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We compared characteristics of HIV diagnosis and recent HIV infection (ie, likely acquired within the last year) in Cambodia. We included individuals ≥ 15 years old accessing HIV testing. From August 2020 to August 2022, 53 031 people were tested for HIV, 6868 were newly diagnosed, and 192 were recently infected. We found differences in geographical burden and risk behaviors with diagnosis and recency (eg, men who have sex with men, transgender women, and entertainment workers had a nearly 2-fold increased odds of testing positive for recent infection compared to being diagnosed with HIV). Recent infection surveillance may provide unique insights into ongoing HIV acquisition to inform programs.

What is already known about this topic? A novel HIV infection surveillance initiative was implemented in Malawi to collect data on recent HIV infections among new diagnoses to characterize the epidemic and guide the public health response. What is added by this report? Higher proportions of recent infections were identified among females, persons aged

Background The extent to which vaccinated persons diagnosed with coronavirus disease 2019 (COVID-19) can transmit to other vaccinated and unvaccinated persons is unclear. Methods Using data from the San Francisco Department of Public Health, this report describes outcomes of household contact tracing during 29 January–2 July 2021, where fully vaccinated patients with COVID-19 were the index case in the household. Results Among 248 fully vaccinated patients with breakthrough infections, 203 (82%) were symptomatic and 105 were identified as the index patient within their household. Among 179 named household contacts, 71 (40%) contacts tested, over half (56%) were fully vaccinated and the secondary attack rate was 28%. Overall transmission from a symptomatic fully vaccinated patient with breakthrough infection to household contacts was suspected in 14 of 105 (13%) of households. Viral genomic sequencing of samples from 44% of fully vaccinated patients showed that 82% of those sequenced were infected by a variant of concern or interest and 77% by a variant carrying mutation(s) associated with resistance to neutralizing antibodies. Conclusions Transmission from fully vaccinated symptomatic index patients to vaccinated and unvaccinated household contacts can occur. Indoor face masking and timely testing of all household contacts should be considered when a household member receives a positive test result in order to identify and interrupt transmission chains.

Zusammenfassung. Zielsetzung: Von 2017 bis 2020 wurde in Niedersachsen das Projekt „re:set! – Beratung bei exzessivem Medienkonsum“ durchgeführt. Der Beitrag adressiert die Inanspruchnahme des Beratungsangebots, die Soziodemographie und die präferierten Anwendungen der Betroffenen sowie die Prävalenz von Internetnutzungsstörungen (INS) in dieser Gruppe. Methodik: Inanspruchnahme und Soziodemographie der Betroffenen wurden anhand eines Dokumentationsbogens erhoben. Die Kurzform der „Assessment for Internet and Computer Game Addiction Scale“ diente der Erhebung der Symptome einer INS. Ergebnisse: 90,2 % der 1053 beratungsaufsuchenden Personen waren männlich, das mittlere Alter lag bei 21.65 Jahren. Mit 49,3 % wurden Online-Spiele am häufigsten genutzt. Online-Spiele/-Erotikangebote wurden eher von männlichen, Online-Kaufportale/-Communities eher von weiblichen Betroffenen genutzt. Bei 64,6 % der Betroffenen zeigten sich Hinweise auf eine INS. Schlussfolgerungen: Suchtberatungsstellen können erste Anlaufstellen für Menschen mit exzessivem Medienkonsum oder INS und deren Angehörige sein.

