach to sensitivity analysis, thus, enabling for the first time the use of sensitivity coefficients for state space reduction. The sensitivity based ir-indices are given as a product of two sensitivity coefficients. This allows not only for a computational more efficient calculation but also for a clear distinction of the extent to which the input impacts a state variable and the extent to which a state variable impacts the output.
The ir-indices give insight into the coordinated action of specific state variables for a chosen input-response relationship.
Our developed model reduction technique results in reduced models that still allow for a mechanistic interpretation in terms of the quantities/state variables of the original system, which is a key requirement in the field of systems pharmacology and systems biology and distinguished the reduced models from so-called empirical drug effect models. The ir-indices are explicitly defined with respect to a reference trajectory and thereby dependent on the initial state (this is an important feature of the measure). This is demonstrated for an example from the field of systems pharmacology, showing that the reduced models are very informative in their ability to detect (genetic) deficiencies in certain physiological entities. Comparing our novel model reduction technique to the already existing techniques shows its superiority.
The novel input-response index as a measure of the importance of state variables provides a powerful tool for understanding the complex dynamics of large-scale systems in the context of a specific drug-response relationship. Furthermore, the indices provide a means for a very efficient model order reduction and, thus, an important step towards translating insight from biological processes incorporated in detailed systems pharmacology models into the population analysis of clinical data.
The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity.
Background
Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective.
Methods
The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures.
Discussion
Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances.
Trial registration
German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.
In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, p(SVC) = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (r(s) = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.
In animals and humans, behavior can be influenced by irrelevant stimuli, a phenomenon called Pavlovian-to-instrumental transfer (PIT). In subjects with substance use disorder, PIT is even enhanced with functional activation in the nucleus accumbens (NAcc) and amygdala. While we observed enhanced behavioral and neural PIT effects in alcohol-dependent subjects, we here aimed to determine whether behavioral PIT is enhanced in young men with high-risk compared to low-risk drinking and subsequently related functional activation in an a-priori region of interest encompassing the NAcc and amygdala and related to polygenic risk for alcohol consumption. A representative sample of 18-year old men (n = 1937) was contacted: 445 were screened, 209 assessed: resulting in 191 valid behavioral, 139 imaging and 157 genetic datasets. None of the subjects fulfilled criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders-IV-TextRevision (DSM-IV-TR). We measured how instrumental responding for rewards was influenced by background Pavlovian conditioned stimuli predicting action-independent rewards and losses. Behavioral PIT was enhanced in high-compared to low-risk drinkers (b = 0.09, SE = 0.03, z = 2.7, p < 0.009). Across all subjects, we observed PIT-related neural blood oxygen level-dependent (BOLD) signal in the right amygdala (t = 3.25, p(SVC) = 0.04, x = 26, y = -6, z = -12), but not in NAcc. The strength of the behavioral PIT effect was positively correlated with polygenic risk for alcohol consumption (r(s) = 0.17, p = 0.032). We conclude that behavioral PIT and polygenic risk for alcohol consumption might be a biomarker for a subclinical phenotype of risky alcohol consumption, even if no drug-related stimulus is present. The association between behavioral PIT effects and the amygdala might point to habitual processes related to out PIT task. In non-dependent young social drinkers, the amygdala rather than the NAcc is activated during PIT; possible different involvement in association with disease trajectory should be investigated in future studies.
Background
Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive impairment, and with comorbidities, and its diagnosis and treatment is dependent on the knowledge of diagnostic criteria, risk factors, and treatment options of the medical staff. In this study, we will investigate whether a cross-sectoral and multimodal intervention for preventing delirium can reduce the prevalence of delirium and postoperative cognitive decline (POCD) in patients older than 70 years undergoing elective surgery. Additionally, we will analyze whether the intervention is cost-effective.
Methods
The study will be conducted at five medical centers (with two or three surgical departments each) in the southwest of Germany. The study employs a stepped-wedge design with cluster randomization of the medical centers. Measurements are performed at six consecutive points: preadmission, preoperative, and postoperative with daily delirium screening up to day 7 and POCD evaluations at 2, 6, and 12 months after surgery. Recruitment goals are to enroll 1500 patients older than 70 years undergoing elective operative procedures (cardiac, thoracic, vascular, proximal big joints and spine, genitourinary, gastrointestinal, and general elective surgery procedures.
