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The Omicron variants BA.1, BA.2, and BA.5 caused several waves of SARS-CoV-2 in Germany in 2022. In this comparative study, public health data on SARS-CoV-2 infections from Mecklenburg-Western Pomerania, Germany, between January and October 2022 were examined retrospectively using Pearson's chi-squared tests and Fisher's exact tests for testing for statistical significance. Compared to BA.5 infections, BA.1 and BA.2 infections affected younger individuals aged up to 19 years significantly more often, whereas BA.5 infections occurred significantly more frequently in patients between 40 and 59 years of age when compared to BA.1 and BA.2. Infections with all three variants predominantly caused flu-like symptoms; nevertheless, there were significant differences between the reported symptoms of BA.1, BA.2, and BA.5 infections. Especially, the symptoms of 'fever', 'severe feeling of sickness', 'loss of taste', and 'loss of smell' were significantly more often present in patients with BA.5 infections compared to BA.1 and BA.2 cases. Additionally, BA.2 and BA.5 cases reported significantly more often the symptoms of 'runny nose' and 'cough' than BA.1-infected cases. Our findings indicate remarkable differences in the clinical presentations among the sub-lineages, especially in BA.5 infections. Furthermore, the study demonstrates a powerful tool to link epidemiological data with genetic data in order to investigate their potential impact on public health. [ABSTRACT FROM AUTHOR]

Obesity-induced dysregulation of hypothalamic neurons is not completely eliminated by restoring body weight, therefore the most urgent task of modern precision medicine is to predict the trajectory of development of metabolic disorders associated with obesity in children. The aim of the study was to determine the level of association of single-nucleotide variants of genes that determine eating behavior – Neuronal growth regulator 1, Fat mass and obesity associated gene, Glucagon-like peptide-1 receptor, ghrelin, leptin receptor, cholecystokinin, in the development of metabolically unhealthy obesity. 252 obese children aged 6-18 years were examined. The main group (n=152) consisted of children with metabolically unhealthy obesity (MUO) according to Identification and prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants 2014 criteria. The control group (n=100) consisted of children with metabolically healthy obesity (MHO). All children underwent a general clinical, immunobiochemical examination at the Synevo laboratory (Ukraine). Whole-genome sequencing (CeGat, Germany) was performed in 31 children of the primary and 21 children of the control group. Static analysis: variance analysis ANOVA, method of estimating data dispersion, ROC-analysis, method of testing statistical hypotheses. The level of single nucleotide variants association of anorexigenic hormone genes with MUO that exceeded the threshold accepted by 75% of the available data was, respectively, in ascending order: leptin receptor (LEPR) rs1137101 (40.38%), Glucagon-like peptide-1 receptor (GLP1R) rs1126476 (40.38%), GLP1R rs2235868 (42.31%), GLP1R rs1042044 (42.31%), LEPR rs3790435 (48.08%), cholecystokinin (CCK) rs754635 (50%), LEPR rs2186248 (55.76%), GLP1R rs6918287 (55.76%). Genotypes of the GLP1R gene, such as CC rs10305421 determine insulin resistance (F=5.6); GA/AA rs3765468 – meta-inflammation (F=5.8); AA rs6918287 – basal hyperglycemia (F=6.3) and triglyceridemia (F=51.3), p<0.05. Single-nucleotide variants of the gene GLP1R rs6918287, LEPR rs2186248, CCK rs754635 of the anorexic hormones that control eating behavior are highly associated with the presence of metabolically unhealthy obesity in children. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed the effects of the COVID-19 pandemic restrictions/lockdowns on physical activity levels, bodymass, quadriceps strength, and gait biomechanics over 18 months. Methods: Ten healthy men were assessed at baseline (~14 wk before first lockdown) and 17.9 ± 0.3 months later (<1 wk after second lockdown). At both times, physical activity levels, body mass, and quadriceps strength were acquired using the International Physical Activity Questionnaire, a force plate, and a dynamometer, respectively. Gait data were also acquired using a motion capture system and force plates during self-paced walking, from which spatiotemporal parameters, knee angles, and externalmoments were computed. Baseline and follow-upmeasurements were compared using two-tailed paired t-tests (a = 0.05). Results: At follow-up, participants spent less time doing vigorous physical activity (Δ = -76 ± 157 min·wk-1, P = 0.048), exhibited a tendency toward increased sedentary time (Δ = +120 ± 162 min·d-1, P = 0.056), weighedmore (Δ = +2.5 ± 2.8 kg, P = 0.021), and showed a trend toward reduced quadriceps strength (Δ = -0.29 ± 0.45 (N·m)·kg-1, P = 0.071) compared with baseline. At follow-up, participants walked slower (Δ = -0.09 ± 0.07 m·s-1, P = 0.005), had greater knee flexion angles at heel strike (Δ = +2.2° ± 1.8°, P = 0.004) and during late stance (Δ = +2.2° ± 1.8°, P = 0.004), had reduced knee extension moments (Δ = -0.09 ± 0.09 (N·m)·kg-1, P = 0.012) and knee internal rotationmoments (Δ = -0.02 ± 0.02 (N·m)·kg-1, P = 0.012) during late stance. Conclusions: Healthymen exhibited reduced physical activity levels, increased body weight, a tendency toward reduced quadriceps strength, and altered gait biomechanics over the initial 18months of the COVID-19 pandemic--alterations that could have far-reaching health consequences. [ABSTRACT FROM AUTHOR]

Localisation of low- and high-frequency sounds in single-sided deaf cochlear implant users was investigated using noise stimuli designed to mitigate monaural localisation cues. Within subject design. Sound source localisation was tested in the horizontal plane using an array of seven loudspeakers along the azimuthal angle span from −90° to +90°. Stimuli were broadband noise and high- and low-frequency noise. Twelve adult subjects with single-sided deafness participated in the study. All had normal hearing in the healthy ear and were supplied with a cochlear implant (CI) in their deaf ear. With broadband noise, the mean angular localisation error was 39° in aided condition as compared to a median angular error of 83.6° when the speech processor was not worn. For high-frequency noise, the median angular error was 30° and for low-frequency noise, it was 46° in the CI-aided condition. Single-sided deaf CI users show the best sound localisation for high-frequency sounds. This supports the view that interaural level differences are dominant for sound localisation in these listeners. Nonetheless, a limited ability to localise low-frequency sounds was observed, which may be based on the supportive perception of interaural time differences. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate the medication calculation skills of graduating nursing students in six European countries and analyse the associated factors. Background: Medication calculation skills are fundamental to medication safety, which is a substantial part of patient safety. Previous studies have raised concerns about the medication calculation skills of nurses and nursing students. Design: As part of a broader research project, this study applies a multinational cross‐sectional survey design with three populations: graduating nursing students, nurse managers and patients. Methods: The students performed two calculations (tablet and fluid) testing medication calculation skills requiring different levels of conceptual understanding and arithmetic. The managers and patients answered one question about the students' medication kills. In total, 1,796 students, 538 managers and 1,327 patients participated the study. The data were analysed statistically. The STROBE guideline for cross‐sectional studies was applied. Results: Almost all (99%) of the students performed the tablet calculation correctly, and the majority (71%) answered the fluid calculation correctly. Older age, a previous degree in health care and satisfaction with their current degree programme was positively associated with correct fluid calculations. The patients evaluated the students' medication skills higher than the nurse managers did and the evaluations were not systematically aligned with the calculation skills tested. Conclusions: Nursing students have the skills to perform simple medication calculations, but a significant number of students have difficulties with calculations involving multiple operations and a higher level of conceptual understanding. Due to the variation in students' medication calculation skills and the unalignment between the managers' and patients' evaluations and the calculation tests, further research is needed. Relevance to clinical practice: Graduating nursing students enter clinical field as qualified professionals, but there is still room for improvement in their medication calculation skills. This calls for attention in the fields of clinical nursing, education and research. [ABSTRACT FROM AUTHOR]