Zusammenfassung Ziel Häufig sind Suchtberatungsstellen erster Anlaufpunkt für Betroffene mit exzessivem Medienkonsum und internetbezogenen Störungen (IBS) sowie deren Angehörige. Aktuell ist das Suchthilfenetzwerk bezogen auf IBS weder flächendeckend, noch sind alle Fachstellen ausreichend auf diese Klientel vorbereitet. Das Projekt „re:set! – Beratung bei exzessivem Medienkonsum“ sollte dazu beitragen, diese Versorgungslücke in Niedersachsen zu schließen. Zudem wurden Empfehlungen zur Implementierung eines Beratungsangebots bei exzessivem Medienkonsum und IBS erarbeitet. Methodik Für die Erstellung der Empfehlungen wurde ein Mixed-Methods-Vorgehen gewählt. Zunächst wurden halbstrukturierte Interviews mit 8 Themenblöcken durchgeführt und inhaltsanalytisch anhand deduktiver Kategorienbildung ausgewertet. Die Kategorien wurden in einem ExpertInnenworkshop diskutiert. Anschließend wurden Aussagen zur Beratung bei exzessivem Medienkonsum generiert. Die am Projekt beteiligten Fachkräfte sowie deren Fachstellenleitungen wurden in einem Online-Survey gebeten, das Ausmaß an Zustimmung zu jeder Aussage anzugeben. Ergebnisse Den 8 Themenblöcken des halb-strukturierten Interviews konnten 26 deduktive Kategorien zugeordnet werden. Für den Online-Survey wurden 99 Aussagen generiert. Davon richteten sich 50 an sowohl Fachkräfte als auch deren Vorgesetzte. Weitere 49 Aussagen waren ausschließlich für die Fachkräfte relevant. Basierend auf den Ergebnissen wurden in einem iterativen Prozess 13 Implementierungsempfehlungen erarbeitet. Schlussfolgerung Angesichts der unzureichenden Versorgung von Menschen mit exzessivem Medienkonsum und IBS sind Projekte wie re:set! notwendig, um Fachkräfte der Suchthilfe zu unterstützen, notwendige Kompetenzen zu vermitteln sowie ein flächendeckendes professionelles Netzwerk aufzubauen. Die Empfehlungen zur Implementierung können beim Etablieren und Verstetigen eines entsprechenden Beratungsangebots hilfreich sein.

The impact of memory loss on the self in Alzheimer's disease (AD) is poorly understood. Previous research is mixed on whether episodic or semantic memories are most important for supporting identity. The present study examined autobiographical memories cued by self-images (e.g., I am a father) and non-self-related cues in 16 AD patients and 29 healthy older adults. The AD group generated fewer self-images and memories compared to controls, but demonstrated similar temporal organization of self-cued memories. In both groups, self-images were supported by semantic memories that were temporally clustered around times of identity-formation. These self-supporting memories are proposed to form a scaffold to support the self and may persist the longest in AD, as opposed to memories from early adulthood per se. In both AD and control groups, self-images cued more semantic memories than non-self-relevant cues, further suggesting that semantic autobiographical memories play a fundamental role in supporting the self. These findings demonstrate that the self remains largely intact in AD, in spite of severe episodic memory deficits and global cognitive decline. In later stages of the disease, these self-supporting memories could provide effective tools for reminiscence therapy.

International audience

We evaluated the impact of language concordance—clinician or public health worker fluency in a patient’s primary language—on coronavirus disease 2019 (COVID-19) contact tracing outcomes among 2668 Spanish-speaking adults in San Francisco. Language concordance was associated with 20% greater odds of COVID-19 testing and 53% greater odds of support service referrals.

To effectively control the spread of COVID-19, it is essential that all jurisdictions have the capacity to rapidly contact trace all close contacts of each and every case. We describe the early experience in the City and County of San Francisco, where contact tracing capability was rapidly expanded to respond to COVID-19. Important prerequisites to scale up included rapid expansion of the COVID-19 contact tracing workforce, a comprehensive training and onboarding program, and the institution of effective performance management metrics. The San Francisco model for contact tracing, including focusing on rigorous training, recruiting, and partnering with community-based organizations from diverse, affected communities, is an inclusive approach relevant to other jurisdictions and settings.

International audience; Our senses are constantly stimulated in our daily lives but we have only a limited understanding of how they affect our cognitive processes and, especially, our autobiographical memory. Capitalizing on a public science event, we conducted the first empirical study that aimed to compare the relative influence of the five senses on the access, temporal distribution, and phenomenological characteristics of autobiographical memories in a sample of about 400 participants. We found that the access and the phenomenological features of memories varied as a function of the type of sensory cues, but not their temporal distribution. With regard to their influence on autobiographical memory, an overlap between some senses was found, with on one hand, olfaction and taste and, on the other, vision, audition, and touch. We discuss these findings in the light of theories of perception, memory, and the self, and consider methodological implications of the sensory cuing technique in memory research, as well as clinical implications for research in psychopathological and neuropsychological populations.

