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Two long-lasting thunderstorm ground enhancement (TGE) events were registered at the Milešovka meteorological observatory in Czechia (50.55∘ N, 13.93∘ E; 837 m altitude) on 23 April 2018, during linearly organized thunderstorms. Two intervals of increased photon counts were detected by a plastic scintillator, respectively lasting 70 and 25 min and reaching 31 % and 48 % above the background radiation levels. Using numerical simulations, we verified that the observed increases in count rates are consistent with the energy spectrum of previously observed TGEs. We investigated the relevant data from a suite of meteorological instruments, a Ka-band cloud radar, an electric field mill, and a broadband electromagnetic receiver, all placed at the Milešovka observatory, in order to analyse the context in which these unique continental TGEs occurred at an exceptionally low altitude. The onset of the TGEs preceded the onset of precipitation by 10 and 3 min, respectively, for the two events. Both this delayed rain arrival and an energy threshold of 6.5 MeV for registered particles clearly exclude the detection the decay products of the radon progeny washout during the TGE intervals. At the same time, the European lightning detection network EUCLID detected numerous predominantly negative intracloud lightning discharges at distances closer than 5 km from the particle detector, while the occurrence of cloud-to-ground discharges was suppressed. The cloud radar recorded presence of graupel below the melting level, and the composition of hydrometeors suggested good conditions for cloud electrification. The observed variations in the near-surface electric field were unusual, with very brief negative-electric-field excursions reaching −20 kV in a quick succession. At the same time, sub-microsecond unipolar pulses emitted by close corona discharges saturated the broadband magnetic loop antenna. All these measurements indicate that a strong lower positive-charge region was present inside the thundercloud. The bottom thundercloud dipole was probably responsible for acceleration of the seed electrons in the air. These seed electrons might originate in the secondary cosmic ray particles but could also come from a high concentration of radon in the air collected during the propagation of the convective system above the uranium-rich soils before the thunderstorms overpassed the Milešovka observatory.

Abstract High electric fields that occur in thunderstorm clouds in the Earth’s atmosphere might accelerate energetic charged particles produced by cosmic rays. Such energetic particles, especially electrons, can cause additional ionization as they are multiplied and thus form avalanche of relativistic electrons. These relativistic electrons emit Bremsstrahlung in the X- or gamma-ray spectral ranges as they lose their kinetic energy via collisions. Thunderstorm ground enhancements (TGEs) of secondary cosmic ray fluxes recorded at the top of a sharp rocky mountain of Lomnický Štít in High Tatras (2634 m, Slovak Republic) are compared with simultaneous measurements of electric field at the mountain top and on its slope at the observatory of Skalnaté Pleso (1780 m). Results of measurements performed from May to September in 2017 and from May to October in 2018 are presented. The cosmic ray flux is measured by Space Environment Viewing and Analysis Network (SEVAN) and by neutron monitor with 1-s resolution. The TGEs that persisted usually several minutes were mainly detected in the SEVAN channel 1 which has the lowest energy threshold, about 7–8 MeV. A statistical analysis shows that these enhancements usually occurred (not only) during large values of vertical, upward-pointing electric fields measured just above the detector. It is shown that the measurement of electric field at Skalnaté Pleso, distant about 1.86 km from the mountain top is also partly correlated with the enhancements and can provide additional useful information about the distance or dimension of charge structure and dynamics of electric field, especially on short time scales. The enhancements usually did not exceed several tens of percent of background values. However, events that exceeded the background values several times were also recorded. The most extreme event exceeded the background values about 215 times. This event was also detected by other SEVAN channels and by the neutron monitor (~ 130% enhancement), which indicates a possibility of photonuclear reactions. The enhancements were often terminated by a nearby lightning.