Introduction: Myeloid leukaemic blasts can be converted into leukaemia-derived dendritic cells (DCleu), characterised by the simultaneous expression of dendritic- and leukaemia-associated antigens, which have the competence to prime and enhance (leukaemia-specific) immune responses with the whole leukaemic antigen repertoire. To display and further specify dendritic cell (DC)- and DCleu-mediated immune responses, we analysed the interferon gamma (IFNy) secretion of innate and adaptive immune cells. Methods: DC/DCleu were generated from leukaemic whole blood (WB) with (blast)modulatory Kit-I (granulocyte-macrophage colony-stimulating factor [GM-CSF] + Picibanil [OK-432]) and Kit-M (GM-CSF + prostaglandin E1) and were used to stimulate T cell-enriched immunoreactive cells. Initiated anti-leukaemic cytotoxicity was investigated with a cytotoxicity fluorolysis assay. Initiated IFNy secretion of T, NK, CIK, and iNKT cells was investigated with a cytokine secretion assay (CSA). IFNy positivity was additionally evaluated with an intracellular cytokine assay (ICA). Recent activation of leukaemia-specific cells was verified through addition of leukaemia-associated antigens (LAA; WT-1 and Prame) Results: We found Kit-I and Kit-M competent to generate mature DC and DCleu from leukaemic WB without induction of blast proliferation. Stimulation of immunoreactive cells with DC/DCleu regularly resulted in an increased anti-leukaemic cytotoxicity and increased IFNy secretion of T, NK, and CIK cells, pointing to the significant role of DC/DCleu in leukaemia-specific alongside anti-leukaemic reactions. Interestingly, an addition of LAA did not further increase IFNy secretion, suggesting an efficient activation of leukaemia-specific cells. Here, both the CSA and ICA yielded comparable frequencies of IFNy-positive cells. Remarkably, the anti-leukaemic cytotoxicity positively correlated with the IFNy secretion in TCD3+, TCD4+, TCD8+, and NKCD56+ cells. Conclusion: Ultimately, the IFNy secretion of innate and adaptive immune cells appeared to be a suitable parameter to assess and monitor the efficacy of in vitro and potentially in vivo acute myeloid leukaemia immunotherapy. The CSA in this regard proved to be a convenient and reproducible technique to detect and phenotypically characterise IFNy-secreting cells. In respect to our studies on DC-based immunomodulation, we were able to display the potential of DC/DCleu to induce or improve leukaemia-specific and anti-leukaemic activity. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic caught the health care systems of all countries unprepared. For the further education of healthcare personnel in the Republic of Kosovo, it became necessary to implement a concept for practical training in hygienic working. A video-conference–based educational concept to bridge the physical distance between Germany and Kosovo enabled the rapid, theoretical and practical transfer of knowledge. Methods: Current evidence on COVID-19 and Standard Operation Procedures (SOP) were researched. Healthcare staff in Pristina were advised and trained in ten online sessions on hygienic working under pandemic conditions via the "Logitech Rally for DFNconf" video conferencing system. The seminars were interpreted consecutively (Albanian). The Situational Judgement Test (HygiKo-SJT) should describe changes in participants' hygiene knowledge. Results: A total of 25 people were trained in hygiene-related knowledge in terms of basic and specific hygiene for COVID-19. The weekly training sessions made it possible to address questions and subsequently provide practical knowledge. The HygiKo-SJT did not show a generalizable, measurable improvement in hygiene competence. Conclusion: Participants benefited from the concept and rapid implementation of a live video-conference–based seminar on "Hygiene under Pandemic Conditions". The positive experience in terms of guidance, advice and training provides the basis for implementing a dedicated "Hygiene" module in Kosovo [ABSTRACT FROM AUTHOR]

Objective: To compare the one-year postoperative outcomes of anti-gravity treadmill rehabilitation with those of standard rehabilitation in patients with ankle or tibial plateau fractures. Design: An open-label prospective randomised study. Setting: Three trauma centres. Subjects: Patients were randomised into the intervention (anti-gravity treadmill) or control (standard protocol) rehabilitation group. Main measures: The primary endpoint was changes in the Foot and Ankle Outcome Score for ankle fractures and Knee Injury and Osteoarthritis Outcome Score for tibial plateau fractures from baseline to 12 months after operation. Secondary endpoints were the subscores of these scores, muscle atrophy (leg circumference at 20 cm above and 10 cm below the knee joint) and the Dynamic Gait Index. Results: Initially, 73 patients (37 vs 36) underwent randomisation. After 12 months, 29 patients in the intervention group and 24 patients in the control group could be analysed. No significant difference was noted in the Foot and Ankle Outcome Score (80.8 ± 18.4 and 78.4 ± 21.1) and Knee Injury and Osteoarthritis Outcome Score (84.8 ± 15.2 and 81.7 ± 17.0). The change in the Dynamic Gait Index from 12 weeks to 12 months differed significantly between the groups (P = 0.04). Patients with tibial plateau fractures had a 3 cm wider thigh circumference in the intervention group than those in the control group (95% confidence interval: −0.2 to 6.3 cm, P = 0.08). Conclusion: One year after surgery, patients who had undergone anti-gravity treadmill rehabilitation showed better gait than patients in the control group, and those with tibial plateau fractures had less muscle atrophy. [ABSTRACT FROM AUTHOR]

Aim: To identify functional traits that best predict community assembly without knowing the underlying environmental drivers. Methods: We propose a new method based on the correlation r(XY) between two matrices of potential community composition: the matrix X is fuzzy‐weighted by trait similarities of species, and the matrix Y is derived by Beals smoothing using the probabilities of species co‐occurrences. Since X is based on one or more traits, r(XY) measures how well the traits used for fuzzy‐weighting reflect the species co‐occurrence patterns in Y. We developed an optimisation algorithm to identify the traits maximising this correlation, together with an appropriate permutational test for significance. Using metacommunity data generated by a stochastic, individual‐based, spatially explicit model, we assessed the type I error and the power of our method across different simulation scenarios, varying environmental filtering parameters, number of traits and trait correlation structures. Then, we applied the method to real‐world community and trait data of dry calcareous grassland communities across Germany to identify, out of 49 traits, the combination of traits that maximised r(XY). Results: The method correctly identified the relevant traits involved in the assembly mechanisms of simulated communities, showing high power and accurate type I error. It proved to be robust against confounding aspects related to interactions between environmental factors, strength of limiting factors, and trait collinearity. In the grassland dataset, the method identified five traits that best explained community assembly. These traits reflect the size and the leaf economics spectrum, which are related to succession and resource supply, factors that may not be always measured in real‐world situations. Conclusions: Our method successfully identified the relevant traits mediating community assembly, therefore providing insights on the underlying environmental and biotic factors, even if these are hidden, unmeasured or not accessible at the spatial or temporal scale of the study. [ABSTRACT FROM AUTHOR]

Production companies face the challenge of choosing a suitable process optimization method from a variety of methods, even though their effect on operational processes is uncertain. This study shows, using a statistical hypothesis test, the impact of the methods Kanban and Standard Worksheet on an autonomous team in comparison to a team that applies these methods. For this purpose, 44 companies - of different size and operating in various industries - across Germany completed a business game and generated data regarding the KPIs adherence to delivery date, number of reworks and inventory costs. Based on these data, the team's performance could be ascertained and compared with each other. [ABSTRACT FROM AUTHOR]

Objective: Vancomycin-resistant enterococci (VRE) are of major concern in infection control. Although broad infection control actions to check VRE have been implemented, VRE remain part of daily infection preven- tion in clinical settings. Cleaning procedures in the inanimate ward environment might play a key role in controlling VRE. In order to optimize infection control management at University Hospital Frankfurt, Germany (UHF), this study evaluates the impact of H2O2-containing cleaning wipes compared to Glucoprotamin containing wipes on VRE prevalence in intensive care wards. Methods: Retrospective analyses were conducted of the VRE prevalence on environmental materials obtained from three intensive care units (ICU) at UHF for 17 months prior to (T1) and during the 25 months after (T2) the implementation of H2O2-containing cleaning wipes from January 2016 to June 2019. The bactericidal power of the two disinfectants against VRE was compared using the 4-field test according to EN 16615 (2015). Results: At T1 and T2, n=666 and n=710 environmental samples, re- spectively, were obtained. At T1, 24.2% (n=161/666; 95% confidence interval: 21.0–27.6) and at T2, 6.9% (n=49/710; 5.1–9.0) samples were positive for VRE. In vitro disinfectant testing did not reveal any superiority of H2O2 over glucoprotamin. No effect on the VRE prevalence in patients' rectal screening materials was observed. Conclusion: Though Glucoprotamin and H2O2 were in vitro equally effective against VRE, the prevalence of VRE in ICU environment at UHF de- creased after implementation of H2O2-containig wipes. This might be due to multiple factors, of which we consider the impact of the Hawthorne effect to be the strongest. Success of infection control strategies might depend on the compliance of the persons critically in- volved. Transparent information on infection control strategies is sug- gested to increase compliance and should therefore be considered both in daily infection control and outbreak management. [ABSTRACT FROM AUTHOR]