The Malawi Ministry of Health implemented a new surveillance activity in April 2019 to detect recent HIV infections using a rapid test for recent infection (RTRI) to identify areas of ongoing transmission and guide response activities.At 23 health facilities in Blantyre District, healthcare workers (HCWs) were trained to conduct recent infection testing. In September 2019, we conducted a cross-sectional survey at these sites to explore the acceptability and feasibility of integrating this activity into routine HIV testing services (HTS).Research assistants interviewed HCWs using a semi-structured survey. Descriptive statistics were used to summarize quantitative responses and thematic analysis was used to group open-ended text.We interviewed 119 HCWs. Eighty-two percent of participants reported the RTRI was easy-to-use. HCWs perceived high client acceptability; 100% reported clients as 'somewhat' or 'very accepting'. Challenges included 68% of HCWs estimating they spend ≥20 min beyond routine HTS per client for this activity and 51% performing at least two additional finger pricks to complete the testing algorithm. HCWs differed in their perceptions of whether results should be returned to clients.This study assessed HCW experiences using point-of-care RTRIs for HIV recent infection surveillance. Overall, HCWs perceived RTRIs to be acceptable, easy-to-use, and valuable. Though only clients with new HIV diagnoses are tested for recent infection, additional time may be substantial at high-volume health service delivery points. Providing response plans or aggregated recent infection results to HCWs and/or clients may support motivation and sustainability of this novel surveillance activity.

National audience

Learning and memory impairments are common in individuals with multiple sclerosis (MS) and have pervasive effects on everyday life functioning. Hence, memory and learning have received particular attention in the cognitive rehabilitation literature in MS. The effectiveness of memory rehabilitation on memory performance is supported by several studies, but the generalisability of the benefits to daily life and memory for real-life events has rarely been examined. Recently, a new line of research focusing on memory for personal life events (i.e., autobiographical memory) has emerged in the MS literature. This approach is complementary to classical learning and memory paradigms and also allows for approaching memory in a broader context, one that considers memory as the ability to remember past episodes and imagine events that may occur in one's personal future (i.e. future thinking). This review provides an overview of the findings in this line of work. The first part summarises current evidence regarding the cognitive and neural mechanisms underlying autobiographical memory and future thinking impairments in MS. It points out that these domains are frequently and early impaired in individuals with MS because of an executive/frontal-related deficit. Individuals with MS are generally aware of these deficits and their negative impact on everyday life, so the development of strategies to alleviate such deficits seems of paramount importance. Thus, in the second part, I present the main outcomes of a cognitive intervention developed by our research group, which has been specifically designed to alleviate autobiographical memory and future thinking impairments in individuals with MS. The implications of these findings for neuropsychological care and well-being of individuals with MS are discussed in the final section, with an emphasis on the functional role of autobiographical memory and future thinking in various domains, including personal identity.