This study develops methods for estimating lightning climatologies on the day−1 km−2 scale for regions with complex terrain and applies them to summertime observations (2010–2015) of the lightning location system ALDIS in the Austrian state of Carinthia in the Eastern Alps. Generalized additive models (GAMs) are used to model both the probability of occurrence and the intensity of lightning. Additive effects are set up for altitude, day of the year (season) and geographical location (longitude/latitude). The performance of the models is verified by 6-fold cross-validation. The altitude effect of the occurrence model suggests higher probabilities of lightning for locations on higher elevations. The seasonal effect peaks in mid-July. The spatial effect models several local features, but there is a pronounced minimum in the north-west and a clear maximum in the eastern part of Carinthia. The estimated effects of the intensity model reveal similar features, though they are not equal. The main difference is that the spatial effect varies more strongly than the analogous effect of the occurrence model. A major asset of the introduced method is that the resulting climatological information varies smoothly over space, time and altitude. Thus, the climatology is capable of serving as a useful tool in quantitative applications, i.e. risk assessment and weather prediction.

In this paper we present a performance analysis of the European lightning location system EUCLID for cloud-to ground flashes/strokes in terms of location accuracy (LA), detection efficiency (DE) and peak current estimation. The performance analysis is based on ground truth data from direct lightning current measurements at the Gaisberg Tower (GBT) and data from E-field and video recordings. The E-field and video recordings were collected in three different regions in Europe, namely in Austria, Belgium and France. The analysis shows a significant improvement of the LA of the EUCLID network over the past 7 years. Currently, the median LA is in the range of 100 m in the center of the network and better than 500 m within the majority of the network. The observed DE in Austria and Belgium is similar, yet a slightly lower DE is determined in a particular region in France, due to malfunctioning of a relevant lightning location sensor during the time of observation. The overall accuracy of the lightning location system (LLS) peak current estimation for subsequent strokes is reasonable keeping in mind that the LLS-estimated peak currents are determined from the radiated electromagnetic fields, assuming a constant return stroke speed. The results presented in this paper can be used to estimate the performance of the EUCLID network related to cloud-to-ground flashes/strokes for regions with similar sensor baselines and sensor technology.

Cloud-to-ground (CG) lightning data from the European Cooperation for Lightning Detection (EUCLID) network over the period 2006–2014 are explored. Mean CG flash densities vary over the European continent, with the highest density of about 6 km−2 yr−1 found at the intersection of the borders between Austria, Italy and Slovenia. The majority of lightning activity takes place between May and September, accounting for 85 % of the total observed CG activity. Furthermore, the thunderstorm season reaches its highest activity in July, while the diurnal cycle peaks around 15:00 UTC. A difference between CG flashes over land and sea becomes apparent when looking at the peak current estimates. It is found that flashes with higher peak currents occur in greater proportion over sea than over land.

We report a study of penetration of the VLF electromagnetic waves induced by lightning to the ionosphere. We compare the fractional hop whistlers recorded by the ICE experiment onboard the DEMETER satellite with lightning detected by the EUCLID detection network. To identify the fractional hop whistlers, we have developed software for automatic detection of the fractional-hop whistlers in the VLF spectrograms. This software provides the detection times of the fractional hop whistlers and the average amplitudes of these whistlers. Matching the lightning and whistler data, we find the pairs of causative lightning and corresponding whistler. Processing data from ~200 DEMETER passes over the European region we obtain a map of mean amplitudes of whistler electric field as a function of latitudinal and longitudinal difference between the location of the causative lightning and satellite magnetic footprint. We find that mean whistler amplitude monotonically decreases with horizontal distance up to ~1000 km from the lightning source. At larger distances, the mean whistler amplitude usually merges into the background noise and the whistlers become undetectable. The maximum of whistler intensities is shifted from the satellite magnetic footprint ~1° owing to the oblique propagation. The average amplitude of whistlers increases with the lightning current. At nighttime (late evening), the average amplitude of whistlers is about three times higher than during the daytime (late morning) for the same lightning current.

We study the penetration of lightning induced whistler waves through the ionosphere by investigating the correspondence between the whistlers observed on the DEMETER and MAGION-5 satellites and the lightning discharges detected by the European lightning detection network EUCLID. We compute all the possible differences between the times when the whistlers were observed on the satellite and times when the lightning discharges were detected. We show that the occurrence histogram for these time differences exhibits a distinct peak for a particular characteristic time, corresponding to the sum of the propagation time and a possible small time shift between the absolute time assigned to the wave record and the clock of the lightning detection network. Knowing this characteristic time, we can search in the EUCLID database for locations, currents, and polarities of causative lightning discharges corresponding to the individual whistlers. We demonstrate that the area in the ionosphere through which the electromagnetic energy induced by a lightning discharge enters into the magnetosphere as whistler mode waves is up to several thousands of kilometres wide.