Background: The stabilization strategy for acute high-grade acromioclavicular (AC) joint separations with AC-stabilizing clavicular hook plate (cHP) or coracoclavicular (CC)–stabilizing double double-button suture (dDBS) is still under consideration. Hypothesis: The CC-stabilizing dDBS is superior to the cHP according to an AC-specific radiologic assessment and score system. Study Design: Cohort study; Level of evidence, 2. Methods: Seventy-three consecutive patients with acute high-grade AC joint separation were prospectively followed in 2 treatment groups (64.4% randomized, 35.6% patient-selected treatment): open reduction and cHP (cHP group) or arthroscopically assisted dDBS (dDBS group) performed within 14 days of injury. Patients were prospectively analyzed by clinical scores (Taft, Constant score [CS], numeric analog scale for pain) and AC-specific radiographs (AC distance, CC distance [CCD], relative CCD [rCCD; 100 / AC distance × CCD]) at points of examination (preoperative and 6, 12, and 24 months). The minimal clinically important differences (MCIDs) were assessed by the anchor-based method. Results: Twenty-seven of 35 patients (mean age ± SD: 37.7 ± 9.7 years) after cHP implantation and 29 of 38 patients (34.2 ± 9.7 years) after dDBS implantation were continuously followed until the 24-month follow-up. All patients showed significantly increased scores after surgery as compared with preoperative status (all P < .05). As compared with GI, GII had significantly better outcomes at 24 months (Taft: cHP = 9.4 ± 1.7 vs dDBS = 10.9 ± 1.1, P < .05, MCID = 2.9; CS: cHP = 90.2 ± 7.8 vs dDBS = 95.3 ± 4.4, P < .02, MCID = 16.6) and at 24 months for Rockwood IV/V (Taft: cHP = 9.4 ± 1.7 vs dDBS = 11.1 ± 0.8, P < .0005; CS: cHP = 90.1 ± 7.7 vs dDBS = 95.5 ± 3.1, P < .04). Clinically assessed horizontal instability persisted in 18.52% (GI) and 6.89% (GII; P = .24). The rCCD showed equal loss of reduction at 24 months (GII = 130.7% [control = 111%] vs GI = 141.8% [control = 115%], MCID = 11.1%). Conclusion: This prospective study showed significantly superior outcomes in all clinical scores between GII and GI. The subanalysis of the high-grade injury type (Rockwood IV/V) revealed that these patients showed significant benefits from the dDBS procedure in the clinical assessments. The cHP procedure resulted in good to excellent clinical outcome data and displayed an alternative procedure for patients needing less restrictive rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Abstract: Background: SAPS—‘Sprachsystematisches Aphasiescreening’—is a novel language‐systematic aphasia screening developed for the German language, which already had been positively evaluated. It offers a fast assessment of modality‐specific psycholinguistic components at different levels of complexity and the derivation of impairment‐based treatment foci from the individual performance profile. However, SAPS has not yet been evaluated in combination with the new SAPS‐based treatment. Aims: To replicate the practicality of SAPS and to investigate the effectiveness of a SAPS‐based face‐to‐face therapy combined with computerised home training in a feasibility study. To examine the soundness of the treatment design, to determine treatment‐induced changes in patient performance as measured by SAPS, to assess parallel changes in communicative abilities, and to differentiate therapy effects achieved by face‐to‐face therapy versus add‐on effects achieved by later home training. Methods & Procedures: Sixteen participants with post‐stroke aphasia (PWAs) were included into the study. They were administered the SAPS and communicative testing before and after the treatment regimen. Each PWA received one therapy session followed by home training per day, with the individual treatment foci being determined according to initial SAPS profile, and duration of treatment and possible change of focus dependent on performance assessed by continuous therapy monitoring. Outcomes & Results: The combination of therapy and home training based on the SAPS was effective for all participants. We showed significant improvements for impairment‐based SAPS performance and, with high inter‐individual variability, in everyday communication. These two main targets of speech and language therapy were correlated and SAPS improvements after therapy were significantly higher than after home training. Conclusions & Implications: SAPS offers the assessment of an individual performance profile in order to derive sufficiently diversified, well‐founded and specific treatment foci and to follow up changes in performance. The appending treatment regimen has shown to be effective for our participants. Thus, the study revealed feasibility of our approach. [ABSTRACT FROM AUTHOR]

This longitudinal study was designed to assess patients' desire for early retirement and investigate which cancer-related and psychosocial characteristics are associated with early retirement. We assessed 750 cancer patients at the beginning ( t0) and end ( t1) of, and 12 months after ( t2) inpatient cancer rehabilitation. At t0, 22% had a desire to retire early. These patients reported significantly longer sick leave periods, less favourable workplace environments, lower work ability, higher psychological distress and lower quality of life than other patients. At t2, 12.5% of patients received temporary or permanent early retirement pensions. Of all patients with a desire for early retirement at t0, 43% had returned to work at t2. This subgroup had a significantly lower physical quality of life than other patients returning to work. The most influential predictors of early retirement were being on sick leave ( OR = 6.50, 95% CI = 1.97-21.47) and a desire for early retirement ( OR = 5.61, 95% CI = 2.73-11.52). Inverse predictors of early retirement were cancer remission ( OR = 0.23, 95% CI = 0.10-0.53), perceived productivity ( OR = 0.38, 95% CI = 0.18-0.83), work satisfaction ( OR = 0.36, 95% CI = 0.17-0.77) and mental quality of life ( OR = 0.94, 95% CI = 0.91-0.98). This underlines the need for cancer-specific multi-professional rehabilitation and occupational therapy programmes. [ABSTRACT FROM AUTHOR]

Several studies suggest that pain is a trigger for challenging behaviour in older adults with cognitive impairment. However, such measured relationships might be confounded due to item overlap as instruments share similar or identical items. The purpose of this study was to examine whether the frequently observed association between pain and challenging behaviour might be traced back to item overlap. This multicentre cross-sectional study was conducted in 13 nursing homes and examined pain (measure: Pain Assessment in Advanced Dementia Scale) and challenging behaviour (measure: Cohen-Mansfield Agitation Inventory) in 150 residents with severe cognitive impairment. The extent of item overlap was determined by juxtaposition of both measures' original items. As expected, comparison between these instruments revealed an extensive item overlap. The statistical relationship between the two phenomena can be traced back mainly to the contribution of the overlapping items, which renders the frequently stated relationship between pain and challenging behaviour trivial. The status quo of measuring such associations must be contested: constructs' discrimination and instruments' discrimination have to be discussed critically as item overlap may lead to biased conclusions and assumptions in research as well as to inadequate care measures in nursing practice. [ABSTRACT FROM AUTHOR]

The inter-relationship of stuttering and bilingualism to functional cerebral hemispheric processing was examined on a dual-task paradigm. Eighty native German (L1) speakers, half of whom were sequential bilinguals (L2 = English), were recruited. The participants (mean age = 38.9 years) were organised into four different groups according to speech status and language ability: 20 bilinguals who stutter (BWS), 20 monolinguals who stutter (MWS), 20 bilinguals who do not stutter (BWNS), and 20 monolinguals who do not stutter (MWNS). All participants completed a dual-task paradigm involving simultaneous speaking and finger tapping. No performance differences between BWS and BWNS were found. In contrast, MWS showed greater dual-task interference compared to BWS and MWNS, as well as greater right- than left-hand disruption. A prevailing finding was that bilingualism seems to offset deficits in executive functioning associated with stuttering. Cognitive reserve may have been reflected in the present study, resulting in a bilingual advantage. [ABSTRACT FROM PUBLISHER]

In the present study, we tested the consequences of attention towards goalkeepers in association football penalty shootouts that have exclusively been derived from laboratory experiments. We conducted a retrospective analysis of all penalty shootouts during FIFA World Cups (1986–2010) and UEFA European Football Championships (1984–2012). We linked key variables of previous laboratory research to observable behaviour in the field that was coded by two independent coders. The following hypotheses were tested: first, attention towards goalkeepers results in more saves/better goalkeeper performance; second, goalkeepers can deliberately distract penalty takers by drawing attention towards themselves which results in less accurate penalty kicks/better goalkeeper performance. Results were in line with previous laboratory analyses as they showed that attention towards goalkeepers resulted in more saves/better goalkeeping performance. Further, if goalkeepers distracted penalty takers this also resulted in better goalkeeping performance. The applied implications of these findings are discussed for both goalkeepers and penalty takers in association football. [ABSTRACT FROM PUBLISHER]