Discussion
Results of the trial should form the basis of future standards for preventing delirium and POCD in surgical wards. Key aims are the improvement of patient safety and quality of life, as well as the reduction of the long-term risk of conversion to dementia. Furthermore, from an economic perspective, we expect benefits and decreased costs for hospitals, patients, and healthcare insurances.
Trial registration
German Clinical Trials Register, DRKS00013311. Registered on 10 November 2017.
The concurrent performance of cognitive and postural tasks is particularly impaired in old adults and associated with an increased risk of falls. Biological aging of the cognitive and postural control system appears to be responsible for increased cognitive-motor interference effects. We examined neural and behavioral markers of motor-cognitive dual-task performance in young and old adults performing spatial one-back working memory single and dual tasks during semitandem stance. On the neural level, we used EEG to test for age-related modulations in the frequency domain related to cognitive-postural task load. Twenty-eight healthy young and 30 old adults participated in this study. The tasks included a postural single task, a cognitive-postural dual task, and a cognitive-postural triple task (cognitive dual-task with postural demands). Postural sway (i.e., total center of pressure displacements) was recorded in semistance position on an unstable surface that was placed on top of a force plate while performing cognitive tasks. Neural activation was recorded using a 64-channel mobile EEG system. EEG frequencies were attenuated by the baseline postural single-task condition and demarcated in nine Regions-of-Interest (ROIs), i.e., anterior, central, posterior, over the cortical midline, and both hemispheres. Our findings revealed impaired cognitive dual-task performance in old compared to young participants in the form of significantly lower cognitive performance in the triple-task condition. Furthermore, old adults compared with young adults showed significantly larger postural sway, especially in cognitive-postural task conditions. With respect to EEG frequencies, young compared to old participants showed significantly lower alpha-band activity in cognitive-cognitive-postural triple-task conditions compared with cognitive-postural dual tasks. In addition, with increasing task difficulty, we observed synchronized theta and delta frequencies, irrespective of age. Taskdependent alterations of the alpha frequency band were most pronounced over frontal and central ROIs, while alterations of the theta and delta frequency bands were found in frontal, central, and posterior ROIs. Theta and delta synchronization exhibited a decrease from anterior to posterior regions. For old adults, task difficulty was reflected by theta synchronization in the posterior ROI. For young adults, it was reflected by alpha desynchronization in bilateral anterior ROIs. In addition, we could not identify any effects of task difficulty and age on the beta frequency band. Our results shed light on age-related cognitive and postural declines and how they interact. Modulated alpha frequencies during high cognitive-postural task demands in young but not old adults might be reflective of a constrained neural adaptive potential in old adults. Future studies are needed to elucidate associations between the identified age-related performance decrements with task difficulty and changes in brain activity.
Effective antibiotic dosing is vital for therapeutic success in critically ill patients. This work aimed to develop an algorithm to identify appropriate meropenem dosing in critically ill patients. Population pharma-cokinetic (PK) modelling was performed in NONMEM (R) 7.3 based on densely sampled meropenem serum samples (n(patients) = 48; n(samples) =1376) and included a systematic analysis of 27 pre-selected covariates to identify factors influencing meropenem exposure. Using Monte Carlo simulations newly considering the uncertainty of PK parameter estimates, standard meropenem dosing was evaluated with respect to attainment of the pharmacokinetic/pharmacodynamic (PK/PD) target and was compared with alternative infusion regimens (short-term, prolonged, continuous; daily dose, 2000-6000 mg). Subsequently, a dosing algorithm was developed to identify appropriate dosing regimens. The two-compartment population PK model included three factors influencing meropenem pharmacokinetics: the Cockcroft-Gault creatinine clearance (CLCRCG ) on meropenem clearance; and body weight and albumin on the central and peripheral volume of distribution, respectively; of these, only CLCRCG was identified as a vital influencing factor on PK/PD target attainment. A three-level dosing algorithm was developed (considering PK parameter uncertainty), suggesting dosing regimens depending on renal function and the level (L) of knowledge about the infecting pathogen (L1, pathogen unknown; L2, pathogen known; L3((-MIC)), pathogen and susceptibility known; L3((+MIC)), MIC known). Whereas patients with higher CLCRCG and lower pathogen susceptibility required mainly intensified dosing regimens, lower than standard doses appeared sufficient for highly susceptible pathogens. In conclusion, a versatile meropenem dosing algorithm for critically ill patients is proposed, indicating appropriate dosing regimens based on patient- and pathogen-specific information. (C) 2019 Published by Elsevier B.V.