Upward lightning (UL) has become a major threat to the growing number of wind turbines producing renewable electricity. It can be much more destructive than downward lightning due to the large charge transfer involved in the discharge process. Ground-truth lightning current measurements indicate that less than 50% of UL could be detected by lightning location systems (LLS). UL is expected to be the dominant lightning type during the cold season. However, current standards for assessing the risk of lightning at wind turbines mainly consider summer lightning, which is derived from LLS. This study assesses the risk of LLS-detectable and LLS-undetectable UL at wind turbines using direct UL measurements at instrumented towers. These are linked to meteorological data using random forests. The meteorological drivers for the absence/occurrence of UL are found from these models. In a second step, the results of the tower-trained models are extended to a larger study area (central and northern Germany). The tower-trained models for LLS-detectable lightning are independently verified at wind turbine sites in this area and found to reliably diagnose this type of UL. Risk maps based on cold season case study events show that high probabilities in the study area coincide with actual UL flashes. This lends credibility to the application of the model to all UL types, increasing both risk and affected areas., Competing Interests: The authors declare no conflicts of interest relevant to this study., (© 2023. The Authors.)

Purpose: Nonword repetition tests (NWRT) can be useful tools together with other assessment procedures for diagnosing a developmental learning disorder in bilingual children. Concerning typically developing children, however, the link between NWRT performance and language development is still unclear. The present study contributes to this discussion by investigating the link between language-dependent NWRT performance, language development, and language exposure., Methods: A total of 20 simultaneously bilingual Russian-German children, aged 4-6 years, were tested with "The Russian language proficiency test for multilingual children (SRUK)" and "Patholinguistische Diagnostik bei Sprachentwicklungsstörungen (PDSS)" as well as language-specific nonwords for Russian and German., Results: Most children scored within the mean range in SRUK. In PDSS they scored two standard deviations below the mean range in most of the subtests. NWRT in Russian significantly correlated with the NWRT in German and also positively correlated with both comprehension and production in Russian. In contrast, the German NWRT did not correlate with comprehension or with production in German. Moreover, the correlation between the German NWRT and the comprehension of grammatical structures in Russian was significant, and the correlations between the German NWRT and the two other Russian language development tests just failed to reach significance., Conclusion: High scores in both the Russian and the German NWRT offer evidence that the ability to repeat language-specific nonwords does not differ depending on language exposure. The aim to distinguish between typical and atypical language development based on NWRT can be reached only when NWRT and all possible influencing factors in typically developed children are analyzed., (© 2023. The Author(s).)

Upward lightning is rarer than downward lightning and requires tall (100+ m) structures to initiate. It may be either self-initiated or triggered by other lightning discharges. While conventional lightning location systems (LLSs) detect most of the upward lightning flashes superimposed by pulses or return strokes, they miss a specific flash type that consists only of a continuous current. Globally, only few specially instrumented towers can record this flash type. The proliferation of wind turbines in combination with damages from upward lightning necessitates an improved understanding under which conditions self-initiated upward lightning and the continuous-current-only subtype occur. This study uses a random forest machine learning model to find the larger-scale meteorological conditions favoring the occurrence of the different phenomena. It combines ground truth lightning current measurements at the specially instrumented tower at Gaisberg mountain in Austria with variables from larger-scale meteorological reanalysis data (ERA5). These variables reliably explain whether upward lightning is self-initiated or triggered by other lightning discharges. The most important variable is the height of the -10°C isotherm above the tall structure: the closer it is, the higher is the probability of self-initiated upward lightning. For the different flash types, this study finds a relationship to the larger-scale electrification conditions and the LLS-detected lightning situation in the vicinity. Lower amounts of supercooled liquid water, solid, and liquid differently sized particles and no LLS-detected lightning events nearby favor the continuous-current-only subtype compared to the other subtypes, which preferentially occur with LLS-detected lightning events within 3 km from the Gaisberg Tower., Competing Interests: The authors declare no conflicts of interest relevant to this study., (© 2023. The Authors.)