Objectives Evidence on possible associations between facial morphology, attachment loss and gingival recession is lacking. We analysed whether the facial type, which can be described by the ratio of facial width and length (facial index), is related to periodontal loss of attachment, hypothesizing that a broad face might be associated with less gingival recession ( GR) and less clinical attachment loss ( CAL) than a long face. Materials and methods Data from the 11-year follow-up of the population-based Study of Health in Pomerania were used. Periodontal loss of attachment was assessed by GR and CAL. Linear regression models, adjusted for age and gender, were used to assess associations between specific landmark based distances extracted from magnetic resonance imaging head scans and clinically assessed GR or CAL ( N = 556). Results Analysing all teeth, a higher maximum cranial width was associated with a lower mean GR ( B = −0.016, 95% CI: −0.030; −0.003, p = 0.02) and a lower mean CAL ( B = −0.023, 95% CI: −0.040; −0.005, p = 0.01). Moreover, a long narrow face was significantly associated with increased mean GR and CAL (facial index, P for trend = 0.02 and p = 0.01, respectively). Observed associations were more pronounced for incisors and canines than for premolars and molars. Conclusion This study revealed craniofacial morphology, specifically the cranial width and the facial index, as a putative risk factor for periodontal loss of attachment. [ABSTRACT FROM AUTHOR]

Background. Phentolamine mesylate (PM) is widely used to reverse local anesthesia after dental procedures. Limited knowledge is available regarding effectiveness and safety in routine dental practice. Methods. The authors conducted 2 national, prospective, non-interventional, postauthorization effectiveness studies (OraVerse Post-Authorization Efficacy Study [ORAPAES] controlled, Ora-Verse Non-Interventional Study [ORANIS] uncontrolled) in patients receiving a local anesthetic as part of their dental treatment. They investigated time to recovery of normal sensation and function and the frequency of adverse events (AEs). The authors used Kaplan-Meier methods to analyze times to recovery; in ORAPAES, they used hazard ratios based on Cox models using the control group as a reference. Results. In ORAPAES (n -- 856), PM reduced the time to recovery of normal sensation and function with a difference in the median time of 70 and 79 minutes, respectively, with similar results observed in ORANIS (n = 445). In ORAPAES, patients in the PM group had, at any time point, a 2.77-fold higher chance of recovery to normal sensation (hazard ratio, 2.77; 95% confidence interval [CI], 2.35-3.26; P < .001) and for normal function 2.94-fold higher chance of recovery to normal sensation (95% CI, 2.49-3.47; P < .001) than in the control group. The observed incidence of AEs with PM treatment was 8.4% in ORAPAES (95% CI, 6.2-10.9) and 9.7% (95% CI, 7.1-12.7) in ORANIS. No serious AEs occurred. Conclusions. PM substantially reduced the time to recovery of normal sensation and function after local anesthesia in routine dental treatment. The results confirm the effectiveness, safety, and tolerability of PM used in patients with routine dental conditions in Germany, and that PM augments the safety of dental treatments. Practical Implications. The authors determined that PM is well suited to reverse local anesthesia after routine dental procedures. [ABSTRACT FROM AUTHOR]

This study examined contributions of different types of sport activities to the development of elite youth soccer performance. Match-play performance of 44 German male players was assessed by expert coaches twice, 24 months apart (age 11.1–13.1 years), based on videotaped 5v5 matches. Player pairs were matched by identical age and initial performance at t1. Each player was assigned to a group of either "Strong" or "Weak Responders" based on a higher or lower subsequent performance improvement at t2 within each pair (mean Δperformance 29% vs. 7%). A questionnaire recorded current and earlier amounts of organised practice/training and non-organised sporting play, in soccer and other sports, respectively. Group comparison revealed that "Strong Responders" accumulated more non-organised soccer play and organised practice/training in other sports, but not more organised soccer practice/training. Subsequent multivariate analyses (multiple linear regression analyses (MLR)) highlighted that higher resultant match-play performance at t2 was accounted for R2adj = 0.65 by performance at t1, together with more non-organised soccer play and organised engagement in other sports, respectively, and greater current, but less earlier volume of organised soccer. The findings suggest that variable early sporting experience facilitates subsequent soccer performance development in German elite youth footballers. [ABSTRACT FROM AUTHOR]

Background: The licensed anesthetic xenon, which exerts organ protective properties, was recently added by the World Anti-Doping Agency to the list of prohibited substances. Xenon is supposed to trigger the production of hypoxia-inducible factor 1α (HIF-1α) and subsequently erythropoietin, but data are limited to in vivo experimental work. Therefore we evaluated the effect of xenon on erythropoietin levels in healthy persons. Methods: Twenty-four healthy volunteers were randomly assigned either to a group spontaneously breathing xenon 30 % (Xe/O 30 %/60 %) or a group breathing control gas (N/O 40 %/60 %) for 45 min. Primary outcome parameters were erythropoietin levels at several time-points after exposure. Secondary outcome parameters were serum levels of testosterone, cytokines, and growth factors as well as concentrations of xenon in blood and exhalation samples measured at several time-points after exposure. In addition, hemodynamic safety parameters were monitored during exposure. Results: The administration of xenon significantly increased erythropoietin levels 8 h after exposure (1.34 [±0.368]; p = 0.008), peaking at 24 h compared to the baseline values (1.45 [±0.498]; p = 0.01) and remained traceable in blood and exhalation probes until 24 h after exposure. In contrast, no significant change was observed in the control group. Measurement of stromal cell-derived factor 1 (SDF-1) revealed a significant increase of SDF-1 levels ( p = 0.005), whereas no differences were observed with respect to growth factors, cytokines, or androgens. In an in vitro chemotaxis assay, endothelial progenitor cells (EPCs) showed a trend towards increased migration in serum samples received from participants after xenon exposure ( p = 0.080). Conclusion: The present study presents first evidence about a xenon-induced effect on increased erythropoietin levels in healthy volunteers. The study was registered at the European Medicines Agency (EudraCT-number: 2014-000973-38) and at ClinicalTrials.gov (NCT number: 02129400). [ABSTRACT FROM AUTHOR]

Behavioral inhibition (BI) is a suspected precursor of selective mutism. However, investigations on early behavioral inhibition of children with selective mutism are lacking. Children aged 3-18 with lifetime selective mutism ( n = 109), social phobia ( n = 61), internalizing behavior ( n = 46) and healthy controls ( n = 118) were assessed using the parent-rated Retrospective Infant Behavioral Inhibition (RIBI) questionnaire. Analyses showed that children with lifetime selective mutism and social phobia were more inhibited as infants and toddlers than children of the internalizing and healthy control groups, who displayed similar low levels of behavioral inhibition. Moreover, behavioral inhibition was higher in infants with lifetime selective mutism than in participants with social phobia according to the Total BI score ( p = 0.012) and the Shyness subscale ( p < 0.001). Infant behavioral inhibition, particularly towards social stimuli, is a temperamental feature associated with a lifetime diagnosis of selective mutism. Results yield first evidence of the recently hypothesized temperamental origin of selective mutism. Children at risk should be screened for this debilitating child psychiatric condition. [ABSTRACT FROM AUTHOR]

Background: The increased cardiovascular morbidity of adults with late repair of aortic coarctation (CoA) has been well documented. In contrast, successful CoA repair in early childhood has a generally good prognosis, though adverse vascular and ventricular characteristics may be abnormal, which could increase long-term risk. This study sought to perform a comprehensive analysis of aortic elasticity and left ventricular (LV) function in patients with aortic coarctation (CoA) using cardiovascular magnetic resonance (CMR). In a subgroup of patients, we assessed structure and function of the common carotid arteries to probe for signs of systemic vascular remodeling. Methods: Fifty-one patients (median age 17.3 years), 13.9 ± 7.5 years after CoA repair, and 54 controls (median age 19.8 years) underwent CMR. We determined distensibility and pulse wave velocity (PWV) at different aortic locations. In a subgroup, common carotid artery distensibility, PWV, wall thickness and wall area were measured. LV ejection fraction (EF), volumes, and mass were measured from short axis views. Left atrial (LA) volumes and functional parameters (LAEFPassive, LAEFContractile, LAEFReservoir) were assessed from axial cine images. Results: In patients distensibility of the whole thoracic aorta was reduced (p < 0.05) while PWV was only significantly higher in the aortic arch (p < 0.01). Distensibility of the descending aorta at the level of the pulmonary arteries and PWV in the descending aorta, both correlated negatively with age at CoA repair. LA volume before atrial contraction and minimal LA volume were higher in patients (p < 0.05). LAEFPassive and LAEFReservoir were reduced (p < 0.05), and LAEFReservoir correlated negatively with aortic arch PWV (p < 0.05). LVEF, volumes and mass were not different from controls. Carotid wall thickness and PWV were higher in patients compared to controls (p < 0.05). Conclusions: Patients after CoA repair have impaired bioelastic properties of the thoracic aorta with impact on LV diastolic function. Reduced descending aortic elasticity is associated with older age at time of CoA repair. The remodeling of the common carotid artery in our sub-study suggests systemic vessel wall changes. [ABSTRACT FROM AUTHOR]