International audience

Objectives To evaluate the available literature for associations between nutrition and outcomes after operative treatment of long bone and long bone periarticular fractures. Data sources Systematic review of English-language articles in the MEDLINE, Embase, PubMed, and Cochrane computerized literature databases (through December 2015) using PRISMA guidelines. Study selection Randomized controlled trials, quasi-randomized controlled trials, case-control studies, and cohort studies (retrospective and prospective) involving long bone and long bone periarticular fractures that included the effect of nutritional status on fracture union, time to union, and any related soft-tissue complication were eligible for review. Data extraction Two authors independently extracted data from the selected studies using a standardized data collection form with predefined data fields for demographics, interventions, study methods, complications, and management outcomes. Data synthesis Although one of the original aims of the study was to conduct a meta-analysis, the available literature did not offer sufficient data for meta-analysis. Conclusions Although our systematic review demonstrates a possible role for oral nutritional supplementation and vitamin supplementation in the orthopaedic trauma patient, there remains a need for well-designed trials to clarify this role. There is likely benefit to multidisciplinary approaches to nutritional optimization in the orthopaedic trauma patient, and this should be explored further in forthcoming work. Level of evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Objective To review the current literature on the use of viscoelastic hemolytic assays, such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM), during the perioperative period of patients and determine the ability of TEG and ROTEM to detect hypercoagulability and identify increased risk of the development of venous thromboembolism (VTE). Data sources PubMed, EMBASE, and Cochrane online databases were queried through February 11, 2018, by pairing the terms "thromboelastography," "viscoelastic hemostatic assays," and "rotational thromboelastometry" with "venous thromboembolism," "deep vein thrombosis," "pulmonary embolism," and "hypercoagulability." Study selection Inclusion and exclusion criteria were established to determine relevance and quality of data, of which 2.54% of initially identified studies met. Data extraction and synthesis Articles and citations were reviewed for relevance by 2 independent individuals following PRISMA guidelines as well as a quality assessment of data as established by Zaza et al. In studies that separated patients postoperatively by VTE development or no VTE development, data were pooled utilizing a modified DerSimmion and Laird random effects model. Results One thousand eight hundred ninety-three articles were assessed for eligibility, yielding 370 abstracts. Of the 370 abstracts, 35 studies were included, and of these, only 5 were included in the meta-analysis. Studies included postsurgical patients in a variety of surgical fields, encompassing a total of 8939 patients, with 717 thrombotic events reported. Elevated maximum amplitude (MA) was a statistically significant indicator of hypercoagulability across at least 1 perioperative time point in 17 (50%) of the articles reviewed, consisting of 6348 (72%) patients. The pooled mean MA value for defining hypercoagulability was greater than 66.70 mm. Using a prepublished value for hypercoagulability of 65 mm, the combined effect of MA on the development of VTE in postsurgical patients was determined to be 1.31 (95% confidence, 0.74-2.34, P = 0.175) and was 46% sensitive and 62% specific in predicting a postoperative VTE. Conclusions Only 1 parameter, MA, was consistently used to both define hypercoagulability and be predictive of VTE after traumatic injury and surgical intervention; however, there remains a broad variability in the definition of hypercoagulability as determined by MA and thus limits its predictive ability. In addition, when hypercoagulability was measured throughout the perioperative period, TEG consistently demonstrated hypercoagulability starting on post-op day 1 (POD1). Level of evidence Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Nanoparticles, such as polymersomes, can be directed to the hepatic asialoglycoprotein receptor to achieve targeted drug delivery. In this study, we prepared asialofetuin conjugated polymersomes based on the amphiphilic di-block copolymer poly(dimethylsiloxane)-b-poly(2-methyloxazoline) (PDMS-b-PMOXA). They had an average diameter of 150nm and formed monodisperse vesicles. Drug encapsulation and sustained release was monitored using the hydrophilic model compound carboxyfluorescein. Asialoglycoprotein receptor specific uptake by HepG2 cells in vitro was energy dependent and could be competitively inhibited by the free targeting ligand. Mechanistic uptake studies revealed intracellular trafficking of asialofetuin conjugated polymersomes from early endosomes and to the lysosomal compartment. Polymersomes showed no toxicity in the MTT assay up to concentrations of 500μg/mL. In addition, acute toxicity and tolerability of our PDMS-b-PMOXA polymersome formulations was assessed in vivo using zebrafish embryos as a vertebrate screening model. In conclusion, a hepatocyte specific drug delivery system was designed, which is safe and biocompatible and which can be used to implement liver-specific targeting strategies.

