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Previous clinical research found that invasive vagus nerve stimulation (VNS) enhanced word recognition memory in epileptic patients, an effect assumed to be related to the activation of brainstem arousal systems. In this study, we applied non-invasive transcutaneous auricular VNS (tVNS) to replicate and extend the previous work. Using a single-blind, randomized, between-subject design, 60 healthy volunteers received active or sham stimulation during a lexical decision task, in which emotional and neutral stimuli were classified as words or non-words. In a subsequent recognition memory task (1 day after stimulation), participants' memory performance on these words and their subjective memory confidence were tested. Salivary alpha-amylase (sAA) levels, a putative indirect measure of central noradrenergic activation, were also measured before and after stimulation. During encoding, pleasant words were more accurately detected than neutral and unpleasant words. However, no tVNS effects were observed on task performance or on overall sAA level changes. tVNS also did not modulate overall recognition memory, which was particularly enhanced for pleasant emotional words. However, when hit rates were split based on confidence ratings reflecting familiarity- and recollection-based memory, higher recollection-based memory performance (irrespective of emotional category) was observed during active stimulation than during sham stimulation. To summarize, we replicated prior findings of enhanced processing and memory for emotional (pleasant) words. Whereas tVNS showed no effects on word processing, subtle effects on recollection-based memory performance emerged, which may indicate that tVNS facilitates hippocampus-mediated consolidation processes.
Although a relatively large number of studies on acquired language impairments have tested the case of derivational morphology, none of these have specifically investigated whether there are differences in how prefixed and suffixed derived words are impaired. Based on linguistic and psycholinguistic considerations on prefixed and suffixed derived words, differences in how these two types of derivations are processed, and consequently impaired, are predicted. In the present study, we investigated the errors produced in reading aloud simple, prefixed, and suffixed words by three German individuals with agrammatic aphasia (NN, LG, SA). We found that, while NN and LG produced similar numbers of errors with prefixed and suffixed words, SA showed a selective impairment for prefixed words. Furthermore, NN and SA produced more errors specifically involving the affix with prefixed words than with suffixed words. We discuss our findings in terms of relative position of stem and affix in prefixed and suffixed words, as well as in terms of specific properties of prefixes and suffixes.
River floods are among the most damaging natural hazards that frequently occur in Germany. Flooding causes high economic losses and impacts many residents. In 2016, several southern German municipalities were hit by flash floods after unexpectedly severe heavy rainfall, while in 2013 widespread river flooding had occurred. This study investigates and compares the psychological impacts of river floods and flash floods and potential consequences for precautionary behaviour. Data were collected using computer-aided telephone interviews that were conducted among flood-affected households around 9 months after each damaging event. This study applies Bayesian statistics and negative binomial regressions to test the suitability of psychological indicators to predict the precaution motivation of individuals. The results show that it is not the particular flood type but rather the severity and local impacts of the event that are crucial for the different, and potentially negative, impacts on mental health. According to the used data, however, predictions of the individual precaution motivation should not be based on the derived psychological indicators – i.e. coping appraisal, threat appraisal, burden and evasion – since their explanatory power was generally low and results are, for the most part, non-significant. Only burden reveals a significant positive relation to planned precaution regarding weak flash floods. In contrast to weak flash floods and river floods, the perceived threat of strong flash floods is significantly lower although feelings of burden and lower coping appraisals are more pronounced. Further research is needed to better include psychological assessment procedures and to focus on alternative data sources regarding floods and the connected precaution motivation of affected residents.
Background
Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization.
Methods
From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented. Out of these, predictors for assignment to CR or GR after TAVI were identified using a multivariable regression model.
Results
After TAVI, 249 patients (80.7 ± 5.1 years, 59.0% female) underwent CR (n = 198) or GR (n = 51). GR patients were older, less physically active and more often had a level of care, peripheral artery disease as well as a lower left ventricular ejection fraction. The groups also varied in 6MWD. Furthermore, individual components of frailty revealed prognostic impact: higher values in instrumental ADL reduced the probability for referral to GR (OR:0.49, p < 0.001), while an impaired mobility was positively associated with referral to GR (OR:3.97, p = 0.046). Clinical parameters like stroke (OR:0.19 of GR, p = 0.038) and the EuroSCORE (OR:1.04 of GR, p = 0.026) were also predictive.
Conclusion
Advanced age patients after TAVI referred to CR or GR differ in several parameters and seem to be different patient groups with specific needs, e.g. regarding activities of daily living and mobility. Thus, our data prove the eligibility of both CR and GR settings.
Objective: To determine immediate performance measures for short-term, multicomponent cardiac rehabilitation (CR) in clinical routine in patients of working age, taking into
account cardiovascular risk factors, physical performance, social medicine, and subjective health parameters and to explore the underlying dimensionality.
Design: Prospective observational multicenter register study in 12 rehabilitation centers throughout Germany.
Setting: Comprehensive 3-week CR.
Compulsive behaviors (e.g., addiction) can be viewed as an aberrant decision process where inflexible reactions automatically evoked by stimuli (habit) take control over decision making to the detriment of a more flexible (goal-oriented) behavioral learning system. These behaviors are thought to arise from learning algorithms known as "model-based" and "model-free" reinforcement learning. Gambling disorder, a form of addiction without the confound of neurotoxic effects of drugs, showed impaired goal-directed control but the way in which problem gamblers (PG) orchestrate model-based and model-free strategies has not been evaluated. Forty-nine PG and 33 healthy participants (CP) completed a two-step sequential choice task for which model-based and model-free learning have distinct and identifiable trial-by-trial learning signatures. The influence of common psychopathological comorbidities on those two forms of learning were investigated. PG showed impaired model-based learning, particularly after unrewarded outcomes. In addition, PG exhibited faster reaction times than CP following unrewarded decisions. Troubled mood, higher impulsivity (i.e., positive and negative urgency) and current and chronic stress reported via questionnaires did not account for those results. These findings demonstrate specific reinforcement learning and decision-making deficits in behavioral addiction that advances our understanding and may be important dimensions for designing effective interventions.
Background
In Europe, bank voles (Myodes glareolus) are widely distributed and can transmit Puumala virus (PUUV) to humans, which causes a mild to moderate form of haemorrhagic fever with renal syndrome, called nephropathia epidemica. Uncovering the link between host and virus dynamics can help to prevent human PUUV infections in the future. Bank voles were live trapped three times a year in 2010–2013 in three woodland plots in each of four regions in Germany. Bank vole population density was estimated and blood samples collected to detect PUUV specific antibodies.
Results
We demonstrated that fluctuation of PUUV seroprevalence is dependent not only on multi-annual but also on seasonal dynamics of rodent host abundance. Moreover, PUUV infection might affect host fitness, because seropositive individuals survived better from spring to summer than uninfected bank voles. Individual space use was independent of PUUV infections.
Conclusions
Our study provides robust estimations of relevant patterns and processes of the dynamics of PUUV and its rodent host in Central Europe, which are highly important for the future development of predictive models for human hantavirus infection risk