Introduction: Data evaluating mortality benefit from replacing sedentary time with physical activity are sparse. We explored reallocating time spent in sedentary behavior to physical activity of different intensities in relation to mortality risk. Methods: Women and men age 50-85 yr from the National Health and Nutrition Examination Survey 2003-2004 and 2005-2006 cycles with follow-up through December 31, 2011, were included. Sedentary time and physical activity were assessed using an ActiGraph accelerometer. Isotemporal substitution models were used to estimate the effect of replacing one activity behavior with another activity behavior for the same amount of time while holding total accelerometer wear time constant. Results: During a mean follow-up of 6.35 yr, 697 deaths from any cause occurred. Replacing 30 min of sedentary time with an equal amount of light activity was associated with 14% reduced risk of mortality (multivariable-adjusted hazard ratio (HR), 0.86; 95% confidence interval (CI), 0.83-0.90). Replacement of sedentary time with moderate to vigorous activity was related to 50% mortality risk reduction (HR, 0.50; 95% CI, 0.31-0.80). We also noted a 42% reduced risk of mortality when light physical activity was replaced by moderate to vigorous activity (HR, 0.58; 95% CI, 0.36-0.93). Conclusion: Replacing sedentary time with an equal amount of physical activity may protect against preterm mortality. Replacement of light physical activity with moderate to vigorous activity is also associated with protection from premature mortality. [ABSTRACT FROM AUTHOR]

Objectives: even though a great number of research studies have shown that high education has protective effects against dementia, some studies did not observe such a significant effect. In that respect, the aim of our study was to investigate and compare various operationalisation approaches of education and how they impact dementia risk within one sample. Methods: data were derived from the Leipzig longitudinal study of the aged (LEILA75+). Individuals aged 75 and older underwent six cognitive assessments at an interval of 1.5 years and a final follow-up 15 years after the baseline assessment. We operationalised education according to different approaches used in previous studies and analysed the impact on dementia incidence via multivariate cox regression modelling. Results: the results showed that whether education is identified as significant protector against dementia strongly depends on the operationalisation of education. Whereas the pure number of years of education showed statistically significant protective effects on dementia risk, other more complex categorical classification approaches did not. Moreover, completing >10 years of education or a tertiary level seems to be an important threshold to significantly reduce dementia risk. Conclusion: findings suggest a protective effect of more years of education on a lower dementia risk with a particular critical threshold of completing >10 years of education. Further, the findings highlight that, when examining risks and protective factors of dementia, a careful consideration of the underlying definitions and operationalisation approaches is required. [ABSTRACT FROM AUTHOR]

Background: Long axis strain (LAS) has been shown to be a fast assessable parameter representing global left ventricular (LV) longitudinal function in cardiovascular magnetic resonance (CMR). However, the prognostic value of LAS in cardiomyopathies with reduced left ventricular ejection fraction (LVEF) has not been evaluated yet. Methods and results: In 146 subjects with non-ischemic dilated cardiomyopathy (NIDCM, LVEF =45 %) LAS was assessed retrospectively from standard non-contrast SSFP cine sequences by measuring the distance between the epicardial border of the left ventricular apex and the midpoint of a line connecting the origins of the mitral valve leaflets in end-systole and end-diastole. The final values were calculated according to the strain formula. The primary endpoint of the study was defined as a combination of cardiac death, heart transplantation or aborted sudden cardiac death and occurred in 24 subjects during follow-up. Patients with LAS values > -5 % showed a significant higher rate of cardiac events independent of the presence of late gadolinium enhancement (LGE). The multivariate Cox regression analysis revealed that LVEDV/BSA (HR: 1.01, p < 0.05), presence of LGE (HR: 2.51, p < 0.05) and LAS (HR: 1.28, p < 0.05) were independent predictors for cardiac events. In a sequential cox regression analysis LAS offered significant incremental information (p < 0.05) for the prediction of outcome in addition to LGE and LVEDV/BSA. Using a dichotomous three point scoring model for risk stratification, including LVEF <35 %, LAS > -10 % and the presence of LGE, patients with 3 points had a significantly higher risk for cardiac events than those with 2 or less points. Conclusion: Assessment of long axis function with LAS offers significant incremental information for the prediction of cardiac events in NIDCM and improves risk stratification beyond established CMR parameters. [ABSTRACT FROM AUTHOR]

Primary care physicians (PCPs) play a key role in the initial assessment and management of children and adolescents with mental health problems. However, it is unclear whether current medical education curricula sufficiently equip PCPs for this task. The aim of this study was to investigate, which child and adolescent psychiatry (CAP)-related skills and knowledge PCPs say they require in their daily practice. A questionnaire was generated, employing a modified two-step Delphi approach. Besides socio-demographic items, the questionnaire contained 17 CAP-related knowledge items and 13 CAP-related skills items, which had to be rated by importance in daily practice. The questionnaire was distributed to 348 office-based paediatricians and 500 general practitioners (GPs) in Germany. The overall return rate was 51.3 % (435/848). Regarding CAP-related knowledge, both paediatricians and GPs rated somatoform disorders and obesity as highly important for daily practice. Moreover, paediatricians also deemed regulatory disorders during infancy (e.g. crying, sleep disorders) as important, while GPs assessed knowledge on paediatric depression as relevant. For paediatricians and GPs, the most relevant CAP-related skills were communicating with children and adolescents and their parents. Additionally, paediatricians rated differentiating between non-pathologic and clinically relevant behaviour problems very relevant, while GPs considered basic psychotherapeutic skills essential. The CAP-related knowledge and skills perceived relevant for doctors in primary care differ from the majority of current medical school CAP curricula, which cover mainly typical, epitomic CAP disorders and are predominantly knowledge-oriented. Therefore, medical education in CAP should be amended to reflect the needs of PCPs to improve healthcare for children and adolescents with mental health problems. [ABSTRACT FROM AUTHOR]

Purpose: Unmetabolized folic acid (UMFA) is common in serum of elderly individuals receiving folic acid (FA)-fortified foods or supplements. We studied the effect of supplementing FA or B-complex on serum concentrations of (6 S)-5-methyltetrahydropteroylglutamate [(6S)-5-CH-HPte] and UMFA in elderly people and explored factors associated with detectable UMFA post-supplementation. Methods: This is a randomized single-blind non-controlled trial on 58 elderly people using daily 400 µg FA ( n = 31) or 400 µg FA, 10 µg cyanocob(III)alamin and 8 mg pyridoxine ( n = 27) for a median of 23 days. Main outcome includes changes in concentrations of serum (6S)-5-CH-HPte and UMFA. Results: Total homocysteine declined by a median of 1.6 ( p = 0.074) in the FA and 1.3 µmol/L ( p = 0.009) in the B-complex arms ( p = 0.66 between the arms). Serum (6S)-5-CH-HPte significantly ( p < 0.001 vs. baseline) increased by a median of 9.2 and 6.5 nmol/L in the FA and B-complex groups, respectively ( p = 0.152 between the groups). Compared to FA, B-complex reduced cystathionine and caused lower post-intervention serum UMFA, percentage of UMFA to (6S)-5-CH-HPte and prevalence of UMFA ≥ 0.21 nmol/L. Higher serum cystathionine and whole-blood folate predicted higher post-intervention serum UMFA. Conclusions: FA caused higher UMFA as compared to B-complex. Pyridoxine appears to improve folate recycling. Data on serum UMFA should be interpreted in relation to other vitamins involved in folate metabolism. Serum UMFA is suggested to play a sensory role through which the cell recognizes FA available for metabolism via dihydrofolate reductase. [ABSTRACT FROM AUTHOR]