To assess how intrauterine growth restriction (IUGR) is defined by gynecologists in routine practice.We surveyed primary care gynecologists in Bremen and Lower Saxony, Northwest Germany, between January and July 2014. Descriptive statistics were used to analyze the data; consensus was considered as 90% agreement among the respondents. Multiple logistic regression models were performed for the associations between respondents' background characteristics and choice of the small for gestational age (SGA) cutoff values.Overall, 185 primary care gynecologists participated in the survey. Consensus was only observed in two items: (1) an accurate determination of gestational age (91%) and (2) repeated measurement of the abdominal circumference (91%). Umbilical artery Doppler (76%) and repeated ultrasonography (76%) were the most frequently used methods to confirm suspected IUGR diagnoses, but different responses prevailed. Notably, only 46% of the respondents opted for the 10th percentile of estimated fetal weight as a cutoff for SGA classification, which is the internationally recommended value.The results of this survey indicate considerable practice variation regarding detection and management of IUGR pregnancies. There is a need for better agreement in terminology and definition of core aspects of IUGR in antenatal care.

The study of the self in neuropsychological patients raises not only theoretical questions on the relationships between the self, autobiographical memory (AM), and episodic future thinking but also clinical issues for patients’ daily life and care. We addressed this issue in Parkinson’s disease patients for whom AM and future thinking impairments have been documented. All patients and controls generated and dated up past and future self-images and provided associated past and future events. Our findings suggest a subtle pattern of preservation/impairment of different dimensions (quantitative and qualitative) of self-images, which rely partially on the episodic quality of past and future events.

International audience; This chapter reviews the organizational role of the self in the distributions and accessibility of memories and imagined future events. It covers research on the self-reference effect, self-defining memories, and the reminiscence bump. In this context, the different methods used to explore the relationships between the self, autobiographical memory, and future thinking are reviewed. A comparative view of the findings obtained for the past and the future are also given. The contributions of studies conducted in both healthy controls and clinical populations are discussed. One section is devoted to investigations in people with neurological and neuropsychiatric conditions and their contribution to improving our understanding of the relationships between autobiographical memory and the self.

International audience; Recent studies suggest that different forms of episodic simulation—mental representations of past, future, or atemporal events—recruit many of the same underlying cognitive and neural processes. This leads to the question whether there are distinctive hallmark characteristics of episodic future thinking: the subjective sense that imagined events belong to and will occur in the personal future. In this study, we aimed at shedding light on the cognitive ingredients that contribute to this sense of future occurrence by asking participants to imagine personal and experimenter-provided future events associated with high or low degrees of belief in future occurrence and then to reflect on the bases for their beliefs. Results showed that contextualising autobiographical knowledge (i.e., articulating links between items of information associated with imagined future events, goals, and personal characteristics) is a critical aspect of belief in future occurrence, and autobiographical knowledge can be flexibly used to either support or suppress belief in future occurrence. These findings indicate that episodic future thought not only depends on simulation processes (i.e., the construction of detailed mental representations for future events) but also requires that imagined events are meaningfully integrated within an autobiographical context.

International audience

Increasingly studied, episodic future thought (EFT) impairment negatively affects patients' daily life. Along these lines, working with relapsing-remitting multiple sclerosis (RR-MS) patients, we documented the clinical effectiveness of a mental visual imagery (MVI)-based facilitation programme on EFT impairment related to executive function difficulties. We aimed at improving the characterisation of the cognitive and neural underpinnings of RR-MS patients' EFT amelioration, by exploring the structural and functional brain changes following the MVI programme. Seventeen non-depressed RR-MS patients were recruited and randomly assigned in the (i) experimental group (n=10), who followed the MVI programme or in the control group (n=7), who followed a verbal control programme. Using an adapted version of the Autobiographical Interview to assess EFT, after facilitation, significant improvement was observed in the experimental group only. This was accompanied by increased activation in the prefrontal region during the generation of future events and was positively correlated with grey matter volume increase in this same brain area. Increased activations in the parahippocampal and the middle temporal gyri were also observed in the experimental group in post-facilitation. Likewise, functional connectivity changes were observed in the posterior brain regions after facilitation. Only minor cerebral changes were observed in the control group, likely reflecting practice effects. Our study showed that EFT improvement following the MVI programme led to functional and structural changes in brain regions sustaining contextual processing, visual imagery, the integration and maintenance of multimodal information. Taken together, these findings suggest that a cognitive intervention focusing on scene construction can be efficient to alleviate EFT impairment related to executive dysfunction. As such, this study opens the way to the development of tailor-made rehabilitation programmes using the different cognitive mechanisms involved in EFT.