Bisher ist die Ursache für die Entstehung der meisten Skoliosen noch ungeklärt und damit eine kausale Behandlung der Betroffenen unmöglich. Die vorliegende Arbeit geht davon aus, dass der Auslöser für die sogenannte idiopathische Skoliose eine funktionelle Störung von Muskeln ist, die sich in einer verminderten relativen Haltekraft äußert. Durch gezielte willkürliche Muskelanspannungen könnte es möglich sein, kompensatorisch auf die Deformität einzuwirken, um damit ein Fortschreiten zu verhindern bzw. sogar eine Regression hervorzurufen. Insbesondere Patientengruppen mit einem hohen Progressionsrisiko, wie Jugendliche im Wachstumsalter, könnten davon profitieren.
Ein Muskeltraining kann mit unterschiedlichsten Hilfsmitteln und Methoden erfolgen. Eine Möglichkeit bietet auch das Klettern. Im Kern wird daher ein Trainingskonzept zum Therapeutischen Klettern bei Jugendlichen mit Skoliose vorgestellt. Dabei beruft sich der Autor auf das Potsdamer Modell. Dieses Modell erlaubt es, gezielte Kraftübungen systematisiert an der Kletterwand in Absprunghöhe umzusetzen. Materielle Sicherungsmaßnahmen sind dadurch nicht erforderlich und eventuell notwendige Korrekturen bzw. Hilfestellungen können direkt erfolgen. Hauptinhalt eines Trainings nach dem vorgestellten Konzept sind spielerische Bewegungserfahrung innerhalb der Sportart Klettern und ein Systembouldertraining.
In einem beigefügten Übungskatalog werden für letzteres Möglichkeiten der praktischen Umsetzun-gen gegeben. Die Übungen fokussieren sich auf die Aktivierung und das Training wirbelkörperdero-tierender Muskeln. Im Hauptteil einer Trainingseinheit können sie dann in Kombination mit der Kor-rektur der Seitverbiegung und des sagittalen Profils (3D Autokorrektur) unter Aufsicht eines geschul-ten Therapeuten durchgeführt werden. Die Arbeit erhebt den Anspruch, einem Leser vom Fach, die Auswahl der Übungen und die darin enthaltene individuelle Anpassung an den Patienten aus funktionell-anatomischer Sicht zu begründen.
In naher Zukunft wird das Konzept in einer randomisiert kontrollierten Studie untersucht. Alle notwendigen Vorbereitungen wurden im Rahmen dieser Arbeit getroffen.
The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach's alpha was found to be high (alpha = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant's perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.
Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD.
Background Aversive stimuli in the environment influence human actions. This includes valence-dependent influences on action selection, e.g., increased avoidance but decreased approach behavior. However, it is yet unclear how aversive stimuli interact with complex learning and decision-making in the reward and avoidance domain. Moreover, the underlying computational mechanisms of these decision-making biases are unknown. Methods To elucidate these mechanisms, 54 healthy young male subjects performed a two-step sequential decision-making task, which allows to computationally model different aspects of learning, e.g., model-free, habitual, and model-based, goal-directed learning. We used a within-subject design, crossing task valence (reward vs. punishment learning) with emotional context (aversive vs. neutral background stimuli). We analyzed choice data, applied a computational model, and performed simulations. Results Whereas model-based learning was not affected, aversive stimuli interacted with model-free learning in a way that depended on task valence. Thus, aversive stimuli increased model-free avoidance learning but decreased model-free reward learning. The computational model confirmed this effect: the parameter lambda that indicates the influence of reward prediction errors on decision values was increased in the punishment condition but decreased in the reward condition when aversive stimuli were present. Further, by using the inferred computational parameters to simulate choice data, our effects were captured. Exploratory analyses revealed that the observed biases were associated with subclinical depressive symptoms. Conclusion Our data show that aversive environmental stimuli affect complex learning and decision-making, which depends on task valence. Further, we provide a model of the underlying computations of this affective modulation. Finally, our finding of increased decision-making biases in subjects reporting subclinical depressive symptoms matches recent reports of amplified Pavlovian influences on action selection in depression and suggests a potential vulnerability factor for mood disorders. We discuss our findings in the light of the involvement of the neuromodulators serotonin and dopamine.