Background: Due to demographic changes over the last few decades, the number of multilingual children has grown rapidly. Many of them face problems in learning their second language. Similarities between linguistic manifestations of stages of second language acquisition and an impairment of language acquisition cause a diagnostic dilemma. The Vienna Model of language assessment in multilingual children will be presented., Methods: A key feature of our procedure is the integration of medical students as native speakers in diagnosing acquisition of the first language. A case study of a boy with Russian as first language illustrates the procedure., Results: The Vienna Model of language assessment in multilingual children offers the possibility to evaluate language competence in a differentiated manner with support of medical students as native speakers. Based on the bilingual assessment on different linguistic levels the diagnosis ICD-10 F80.0 is given. The subsequent short therapy showed an improvement regarding phonological competence., (© 2020. The Author(s).)

In this paper, a full-wave two-dimensional Finite-Difference-Time-Domain model is developed to evaluate the propagation effects of lightning electromagnetic fields over mountainous terrain in the Earth-ionosphere waveguide. In the model, we investigate the effect of the Earth-ionosphere waveguide structure and medium parameters, including the effect of the ionospheric cold plasma characteristics, the effect of the Earth curvature, and the propagation effects over mountainous terrain. For the first time, the obtained results are validated against simultaneous experimental data consisting of lightning currents measured at the Säntis Tower and electric fields measured in Neudorf, Austria, located at 380-km distance from the tower. It is shown that both the time delays and amplitudes of the lightning electromagnetic fields at 380-km distance can be strongly affected by the ionospheric electron density profile, the mountainous terrain, and the Earth curvature. After taking into account the effect of the irregular terrain between the Säntis Tower and the field measurement station, the vertical electric fields calculated by using our model are found to be in good agreement with the corresponding measured cases occurred in both daytime and nighttime. The ideal approximation used in either the classical solutions or the simplified models might lead to inaccuracies in the estimated reflection height. Furthermore, we discuss the sensitivity of our results by considering different return stroke models, as well as different typical values of the return stroke speed and of the ground conductivity., (©2019. The Authors.)