The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation.

While occasional deja vu is benign in the general population, rare neuropsychological cases with persistent deja vu have been described in the literature. We report the case of MN, a 25-year-old woman, who suffered a cerebral haemorrhage in the right thalamo-callosal region and experienced recurrent deja vu episodes. Through clinical interviews and memory tasks related to deja vu, we assumed that source memory errors and an inappropriate feeling of familiarity (measured by the number of false recognitions) were critically involved in MN's deja vu. Based on this, we developed the first neuropsychological intervention dedicated to deja vu. The rationale was to train MN to detect elements that could produce an inappropriate feeling of familiarity and to promote metacognitive awareness about deja vu. This intervention was effective at reducing the frequency of deja vu episodes in MN's daily life, as well as the number of false recognitions in memory tasks. In addition to its clinical contribution, this single-case study contributes to the limited literature on patients whose deja vu is not related to epileptic abnormalities and medial temporal brain damage, and provide supportive evidence of the role of an erroneous feeling of familiarity and of metacognitive processes in deja vu.

While it is established that goal processing is a central component of episodic future thinking, how personal goals shape future event representations is not fully understood. Here, we explored the influence of the source of motivation underlying goal pursuit. Personal goals differ in their degree of self-concordance, which depends on the primary motives underlying goal pursuit. We distinguished between self-concordant (what one wants to achieve) and non-self-concordant (what one has to achieve) goals. Participants were asked to imagine specific future events associated with each type of goals. We found that self-concordant future events have a privileged phenomenological status: they are associated with a stronger sense of “realness” and of pre-experiencing the future, are more integrated with autobiographical knowledge, and are characterized by more positive and intense emotions. Furthermore, psychological need satisfaction was a characteristic component of self-concordant future thoughts. Implications of these findings for motivation and goal pursuit are discussed.

The Haydom, Tanzania, site (TZH) of The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) Study is in north-central Tanzania, 300 km from the nearest urban center. TZH is in a remote rural district where most of the population are agropastoralists and grow maize as the staple food. The average household size is 7. The average woman achieves a parity of 6 and has 1 child death. Socioeconomic indicators are poor, with essentially no household having access to electricity, piped water, or improved sanitary facilities (compared with 14%, 7%, and 12%, respectively, reported nationally). The Demographic Health Survey Tanzania 2004 indicated that the region had high rates of stunting and underweight (40% and 31% of children aged

While the cognitive and neural bases of episodic future thinking are well documented, questions remain as to what gives the sense that an imagined event belongs to one’s personal future. Capitalizing on previous research on metacognitive appraisals in autobiographical remembering, we propose that episodic future thinking involves, in varying degrees, a subjective belief in the potential occurrence of imagined future events and we explore the nature and determinants of such belief. To this aim, participants provided justifications for belief in occurrence for a series of past and future events. For each event, they also assessed their subjective feelings (belief in occurrence, autonoetic experience, and belief in accuracy) and rated various characteristics of mental representations that might contribute to these feelings. Results showed that belief in the occurrence of future events mostly related to their integration in a broader autobiographical context, especially their relevance to personal goals and their personal plausibility. We also found that belief in occurrence, autonoetic experience, and belief in accuracy represented distinct subjective appraisals of future events, which depended in part on different determinants. Based on these findings, we propose a new theoretical model of subjective feelings associated with episodic future thinking that conceives of belief in occurrence as arising from metacognitive appraisals that shape the sense that imagined events belong to one’s personal future.