Objectives: Although age-related differences in planning ability are well known, their cognitive foundations remain a matter of contention. To elucidate the specific processes underlying planning decrements in older age, the relative contributions of fluid reasoning, working memory (WM) capacity, and processing speed to accuracy on the Tower of London (TOL) planning task were investigated. Method: Mediation analyses were used to relate overall and search depth-related TOL accuracy from older (N = 106; 60-89 years) and younger adults (N = 69; 18-54 years) to age and measures of fluid reasoning, WM capacity, and speed. Results: For overall planning, fluid abilities mediated the effects of age, WM capacity, and speed in older adults. By contrast, fluid abilities and WM capacity mediated each other in younger adults. For planning accuracy under low demands on the depth of search, WM capacity was specifically important in older age, whereas younger adults recruited both WM capacity and fluid reasoning. Under high search-depth-demands, fluid abilities underlay the cognitive operations critical for resolving move interdependencies in both age groups. Discussion: Fluid abilities and WM capacity undergo significant changes from younger to older age in their unique contribution to planning, which might represent a mechanism whereby planning decrements in older age are brought about. [ABSTRACT FROM AUTHOR]

Interference Frisian (IF) is a variety of Frisian, spoken by mostly younger speakers, which is heavily influenced by Dutch. IF exhibits all six logically possible word orders in a cluster of three verbs. This phenomenon has been researched by Koeneman and Postma (2006), who argue for a parameter theory, which leaves frequency differences between various orders unexplained. Rejecting Koeneman and Postma’s parameter theory, but accepting their conclusion that Dutch (and Frisian) data are input for the grammar of IF, we will argue that the word order preferences of speakers of IF are determined by frequency and similarity. More specifically, three-verb clusters in IF are sensitive to: their linear left-to-right similarity to two-verb clusters and three-verb clusters in Frisian and in Dutch; the (estimated) frequency of two- and three-verb clusters in Frisian and Dutch. The model will be shown to work best if Dutch and Frisian, and two- and three-verb clusters, have equal impact factors. If different impact factors are taken, the model’s predictions do not change substantially, testifying to its robustness. This analysis is in line with recent ideas that the sequential nature of human speech is more important to syntactic processes than commonly assumed, and that less burden need be put on the hierarchical dimension of syntactic structure. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:182-187). [ABSTRACT FROM AUTHOR]

Existing cross-sectional research considers citizens' preferences for radical right-wing populist (RRP) parties to be centrally driven by their perception that immigrants threaten the well-being of the national ingroup. However, longitudinal evidence for this relationship is largely missing. To remedy this gap in the literature, we developed three competing hypotheses to investigate: (a) whether perceived group threat is temporally prior to RRP party preferences, (b) whether RRP party preferences are temporally prior to perceived group threat, or (c) whether the relation between perceived group threat and RRP party preferences is bidirectional. Based on multiwave panel data from the Netherlands for the years 2008–2013 and from Germany spanning the period 1994–2002, we examined the merits of these hypotheses using autoregressive cross-lagged structural equation models. The results show that perceptions of threatened group interests precipitate rather than follow citizens' preferences for RRP parties. These findings help to clarify our knowledge of the dynamic structure underlying RRP party preferences. [ABSTRACT FROM AUTHOR]

Integrating the perspectives of psychological contract and sex differences, this study examines how organizational decision to reduce labour costs influences employees' perceived psychological contract breach and their commitment to their organizations. Using two experiments, we found three-way interaction effects among the decision to reduce labour costs, employee sex, and the managerial control over the decision. The decision of labour costs reduction leads to stronger feelings of psychological contract breach for females when the decision is in low than in high levels of managerial control, but the same decision leads to stronger psychological contract breach for males when the decision is in high than in low levels of managerial control. Furthermore, the indirect effect of labour costs reduction on employees' organizational commitment through psychological contract breach is also contingent upon the interaction between employee sex and managerial control. Our findings expand the literature of psychological contract and shed light on timely practical issues of management's decisions regarding labour costs reduction. Practitioner points Labour costs reductions in economic downturns lead to different responses from employees, and managers are advised to plan their actions bearing in mind such differences., Management in crisis or difficulties calls for more delicate considerations of employees' psychological feelings towards the organization., Nuanced empirical evidence informs us about the different needs and responses of a diverse group of employees and how their responses contradict. [ABSTRACT FROM AUTHOR]

Objective: The value of optimal timing of tracheostomy in patients with subarachnoid hemorrhage is controversially debated. This study investigates whether early or late tracheostomy is associated with beneficial outcome or reduced rates of adverse events.Design: Retrospective observational multicentric on patients prospectively inserted into a database.Setting: Neurologic ICUs of one academic hospital and two secondary hospitals in Germany.Patients: Data of all patients admitted to the Goethe University Hospital between 2006 and 2011 with poor-grade subarachnoid hemorrhage were prospectively entered into a database. All patients who underwent tracheostomy were included for analysis. Follow-up was maintained in primary and secondary ICUs.Interventions: Patients underwent tracheostomy upon expected long-term ventilation. Early tracheostomy was defined as performed on days 1-7 and late tracheostomy on days 8-20 after admission.Measurement and Main Results: We compared 148 consecutive patients admitted with poor-grade (World Federation of Neurosurgical Societies, 3-5) subarachnoid hemorrhage. Early tracheostomy was performed in 39 patients and late tracheostomy in 109 patients. In early versus late tracheostomy groups, no significant differences were observed with regard to ICU mortality (7.7% vs 7.3%; p=0.93) and median modified Rankin Scale after 6 months (3 vs 3; p=0.94). Of the early group, pneumonia developed in 19 patients, whereas in the late group, pneumonia developed in 75 patients (48.7% vs 68.8%; p=0.03; odds ratio, 2.32; 95% CI, 1.1-4.9). Six patients of the early group (15.4%) and 36 patients of the late group (33%) suffered from respiratory adverse event (p=0.04; odds ratio, 2.71; 95% CI, 1.04-7.06). Mechanical ventilation was shorter (17.4 vs 22.3 d; p<0.05) and decannulation occurred earlier (42 vs 54 d; p=0.039) in the early tracheostomy group.Conclusions: Tracheostomy within 7 days of critical care admission is a feasible and safe procedure for patients with poor-grade subarachnoid hemorrhage. Early tracheostomy was not associated with an improvement in mortality or neurologic outcome but associated with fewer respiratory adverse events. [ABSTRACT FROM AUTHOR]

Much work has been carried out on sexist attitudes, but only little on sexist behaviors. The goal of the present research was to close this gap by testing how a variety of benevolent and hostile sexist behaviors correlate with implicit and explicit sexist attitudes. In Study 1 ( N = 126), we developed implicit association tests for benevolent sexism and hostile sexism and illustrated that implicit and explicit benevolent sexist beliefs, as well as implicit and explicit hostile sexist beliefs, were positively correlated. In Study 2 ( N = 83 of Study 1), we tested whether implicit and explicit benevolent and hostile sexist attitudes correlate with benevolent and hostile sexist behaviors. As expected, explicit benevolent (but not hostile) sexist attitudes predicted benevolent sexist behavior, whereas explicit hostile (but not benevolent) sexist attitudes predicted hostile sexist behavior. Implicit sexist attitudes did not predict sexist behavior. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

The article presents a research on the knowledge of nurses and physicians in unsuitable drug that is not prescribe to patients with dysphagia or feeding tubes. It discusses data collection and knowledge to the case of patient with dysphagia or feeding tubes where data analysis are presented to assess self-estimated knowledge with the use of drug given to patients.