Background: Circulating infliximab (IFX) concentrations correlate with clinical outcomes, forming the basis of the IFX concentration monitoring in patients with Crohn's disease. This study aims to investigate and refine the exposure-response relationship by linking the disease activity markers "Crohn's disease activity index" (CDAI) and C-reactive protein (CRP) to IFX exposure. In addition, we aim to explore the correlations between different disease markers and exposure metrics.
Methods: Data from 47 Crohn's disease patients of a randomized controlled trial were analyzed post hoc. All patients had secondary treatment failure at inclusion and had received intensified IFX of 5 mg/kg every 4 weeks for up to 20 weeks. Graphical analyses were performed to explore exposure-response relationships. Metrics of exposure included area under the concentration-time curve (AUC) and trough concentrations (Cmin). Disease activity was measured by CDAI and CRP values, their change from baseline/last visit, and response/remission outcomes at week 12.
Results: Although trends toward lower Cmin and lower AUC in nonresponders were observed, neither CDAI nor CRP showed consistent trends of lower disease activity with higher IFX exposure across the 30 evaluated relationships. As can be expected, Cmin and AUC were strongly correlated with each other. Contrarily, the disease activity markers were only weakly correlated with each other.
Conclusions: No significant relationship between disease activity, as evaluated by CDAI or CRP, and IFX exposure was identified. AUC did not add benefit compared with Cmin. These findings support the continued use of Cmin and call for stringent objective disease activity (bio-)markers (eg, endoscopy) to form the basis of personalized IFX therapy for Crohn's disease patients with IFX treatment failure.
Objective: The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. Method: A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (>= 18 years of age). Ten studies were included (n = 479 participants, 49.67% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. Results: A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95%CI = [-2.42, 0.04], p = -0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95%CI = [-1.63, -0.30], p = 0.004), a frequency of >= 3 exercise sessions per week (SMD = -1.39, 95%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95%CI = [-2.46, -0.17], p = 0.02). Conclusion: Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.
Ziel der Studie Erfassung der Strukturen zur Frühdiagnostik von Demenzen an Krankenhäusern in Deutschland.
Methodik Fragebogenerhebung.
Ergebnisse 14 % von 1758 kontaktierten Einrichtungen antworteten. 52 % berichteten über ein entsprechendes Angebot, zum großen Teil mit leitlinienorientierten Verfahren, wie Liquordiagnostik. Das Diagnosespektrum umfasste zu 46 % Demenzen und zu 41 % Diagnosen der leichten oder subjektiven kognitiven Störung.
Schlussfolgerung Leitlinienbasierte Diagnostik und Früherkennungskonzepte sind in Gedächtnisambulanzen weitgehend etabliert.
Evaluation of technology-based interventions for informal caregivers of patients with dementia
(2019)
Objective: The aim of this study was to estimate the efficacy of technology-based interventions for informal caregivers of people with dementia (PWD). Methods: PubMed, PsycINFO, and Cochrane Library databases were searched in August 2018, with no restrictions in language or publication date. Two independent reviewers identified 33 eligible randomized controlled trials (RCTs) conducting a technology-based intervention for informal carers of PWD. Meta-analyses for the outcome measures caregiver depression and caregiver burden were conducted with subgroup analyses according to mode of delivery (telephone, computer/web-based, combined interventions). To assess methodologic quality, the Cochrane risk-of-bias assessment was rated. Results: Meta-analyses revealed a small but significant postintervention effect of technology-based interventions for caregiver depression and caregiver burden. Combined interventions showed the strongest effects. Conclusion: Technology-based interventions have the potential to support informal caregivers of PWD. Because of advantages such as high flexibility and availability, technology-based interventions provide a promising alternative compared with "traditional services," e.g., those for people living in rural areas. More high-quality RCTs for specific caregiver groups are needed.
Stress plays a key role in modulating addictive behavior and can cause relapse following periods of abstinence. Common effects of stress and alcohol on the dopaminergic system have been suggested, although the precise mechanisms are unclear. Here, we investigated 20 detoxified alcohol-dependent patients and 19 matched healthy controls and assessed striatal D2/D3 availability using [F-18]-fallypride positron emission tomography and stressful life events. We found a strong association between striatal D2/D3 availability and stress in patients, but not in healthy controls. Interestingly, we found increased D2/D3 receptor availability in patients with higher stress levels. This mirrors complex interactions between stress and alcohol intake in animal studies and emphasizes the importance to investigate stress exposure in neurobiological studies of addiction.