Purpose: To add a new set of 24 sentence optotypes to the German version of the RADNER reading charts and to investigate whether sentences constructed based upon an optimised concept of sentence optotypes can be used together with the original 38 sentences., Methods: Twenty-eight optimised sentence optotypes were constructed based upon the concept of sentence optotypes as established for the RADNER Reading Charts, with words having the same number of characters and syllables being placed in the same positions. The best comparable sentences were statistically selected in 30 volunteers. Reading speed and the number of errors were determined. Validity was analysed in comparison to a 111-word long standardised paragraph and 7 of the 38 original sentence optotypes., Results: The mean reading speed obtained with the 28 sentences was 192.30±26.69 words per minute (wpm), as compared with 192.47±25.32 wpm for the 7 original sentence optotypes and 165.28±20.82 wpm for the long paragraph; 24 of the 28 optimised sentences met our selection criteria for reading speed/time (mean reading speed: 192.41±26.58). The mean number of reading errors was 0.10±0.30. The correlation between the 24 optimised sentence optotypes and the long paragraph was r=0.90. Reliability analyses yielded an overall Cronbach's α coefficient of 0.992., Conclusion: The 24 new sentence optotypes can be integrated into the existing set of 38 original sentences. Since all the statistical results obtained were similar to those of the original sentences, the best possible reliability had apparently already been achieved with the original sentence optotypes., Competing Interests: Competing interests: WR receives royalties for the RADNER reading charts, of which seven optotypes were used. All other named authors have no affiliation with or involvement in any organisation or entity with any financial interest in the subject matter or materials discussed in this manuscript., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Purpose: To compare the reading time and reading speed measurements obtained with a stopwatch with those of an automated computer program for measuring reading speed and acuity (rad-rd © ; patent: AT 504635B1/10-2006)., Methods: The rad-rd © was used (in conjunction with a PC and microphone) for the computer-based measurements. In rotation, each of four examiners took a turn reading the 12 sentences from one of the four RADNER Reading Charts to three other examiners, who served as stoppers. The stoppers simultaneously measured the reading time with a stopwatch while a fifth investigator used the rad-rd © to obtain computerized measurements. The stopwatch measurements were then statistically compared with the rad-rd © measurements., Results: The mean reading time obtained with the stopwatch measurements was 4.34 ± 0.57 seconds (196.21 ± 21.79 wpm), versus 4.44 ± 0.59 seconds (192.24 ± 22.20 wpm) by computer measurement (r = 0.84). Of the 144 stopwatch measurements, 97 (67.36%) were shorter, and 47 (32.64%) were equal to (n = 5) or longer than the computer measurements. The mean difference for the shorter measurements was -0.17 ± 0.1 seconds (3.91% of the mean reading time), and the mean difference for the longer measurements was 0.11 ± 0.1 seconds (2.53% of the mean reading time). Most differences ranged from -0.1 to 0.1 seconds (42.36%). The results did not differ significantly among the four stoppers., Conclusion: The rad-rd © is an accurate, automated computer program for measuring reading time. Stopwatch measurements, although subject to inaccuracy from several sources, remain a reliable and simple method for analysis of reading performance., (© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: To develop 27 short sentence optotypes for the Portuguese version of the Radner Reading Charts., Methods: Thirty-four Portuguese sentences were constructed following the concept of the Radner Reading Charts to obtain highly comparable sentences in terms of lexical difficulty, syntactical complexity, word length, number of syllables, and position of words. A long text (106 words) at the 5th grade reading level was also tested to assess the validity of the reading speeds obtained with the short sentences. The short sentences and long text were tested in 50 volunteers with similar educational backgrounds (mean age 30.98 years ± 6.99 years, range 19-47 years). Reading speeds were measured with a stop-watch and reported as words per minute (wpm). The reading time for each of the short sentences to be selected for the chart was defined as falling within the range of the mean ± 0.40 × standard deviation (SD)., Results: The overall mean reading speed for each of the short sentences was 235.43 ± 36.39 wpm. The 27 sentences with a mean between 220.8 and 250.0 wpm (overall mean ± 0.40 × SD) were selected for construction of the reading charts. The mean reading speed for the long text was 212.42 ± 26.20 wpm. Correlation between the selected short sentences and long text was high (r =0.86). Reliability analysis yielded an overall Cronbach's alpha coefficient of 0.97., Conclusions: The 27 short Portuguese sentences were highly comparable in terms of syntactical structure, number, position and length of words, lexical difficulty, and reading length. This reading test can overcome the limitations of the current tests for homogeneity and comparability, reducing subjectivity in the evaluation of the functional outcomes of medical and surgical ophthalmologic treatments.

Purpose: To investigate the reliability, validity, and statistical comparability of long paragraphs that were developed to be equivalent in construction and difficulty., Methods: Seven long paragraphs were developed that were equal in syntax, morphology, and number and position of words (111), with the same number of syllables (179) and number of characters (660). For validity analyses, the paragraphs were compared with the mean reading speed of a set of seven sentence optotypes of the RADNER Reading Charts (mean of 7 × 14 = 98 words read). Reliability analyses were performed by calculating the Cronbach's alpha value and the corrected total item correlation. Sixty participants (aged 20-77 years) read the paragraphs and the sentences (distance 40 cm; font: Times New Roman 12 pt). Test items were presented randomly; reading length was measured with a stopwatch., Results: Reliability analysis yielded a Cronbach's alpha value of 0.988. When the long paragraphs were compared in pairwise fashion, significant differences were found in 13 of the 21 pairs (p < 0.05). In two sequences of three paragraphs each and in eight pairs of paragraphs, the paragraphs did not differ significantly, and these paragraph combinations are therefore suitable for comparative research studies. The mean reading speed was 173.34 ± 24.01 words per minute (wpm) for the long paragraphs and 198.26 ± 28.60 wpm for the sentence optotypes. The maximum difference in reading speed was 5.55 % for the long paragraphs and 2.95 % for the short sentence optotypes. The correlation between long paragraphs and sentence optotypes was high (r = 0.9243)., Conclusions: Despite good reliability and equivalence in construction and degree of difficulty, a statistically significant difference in reading speed can occur between long paragraphs. Since statistical significance should be dependent only on the persons tested, either standardizing long paragraphs for statistical equality of reading speed measurements or increasing the number of presented paragraphs is recommended for comparative investigations.