Although playing a crucial role for the prevention of long-term health impairment, interventions aiming at the improvement of employees' recovery processes are still scarce. In this study, we therefore investigated the effectiveness of a low-dose mindfulness intervention for recovery from work. In addition, differential responding to the treatment in terms of treatment-by-baseline interactions was studied. A sample of 140 employees participated in a randomized field experiment with a self-training and a wait-list control group. Three central recovery processes (psychological detachment, sleep quality, and sleep duration) were assessed with event-sampling methodology involving daily measurements over 10 workdays. Growth curve analyses revealed intervention effects on sleep quality and sleep duration. No effects were found for psychological detachment after work and for the proposed treatment-by-baseline interactions. Our findings are discussed in the context of occupational health promotion in general and mindfulness-based interventions in specific. Practitioner points Although daily recovery from the demands of work has been shown to be vital for employee well-being and performance, research on how workplace interventions can help improve recovery is still scarce., This study investigated the effectiveness of a brief, economic mindfulness intervention on processes that are vital for recovery - psychological detachment, sleep quality, and sleep duration., Findings revealed positive effects of the intervention on sleep quality and duration, but not on psychological detachment. [ABSTRACT FROM AUTHOR]

Background: Continuity of care is important for outcomes and patient satisfaction and includes additional considerations in the context of cross-border health care. Although this has been discussed in research and was picked up in the recently transposed Directive on patients' rights (2011/24/EU), there is limited evidence about related issues actually encountered by patients crossing borders. Methods: An anonymous postal survey was carried out by the Techniker Krankenkasse, one of the largest sickness funds in Germany. The questionnaire was sent to 45 189 individuals who had received treatment in EU/EEA countries and included items on relational, management and informational continuity. Results: The survey had a response rate of 41% (n = 17 543). Of those respondents who had travelled for care (n = 3307), ∼19% (n = 570) did so due to a relationship of trust with a given provider. Only 8% of all respondents required emergency follow-up services due to complications, the majority of which was obtained back in Germany. Twelve percentage of those who were prescribed medication abroad (n = 4208) reported problems, spanning unknown products, dispensation and reimbursement. Information exchange between providers across borders was rare and largely carried out by the patients themselves. Conclusions: Although relational continuity may be important to specific groups of patients travelling for care, it is primarily informational continuity and its interrelation with management continuity that need to be addressed in the cross-border context. Information exchange should be endorsed at European level. Additional focus is required on informing patients about documentation rights and requirements and providing health records that are comprehensive and comprehensible. [ABSTRACT FROM AUTHOR]

Background: Considering the suggested link between vitamin D insufficiency and several chronic diseases, attention should be given to approaches for improving vitamin D status. Elderly subjects are regarded as a high-risk group for developing an insufficient vitamin D status. Socioeconomic, dietary, lifestyle and environmental factors are considered as influencing factors, whereupon sex differences in predictors of vitamin D status are rarely investigated. The purpose of this study is to identify the main predictors of serum 25-hydroxyvitamin D3 [25(OH)D3] concentrations in elderly subjects by taking into account potential sex differences. Methods: This is a cross-sectional study in 162 independently living German elderly aged 66 to 96 years. Serum 25(OH)D3 concentrations were assessed by an electrochemiluminescence immunoassay. Multiple regression analyses were performed to identify predictors of 25(OH)D3 concentrations stratified by sex. Results: Median 25(OH)D3 concentration was 64 nmol/L and none of the subjects had 25(OH)D3 concentrations < 25 nmol/L. In women, intact parathyroid hormone (iPTH) (β = -0.323), % total body fat (β = -0.208), time spent outdoors (β = 0.328), month of blood sampling (β = 0.229) and intake of vitamin D supplements (β = 0.172) were the predominant predictors of 25(OH)D3, whereas in men, iPTH (β = -0.254), smoking (β = -0.282), physical activity (β = 0.336) and monthly household net income (β = 0.302) predicted 25 (OH)D3 concentrations. The final regression models accounted for 30% and 32% of the variance in 25(OH)D3 concentrations in women and men, respectively. Conclusion: The findings indicate that 25(OH)D3 concentrations are influenced by body composition, month of blood sampling, economic factors, lifestyle, supplement intake and iPTH, but may not be associated with age, sex, dietary factors, kidney function and presence of selected chronic diseases in community-dwelling elderly. Furthermore, our results provide evidence for sex-specific determinants of the vitamin D status, which ought to be considered for preventive strategies. [ABSTRACT FROM AUTHOR]

Objectives Spondyloarthritis ( Sp A) is one of the most frequently observed inflammatory joint diseases in HIV-1-seropositive patients. T-cells were described frequently as one of the major driving forces in SpA, therefore we tried to look for T-cell aberrancies in our HIV-positive patients with SpA. Methods A total of 1098 files for HIV-positive patients who attended the HIV out-patient clinic of the Department of Clinical Immunology and Rheumatology at the Medical University Hanover for at least one visit between January 2004 and December 2010 were screened for the presence of a diagnosis of Sp A. A cross-sectional study was conducted to investigate aberrancies in T-cell homeostasis induced by HIV-1 in these subjects. Results The prevalence of Sp A in the HIV-positive patients was 1.6% (18 of 1098). Interestingly, the percentage of patients with Sp A who were human leucocyte antigen ( HLA)- B27 negative in our HIV-positive cohort was 80%. Despite combination antiretroviral therapy (c ART) and viral suppression, an incomplete immune recovery of T-cell naïve/memory distribution and turnover, as identified by intracellular Ki-67 expression, was observed in HIV-positive patients with Sp A. Conclusions Independent of HLA- B27 status and despite c ART, HIV-positive patients can develop Sp A and exhibit an increased T-cell turnover rate. [ABSTRACT FROM AUTHOR]

There is a lack of injury data for the population of veteran football players. Therefore, a prospective study was conducted to investigate injury incidences and characteristics. Over one season, injuries and exposure of 18 teams (n = 265 players, age: 44.2±7.3 years, BMI: 26.6±3.2 kg/m2) were documented. Sixty-three players sustained a total of 88 injuries during the season. The incidence of training injuries (4.5 per 1000 hours) was significantly lower than of match injuries (24.7 per 1000 hours). The majority of injuries (n = 73; 83%) were located at the lower extremities, 52 (47%) were muscle injuries. The injury incidence of veteran football players is similar to other male football players of different skill levels and age groups, indicating a need for the implementation of preventive measures. Prevention programmes should consider the specific injury characteristics, with more muscle injuries in this population compared with younger football players. [ABSTRACT FROM AUTHOR]

Objective To correlate the amount and types of pain medications prescribed to CRPS patients, using the Medication Quantification Scale, and patients' subjective pain levels. Design An international, multisite, retrospective review. Setting University medical centers in the United States, Israel, Germany, and the Netherlands. Subjects/Methods A total of 89 subjects were enrolled from four different countries: 27 from the United States, 20 Germany, 18 Netherlands, and 24 Israel. The main outcome measures used were the Medication Quantification Scale III and numerical analog pain scale. Results There was no statistically significant correlation noted between the medication quantification scale and the visual analog scale for any site except for a moderate positive correlation at German sites. The medication quantification scale mean differences between the United States and Germany, the Netherlands, and Israel were 9.793 ( P < 0.002), 10.389 ( P < 0.001), and 4.984 ( P = 0.303), respectively. Conclusions There appears to be only a weak correlation between amount of pain medication prescribed and patients' reported subjective pain intensity within this limited patient population. The Medication Quantification Scale is a viable tool for the analysis of pharmaceutical treatment of CRPS patients and would be useful in further prospective studies of pain medication prescription practices in the CRPS population worldwide. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnoea (OSA) has interdependently been related to the onset and progression of a large portion of atherosclerotic cardiovascular disorders. In due consideration of OSA-mediated endothelial dysfunction, its impact on peripheral artery disease is conceivable, but undefined. Objectives: The aim of this study was to identify the prevalence of OSA in a lower extremity artery disease (LEAD) study population. Methods: A total of 91 patients receiving in- and outpatient treatment for LEAD were included in this prospectively conducted trial. In addition to an angiological examination, all patients underwent nocturnal screening for sleep-disordered breathing by use of SOMNOcheck micro® (SC micro) and - depending on the results obtained - polysomnography. Results: Patients were principally late middle-aged (69.3 ± 10.8 years), male (71.4%) and slightly overweight (BMI 26.8 ± 3.9). Overnight screening determined a sleep apnoea prevalence of 78.0%, of which 90.1% exhibited a predominantly obstructive genesis. The mean apnoea-hypopnoea index (AHI; events/h) and oxygen desaturation index (events/h) averaged 11.8 ± 13.4 and 8.9 ± 14.2, respectively. The individual AHI categories of non-pathological (<5), mild (5 to <15), moderate (15 to <30) and severe sleep apnoea (≥30) accounted for 22.0, 59.3, 13.2 and 5.5%, respectively. A distributive examination of AHI within LEAD severity groups evinced a significant association (p = 0.047). In cases of at least moderate sleep apnoea (AHI ≥15) polysomnography was performed (n = 17, 18.7% of the whole collective). Correlative analysis revealed a significant correlation between values obtained by SC micro recording and polysomnography, establishing the diagnostic accuracy of the screening results. Conclusions: OSA exhibits an important prevalence of 70.3% in LEAD patients with prior undiagnosed sleep-disordered breathing, indicating major OSA unawareness in this cardiovascular cohort. However, the impact of OSA treatment on LEAD propagation remains to be determined. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Considering the suggested link between vitamin D insufficiency and several chronic diseases, attention should be given to approaches for improving vitamin D status. Elderly subjects are regarded as a high-risk group for developing an insufficient vitamin D status. Socioeconomic, dietary, lifestyle and environmental factors are considered as influencing factors, whereupon sex differences in predictors of vitamin D status are rarely investigated. The purpose of this study is to identify the main predictors of serum 25-hydroxyvitamin D3 [25(OH)D3] concentrations in elderly subjects by taking into account potential sex differences. Methods: This is a cross-sectional study in 162 independently living German elderly aged 66 to 96 years. Serum 25(OH)D3 concentrations were assessed by an electrochemiluminescence immunoassay. Multiple regression analyses were performed to identify predictors of 25(OH)D3 concentrations stratified by sex. Results: Median 25(OH)D3 concentration was 64 nmol/L and none of the subjects had 25(OH)D3 concentrations < 25 nmol/L. In women, intact parathyroid hormone (iPTH) (β = −0.323), % total body fat (β = −0.208), time spent outdoors (β = 0.328), month of blood sampling (β = 0.229) and intake of vitamin D supplements (β = 0.172) were the predominant predictors of 25(OH)D3, whereas in men, iPTH (β = −0.254), smoking (β = −0.282), physical activity (β = 0.336) and monthly household net income (β = 0.302) predicted 25 (OH)D3 concentrations. The final regression models accounted for 30% and 32% of the variance in 25(OH)D3 concentrations in women and men, respectively. Conclusion: The findings indicate that 25(OH)D3 concentrations are influenced by body composition, month of blood sampling, economic factors, lifestyle, supplement intake and iPTH, but may not be associated with age, sex, dietary factors, kidney function and presence of selected chronic diseases in community-dwelling elderly. Furthermore, our results provide evidence for sex-specific determinants of the vitamin D status, which ought to be considered for preventive strategies. [ABSTRACT FROM AUTHOR]