Introduction
Injury prevention programs (IPPs) are an inherent part of training in recreational and professional sports. Providing performance-enhancing benefits in addition to injury prevention may help adjust coaches and athletes’ attitudes towards implementation of injury prevention into daily routine. Conventional thinking by players and coaches alike seems to suggest that IPPs need to be specific to one’s sport to allow for performance enhancement. The systematic literature review aims to firstly determine the IPPs nature of exercises and whether they are specific to the sport or based on general conditioning. Secondly, can they demonstrate whether general, sports-specific or even mixed IPPs improve key performance indicators with the aim to better facilitate long-term implementation of these programs?
Methods
PubMed and Web of Science were electronically searched throughout March 2018. The inclusion criteria were randomized control trials, publication dates between Jan 2006 and Feb 2018, athletes (11–45 years), injury prevention programs and included predefined performance measures that could be categorized into balance, power, strength, speed/agility and endurance. The methodological quality of included articles was assessed with the Cochrane Collaboration assessment tools.
Results
Of 6619 initial findings, 22 studies met the inclusion criteria. In addition, reference lists unearthed a further 6 studies, making a total of 28. Nine studies used sports specific IPPs, eleven general and eight mixed prevention strategies. Overall, general programs ranged from 29–57% in their effectiveness across performance outcomes. Mixed IPPs improved in 80% balance outcomes but only 20–44% in others. Sports-specific programs led to larger scale improvements in balance (66%), power (83%), strength (75%), and speed/agility (62%).
Conclusion
Sports-specific IPPs have the strongest influence on most performance indices based on the significant improvement versus control groups. Other factors such as intensity, technical execution and compliance should be accounted for in future investigations in addition to exercise modality.
Research question: The purpose of this study was to evaluate the test-retest reliability of lower extremity kinematics during squat, hip abduction and lunge exercises captured by the Kinect and to evaluate the agreement to a reference 3D camera-based motion system. Methods: Twenty-one healthy individuals performed five repetitions of each lower limb exercise on two different days. Movements were simultaneously assessed by the Kinect and the reference 3D motion system. Joint angles and positions of the lower limb were calculated for sagittal and frontal plane. For the inter-session reliability and the agreement between the two systems standard error of measurement (SEM), bias with limits of agreement (LoA) and Pearson Correlation Coefficient (r) were calculated. Results: Parameters indicated varying reliability for the assessed joint angles and positions and decreasing reliability with increasing task complexity. Across all exercises, measurement deviations were shown especially for small movement amplitudes. Variability was acceptable for joint angles and positions during the squat, partially acceptable during the hip abduction and predominately inacceptable during the lunge. The agreement between systems was characterized by systematic errors. Overestimations by the Kinect were apparent for hip flexion during the squat and hip abduction/adduction during the hip abduction exercise as well as for the knee positions during the lunge. Knee and hip flexion during hip abduction and lunge were underestimated by the Kinect. Significance: The Kinect system can reliably assess lower limb joint angles and positions during simple exercises. The validity of the system is however restricted. An application in the field of early orthopedic rehabilitation without further development of post-processing techniques seems so far limited.
Previous research has shown that during cataphoric pronoun resolution, the predictive search for an antecedent is restricted by a structure-sensitive constraint known as ‘Condition C’, such that an antecedent is only considered when the constraint does not apply. Evidence has mainly come from self-paced reading (SPR), a method which may not be able to pick up on short-lived effects over the timecourse of processing. This study investigates whether or not the active search mechanism is constrained by Condition C at all points in time during cataphoric processing. We carried out one eye-tracking during reading and a parallel SPR experiment, accompanied by offline coreference judgment tasks. Although offline judgments about coreference were constrained by Condition C, the eye-tracking experiment revealed temporary consideration of antecedents that should be ruled out by Condition C. The SPR experiment using exactly the same materials indicated, conversely, that only structurally appropriate antecedents were considered. Taken together, our results suggest that the application of Condition C may be delayed during naturalistic reading.
Monte-Carlo calculations are carried out to simulate the light transport in dense materials. Focus lies on the calculation of diffuse light transmission through films of scattering and absorbing media considering additionally the effect of dependent scattering. Different influences like interaction type between particles, particle size, composition etc. can be studied by this program. Simulations in this study show major influences on the diffuse transmission. Further simulations are carried out to model a sunscreen film and study best compositions of this film and will be presented.