Purpose: To develop 28 short sentence optotypes for the English version of the Radner Reading Charts that are as comparable as possible in number and length of words, as well as in difficulty and syntactical construction., Methods: Thirty-four English sentences were constructed following the method used for other Radner Reading Charts to obtain "sentence optotypes" with comparable structure and the same lexical and grammatical difficulty. Best comparable sentences were statistically selected and standardized in 50 volunteers. Reading speed and the number of errors were determined. Validity was analyzed with a 124-word long 4th-grade paragraph of the Florida Comprehensive Assessment Test®. Computerized measurements of reading parameters were performed with the RADNER Reading Device (RAD-RD©; in conjunction with a PC and microphone)., Results: The mean reading speed obtained with the 28 selected short sentences was 201.53 ± 35.88 words per minute (wpm), as compared to 215.01 ± 30.37 wpm for the long paragraph. The mean reading times were 4.30 ± 0.79 s and 35.26 ± 4.85 s, respectively. The mean number of reading errors was 0.11 ± 0.34. The correlation between the short sentences and the long paragraph was high (r = 0.76; p < 0.05; n = 50). Reliability analyses yielded an overall Cronbach's alpha coefficient of 0.9743., Conclusion: The present study indicates that the 28 selected English sentence optotypes are comparable in terms of both lexical difficulty as well as in reading length, and it demonstrates the validity and reliability of such sentences as test items for determining reading parameters such as reading acuity and speed.

Purpose: To evaluate reading performance of patients with monofocal intraocular lenses (IOLs) (Acrysof SN60WF) with or without reading glasses under bright and dim light conditions., Setting: Austrian Academy of Ophthalmology, Vienna, Austria., Design: Evaluation of a diagnostic test or technology., Methods: In pseudophakic patients, the spherical refractive error was limited to between +0.50 diopter (D) and -0.75 D with astigmatism of 0.75 D (mean spherical equivalent: right eye, -0.08 ± 0.43 [SD]; left eye, -0.15 ± 0.35). Near addition was +2.75 D. Reading performance was assessed binocularly with or without reading glasses at an illumination of 100 candelas (cd)/m(2) and 4 cd/m(2) using the Radner Reading Charts., Results: In the 25 patients evaluated, binocularly, the mean corrected distance visual acuity was -0.07 ± 0.06 logMAR and the mean uncorrected distance visual acuity was 0.01 ± 0.11 logMAR. The mean reading acuity with reading glasses was 0.02 ± 0.10 logRAD at 100 cd/m(2) and 0.12 ± 0.14 logRAD at 4 cd/m(2). Without reading glasses, it was 0.44 ± 0.13 logRAD and 0.56 ± 0.16 logRAD, respectively (P < .05). Without reading glasses and at 100 cd/m(2), 40% of patients read 0.4 logRAD at more than 80 words per minute (wpm), 68% exceeded this limit at 0.5 logRAD, and 92% exceeded it at 0.6 logRAD. The mean reading speed at 0.5 logRAD was 134.76 ± 48.22 wpm; with reading glasses it was 167.65 ± 32.77 wpm (P < .05)., Conclusion: A considerable percentage of patients with monofocal IOLs read newspaper print size without glasses under good light conditions., (Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was sent into a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise largely recovered. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography. At 4 months after the accident, she developed a psychological reaction consisting of nightmares, with reappearance of the complex visual hallucinations and a depressive syndrome. Using the European Cooperation for Lightning Detection network, a meteorological system for lightning surveillance, the exact geographical location and nature of the lightning strike were retrospectively retraced.