Objectives The diagnosis of extrapulmonary tuberculous infections and nontuberculous mycobacterial ( NTM) infections is difficult because the symptoms are nonspecific and suitable specimens for bacterial culture are often not available. Recent publications reported the existence of autoantibodies in tuberculous infections. We screened for specific autoantibodies in mycobacterial infections. Methods We screened four in 29 patients with active mycobacterial infections and different controls using protein array technology. We could identify autoantibodies against ubiquitin-fold modifier-conjugating enzyme 1 ( Ufc1) and pleckstrin homology domain containing, family G (with Rho Gef domain) member 2 ( Plekhg2) in all four patients. Subsequently, we designed enzyme-linked immunosorbent assays ( ELISAs) for the detection of autoantibodies binding to Ufc1 and Plekhg2. Results Autoantibodies binding to Ufc1 and Plekhg2 were found in 19 of 29 patients (66%) with active mycobacterial infections. In comparison, we found these autoantibodies in one of 31 patients (3%) with successfully treated mycobacterial infections, in three of 40 (8%) HIV-infected patients not receiving combination antiretorviral therapy ( cART) and in six of 134 (5%) blood donors. Interestingly, six of eight (75%) patients with HIV-associated B-cell non-Hodgkin lymphoma ( B- NHL) at the onset of disease had autoantibodies against Ufc1 and Plekhg2, but none of nine (0%) patients after treatment of HIV-associated B- NHL, none of seven patients with non- HIV-associated B- NHL and 11 of 115 (10%) patients with other malignant diseases had autoantibodies against both proteins. Conclusions In view of the high frequency of these autoantibodies, we postulate that they might be of potential use for additional diagnostics for mycobacterial infections, and further studies may shed light on the pathomechanisms of these two autoantibodies. [ABSTRACT FROM AUTHOR]

Data on medical treatment of children and adolescents with tic disorders are scarce. This study examined the administrative prevalence of psychopharmacological prescriptions in this patient group in Germany. Data of the largest German health insurance fund were analysed. In outpatients aged 0-19 years with diagnosed tic disorder, psychotropic prescriptions were evaluated for the years 2006 and 2011. In 2011, the percentage of psychotropic prescriptions was slightly higher than in 2006 (21.2 vs. 18.6 %). The highest prescription prevalence was found in Tourette syndrome (51.5 and 53.0 %, respectively). ADHD drugs were most frequently prescribed, followed by antipsychotics. In 2011, prescriptions of second generation antipsychotics (SGA) were higher and prescriptions of first generation antipsychotics (FGA) lower than in 2006. Concerning prescribed antipsychotic substances, in 2011 risperidone prescriptions were higher and tiapride prescriptions lower. Paediatricians issued 37.4 %, and child and adolescent psychiatrists issued 37.1 % of psychotropic prescriptions. The FGA/SGA ratio was highest in GPs (1.25) and lowest in child and adolescent psychiatrists (0.96). From 2006 to 2011, there was only a slight increase in psychotropic prescriptions for children and adolescents with a diagnosis of tic disorder in Germany, which stands in contrast towards the significant increase in psychotropic prescriptions in other child and adolescent psychiatric disorders (e.g. ADHD). There were marked differences in treatment patterns by tic disorder subgroups, with Tourette syndrome patients receiving most frequently psychopharmacotherapy. Risperidone prescriptions increased, probably reflecting a switch in prescribing practice towards up-to-date treatment guidelines. In primary care physicians, dissemination of current tic disorder treatment guidelines might constitute an important educational goal. [ABSTRACT FROM AUTHOR]

Purpose: Coffee consumption has been reported to decrease oxidative damage in peripheral white blood cells (WBC). However, effects on the level of spontaneous DNA strand breaks, a well established marker of health risk, have not been specifically reported yet. We analyzed the impact of consuming a dark roast coffee blend on the level of spontaneous DNA strand breaks. Methods: Healthy men ( n = 84) were randomized to consume daily for 4 weeks either 750 ml of fresh coffee brew or 750 ml of water, subsequent to a run in washout phase of 4 weeks. The study coffee was a blend providing high amounts of both caffeoylquinic acids (10.18 ± 0.33 mg/g) and the roast product N-methylpyridinium (1.10 ± 0.05 mg/g). Before and after the coffee/water consumption phase, spontaneous strand breaks were determined by comet assay. Results: At baseline, both groups exhibited a similar level of spontaneous DNA strand breaks. In the intervention phase, spontaneous DNA strand breaks slightly increased in the control (water only) group whereas they significantly decreased in the coffee group, leading to a 27 % difference within both arms ( p = 0.0002). Food frequency questionnaires indicated no differences in the overall diet between groups, and mean body weight during the intervention phases remained stable. The consumption of the study coffee substantially lowered the level of spontaneous DNA strand breaks in WBC. Conclusion: We conclude that regular coffee consumption contributes to DNA integrity. [ABSTRACT FROM AUTHOR]

The article discusses the concept of gender role strain paradigm in masculinity ideology. Topics mentioned include relationship between masculinity ideology and psychological strain for men in female-dominated occupations, increased stressors experienced by men adherent to masculinity ideology, and behaviors associated with masculinity ideology including avoiding appearing feminine, demonstrating heterosexuality, and not displaying strong emotions.

The article presents research which discussed the use of subchondral drilling as an established marrow stimulation approach. Topics covered include the importance of osteochondral repair to enhance the condition of the subchondral bone as well as perforation of the bone with small drill holes to address articular cartilage defects. Also mentioned is the need for marrow stimulation to support bone-cutting devices.

Children can represent events in our everyday life in both non-linguistic and linguistic formats. We aimed to investigate whether non-linguistic representations are changed once children acquire their linguistic counterparts. In the present study, we explored whether and how language changes the perception of simple means-end actions using an eye-tracking paradigm. Children between 12 and 24 months of age heard a sentence containing a verb and subsequently watched an action video. Results show an interfering influence of language on action perception at 12 months and a facilitating influence at 24 months. However, this was only the case for verbs that are already in the toddlers' productive vocabulary but not for those that are acquired later. Taken together, the results suggest that a communication between non-linguistic and linguistic representations starts early and develops in the second year of life. The successful facilitatory influence depends on the productive repertoire of the language in question. [ABSTRACT FROM AUTHOR]