Accumulating behavioral and neurophysiological evidence supports the idea of language being grounded in sensorimotor processes, with indications of a functional role of motor, sensory and emotional systems in processing both concrete and abstract linguistic concepts. However, most of the available studies focused on native language speakers (L1), with only a limited number of investigations testing embodied language processing in the case of a second language (L2). In this paper we review the available evidence on embodied effects in L2 and discuss their possible integration into existing models of linguistic processing in L1 and L2. Finally, we discuss possible avenues for future research towards an integrated model of L1 and L2 sensorimotor and emotional grounding.
The numerical prediction of radiative transport is a challenging task due to the complexity of the radiative transport equation. We apply the lattice Boltzmann method (LBM), originally developed for fluid flow problems, to solve the radiative transport in volume. One model (meso RTLBM) is derived directly from a discretization of the radiative transport equation, yielding in a precise but numerical costly scheme. The second model (macro RTLBM) solves the Helmholtz equation, which is a proper approximation for highly scattering volumes. Both numerical algorithms are validated against Monte-Carlo data for a set of 35 optical parameters, which correspond to radiative transport ranging from ballistic to diffuse regimes. Together with a set of four benchmark simulations, the comprehensive validation concludes the overall quality and detects asymptotic trends for radiative transport LBM. Furthermore, an accuracy map is presented, which summarizes the error for all parameters. This graph allows to determine the validity range for both radiative transport LBM at a glance. Finally, comprehensive guidelines are formulated to facilitate the choice of the radiative transport LBM model.
Due to their ability to capture attention, emotional stimuli tend to benefit from enhanced perceptual processing, which can be helpful when such stimuli are task-relevant but hindering when they are task-irrelevant. Altered emotion-attention interactions have been associated with symptoms of affective disturbances, and emerging research focuses on improving emotion-attention interactions to prevent or treat affective disorders. In line with the Human Affectome Project's emphasis on linguistic components, we also analyzed the language used to describe attention-related aspects of emotion, and highlighted terms related to domains such as conscious awareness, motivational effects of attention, social attention, and emotion regulation. These terms were discussed within a broader review of available evidence regarding the neural correlates of (1) Emotion-Attention Interactions in Perception, (2) Emotion-Attention Interactions in Learning and Memory, (3) Individual Differences in Emotion-Attention Interactions, and (4) Training and Interventions to Optimize Emotion-Attention Interactions. This comprehensive approach enabled an integrative overview of the current knowledge regarding the mechanisms of emotion-attention interactions at multiple levels of analysis, and identification of emerging directions for future investigations.
Background: Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function.
Methods/design: A single-blind, four-armed, randomized controlled trial with a 3-week (home-based) intervention phase and two measurement days pre and post intervention (M1/M2) is designed. Experimental procedures on both measurement days will include evaluation of maximum isokinetic and isometric trunk strength (extension/flexion, rotation) including perturbations, as well as neuromuscular trunk activity while performing strength testing. The primary outcome is trunk strength (peak torque). Neuromuscular activity (amplitude, latencies as a response to perturbation) serves as secondary outcome. The control group will perform a standardized exercise program of four sensorimotor exercises (three sets of 10 repetitions) in each of six training sessions (30 min duration) over 3 weeks. The intervention groups’ programs differ in the number of exercises, sets per exercise and, therefore, overall training amount (group I: six sessions, three exercises, two sets; group II: six sessions, two exercises, two sets; group III: six sessions, one exercise, three sets). The intervention programs of groups I, II and III include additional perturbations for all exercises to increase both the difficulty and the efficacy of the exercises performed. Statistical analysis will be performed after examining the underlying assumptions for parametric and non-parametric testing.
Discussion: The results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function.
Regarding verbal mood and complementation patterns of reporting verbs, the distinction between direct and indirect reported speech is well established in present-day German. This paper looks into the history of German: Common knowledge has it that both the use of verbal mood as well as the quality of clause linkage undergo considerable changes giving rise to the question how these changes affect the manifestations of indirect reported speech in earlier stages of German. The historical record of the 16th century (with an outlook on the 17th century) shows that the distinction between direct and indirect reported speech is not yet grammaticalized in historical sources at the time. In particular with respect to dependent (in)direct reported speech, both types prefer V2-complements with only verbal mood differentiating between the types. Although present and past subjunctive have a much wider distribution in earlier stages of German, the occurrence of free indirect speech likewise testifies to its increasing use as a marker of indirect reported speech. The growing conventionalization of patterns of indirect reported speech in the course of Early Modern German may be considered as an example for an increase of subjectification in its development.
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.