OBJECTIVE: To assess whether a combination of Internet‐based and postal survey methods (mixed‐mode) compared to postal‐only survey methods (postal‐only) leads to improved response rates in a physician survey, and to compare the cost implications of the different recruitment strategies. DATA SOURCES/STUDY SETTING: All primary care gynecologists in Bremen and Lower Saxony, Germany, were invited to participate in a cross‐sectional survey from January to July 2014. STUDY DESIGN: The sample was divided into two strata (A; B) depending on availability of an email address. Within each stratum, potential participants were randomly assigned to mixed‐mode or postal‐only group. PRINCIPAL FINDINGS: In Stratum A, the mixed‐mode group had a lower response rate compared to the postal‐only group (12.5 vs. 20.2 percent; RR = 0.61, 95 percent CI: 0.44–0.87). In stratum B, no significant differences were found (15.6 vs. 16.2 percent; RR = 0.95, 95 percent CI: 0.62–1.44). Total costs (in €) per valid questionnaire returned (Stratum A: 399.72 vs. 248.85; Stratum B: 496.37 vs. 455.15) and per percentage point of response (Stratum A: 1,379.02 vs. 861.02; Stratum B 1,116.82 vs. 1,024.09) were higher, whereas variable costs were lower in mixed‐mode compared to the respective postal‐only groups (Stratum A cost ratio: 0.47, Stratum B cost ratio: 0.71). CONCLUSIONS: In this study, primary care gynecologists were more likely to participate by traditional postal‐only than by mixed‐mode survey methods that first offered an Internet option. However, the lower response rate for the mixed‐mode method may be partly due to the older age structure of the responding gynecologists. Variable costs per returned questionnaire were substantially lower in mixed‐mode groups and indicate the potential for cost savings if the sample population is sufficiently large.

Objective. To identify care-related and maternal risk factors for the antenatal nondetection of IUGR.Methods. In this hospital-based case-control study we compared antenatally undetected IUGR neonates (cases) to detected IUGR neonates (controls). Data were collected using newborn documentation sheets and standardized personal interviews with the mothers. We calculated antenatal detection rates and used uni- and multivariable logistic regression models to assess the association of antenatal nondetection of IUGR and maternal and care-related factors.Results. A total of 161 neonates from three hospitals were included in the study. Suboptimal fetal growth was identified antenatally inn=77pregnancies while inn=84it was not detected antenatally (antenatal detection rate: 47.8%). Severity of IUGR, maternal complications, and a Doppler examination during the course of pregnancy were associated with IUGR detection. We did not find statistically significant differences regarding parental socioeconomic status and maternal migration background.Conclusions. In our study, about half of all pregnancies affected by suboptimal growth remained undetected. Future in-depth studies with larger study populations should further examine factors that could increase antenatal detection rates for IUGR.

International audience; Multiple sclerosis (MS) patients are often unable to adequately fulfill their established roles due to physical disabilities and cognitive changes, making this chronic illness particularly threatening to personal identity. Twenty-five MS patients and 25 healthy controls were asked to recall five self-defining memories (SDM). Overall characteristics of SDM did not differ between patients and controls; MS patients displayed preserved capacity to draw meaning upon past events. Moreover, almost two-thirds of MS patients mentioned at least one illness related SDM and about 25% of patients' SDM referred to MS. These memories were experienced as more negative and associated with more tension than other SDM but led toward more positive emotion and less negative emotion over time; they were also more central and more integrated to the personal identity. We concluded that self-challenging events due to MS may trigger both cognitive and emotional processes enabling the integration of illness in patients' self-representations.

International audience; Unilateral spatial neglect (USN) is mainly defined as a condition affecting perception and the mental representation of the environment. However, nothing is known about its impact on the ability to mentally represent one's past and on personal identity. We addressed these questions in a case of chronic USN, DR, a 59-year-old right-handed woman, who underwent a variety of measures exploring the self and autobiographical memory (AM). DR showed preserved self-images and her AM performance was only preserved when memories were prompted by her own self-images and not by self-unrelated cues. Our findings are discussed in light of the interconnection between the self and AM.

Mental time travel (MTT) entails the ability to mentally travel into autobiographical memory (AM) and episodic future thinking (EFT). While AM and EFT share common phenomenological and cerebral functional properties, distinctive characteristics have been documented in healthy and clinical populations. No report, to our knowledge, has informed on the functional underpinnings of MTT impairment in multiple sclerosis (MS) patients, hence the aim of this work. We studied 22 relapsing-remitting MS patients and 22 matched controls. Participants underwent an AM/EFT assessment using the Autobiographical Interview (Levine et al. 2002), followed by a functional MRI session. The latter consisted in AM and EFT tasks, distinguishing the construction and elaboration phases of events. The results showed impaired performance for AM and EFT in patients, accompanied by increased cerebral activations mostly located in the frontal regions, which extended to the parietal, lateral temporal and posterior regions during AM/EFT tasks, relative to healthy controls. Enhanced brain activations in MS patients were particularly evident during the EFT task and involved the hippocampus, frontal, external temporal, and cingulate regions. The construction phase required greater fronto-parieto-temporal activations in MS patients relative to both healthy controls, and the elaboration phase. Taking together, our results suggested the occurrence of cerebral activation changes in the context of MTT in MS patients, expressed by distinct and common mechanisms for AM and EFT. This study may provide new insights in terms of cerebral activation changes in brain lesion and their application to clinical settings, considering AM/EFT's central role in everyday life.

In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to specific IgE antibodies in children and adolescents with and without a migrant background. Using data of the population-based German Health Interview and Examination Survey for children and adolescents (KiGGS; n = 17,450; 0–17 years), lifetime and 12-month prevalence of atopic diseases and point prevalence of 20 common allergic sensitizations were investigated among migrants compared to non-migrants. Multiple regression models were used to estimate the association of atopic disease and allergic sensitization with migrant background. In multivariate analyses with substantial adjustment we found atopic dermatitis about one-third less often (OR 0.73, 0.57–0.93) in participants with a two-sided migrant background. Statistically significant associations between allergic sensitizations and a two-sided migrant background remained for birch (OR 0.73, 0.58–0.90), soybean (OR 0.72, 0.54–0.96), peanut (OR 0.69, 0.53–0.90), rice (OR 0.64, 0.48–0.87), potato (OR 0.64, 0.48–0.85), and horse dander (OR 0.58, 0.40–0.85). Environmental factors and living conditions might be responsible for the observed differences.

International audience

International audience; In animal studies, extensive data revealed the influence of culture medium on embryonic development, foetal growth and the behaviour of offspring. However, this impact has never been investigated in humans. For the first time, we investigated in depth the effects of embryo culture media on health, growth and development of infants conceived by In Vitro Fertilization until the age of 5 years old. This single-centre cohort study was based on an earlier randomized study. During six months, in vitro fertilization attempts (No. 371) were randomized according to two media (Single Step Medium—SSM group) or Global medium (Global group). This randomized study was stopped prematurely as significantly lower pregnancy and implantation rates were observed in the SSM group. Singletons (No. 73) conceived in the randomized study were included (42 for Global and 31 for SSM). The medical data for gestational, neonatal and early childhood periods were extracted from medical records and parental interviews (256 variables recorded). The developmental profiles of the children in eight domains (social, self-help, gross motor, fine motor, expressive language, language comprehension, letter knowledge and number knowledge – 270 items) were compared in relation to the culture medium. The delivery rate was significantly lower in the SSM group than in the Global group (p

International audience; While metacognition and anosognosia have long been studied as distinct concepts, more recently we have endeavored to construct a theoretical framework for exploring how metacognition can contribute to our understanding of anosognosia and vice versa. Following this approach, with a particular focus on Alzheimer's disease (AD), this chapter first gives an overview of the key experimental findings and issues on metacognition in AD patients: in particular, overconfidence and absolute awareness; the sensitivity approach; the fractionation of metacognition in AD; the neural substrates of metacognition in the Alzheimer brain; and metacognitive control in these patients. Second, the chapter discusses the concept of anosognosia in AD patients from a cognitive neuropsychological viewpoint. It addresses models such as the cognitive awareness model and evidence from metacognition studies, and how they contribute to disentangle the issue of measuring anosognosia in AD patients. Finally, it develops the emerging concept of "implicit awareness" in AD patients