The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was set to a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise recovered largely. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning, and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography. Four months after the accident, she developed a psychological reaction consisting of nightmares with reappearance of the complex visual hallucinations and a depressive syndrome. Using the European Cooperation for Lightning Detection network, a meteorological system for lightning surveillance, the exact geographical location and nature of the lightning flash were retrospectively retraced.

Several studies revealed a high percentage of voice problems in future teachers. The influence of vocal constitution on the vocal endurance is, however, still unclear. The goal of this study was to evaluate whether the increase of voice fundamental frequency (F0) during teaching is caused by (1) autonomic regulation patterns under stress, (2) anxiety as an emotional factor, or (3) limitations in voice constitution. Thirty-three subjects with either normal voice constitution (n = 15, group 1) or constitutional hypofunction (n = 18, group 2) assessed by voice range profile measurements were enrolled in this study. Furthermore, they underwent a standardized baseline test to register selected autonomic test parameters and were classified into autonomic outlet types (AOT) as proposed by Johannes et al. Later the subjects were examined during 1 hour of teaching (field study). The parameters tested included heart rate, pulse transition time, finger temperature, and voice fundamental frequency. To measure situational anxiety and general anxiety proneness, a state-trait anxiety inventory was taken. Eleven subjects per group were identified as autonomic stable (AOT 1), two per group as responding cardiovascularly (AOT 2), and two of group 1 and four of group 2, respectively, as having higher heart rate and higher blood pressure responses to stress (AOT 4). One subject had to be excluded because of missing data. However, statistical analyses showed no differences between AOT groups regarding the voice constitution groups. Increased fundamental frequencies of speaking voice after 30 and 45 minutes of teaching were found in group 2 (constitutional hypofunction). No effect of state or trait anxiety on voice endurance could be detected. Thus, the increase of fundamental frequency of voice has to be regarded as a consequence of vocal fatigue. A constitutionally weak voice seems to be a risk factor for developing a professional voice disorder.

Attachment experiences are thought to be important because of their implications for later development. The authors' aim with the questionnaire-based study was to investigate the differences between recalled parental bonding regarding 4 types of maternal and paternal bonding with respect to experienced parenting stress caused by child characteristics, parent attributes, and life events under the consideration of the child's gender and age. The authors gathered parental bonding behavior data with the German version of the Parental Bonding Instrument (PBI). The authors assessed parenting stress with their German version of the "Parenting Stress Index (PSI)." They found significant differences among 120 mothers grouped in the 4 maternal and the 4 paternal bonding types regarding parenting stress caused by child, maternal bonding: F(5, 113) = 4.13, p = .002, paternal bonding: F(5, 111) = 8.50, p < or = .0001, and parent characteristics, maternal bonding: F(5, 113) = 3.33, p = .008, paternal bonding: F(5, 111) = 7.80, p < or = .0001. The lowest level of parenting stress was experienced by mothers who themselves recalled the "optimal parental bonding type" with respect to the child and parental domain. The authors did not find any significant differences between the 4 maternal, F(5, 113) = 1.25, p = .29, and the 4 paternal, F(5, 111) = 1.87, p = .106, bonding types with respect to the life stress. According to the authors' findings, the representation of attachment relationships seems to have a special impact on the adult's capacity to cope with challenges and stress, either directly or indirectly as an internal working model of attachment. For the clinical practice, these findings seem to recommend the combination of both the PSI and PBI regarding the diagnostic of stressful mother-child system to plan an optimal intervention program.

The aim of the present study was to get a differentiated view of stress experience of mothers of children with a specific language impairment with a standardised questionnaire. Our sample consisted of 63 mothers of language impaired children between 3.0 and 6.5 years consecutively recruited at the University-ENT clinic of Vienna. Parenting stress was assessed by the "Parenting Stress Index" of Abidin (1995) and the results were compared to mothers of a control group matched by sex and age of the children. The results showed significant mean differences between mothers of the clinical and the control group. In nearly all subscales mothers of language impaired children have higher stress scores than mothers of the control group. 68% of mothers of the clinical group are exposed to above-average stress levels whereas only 1.5% of mothers of children with normal language development show above-average parenting stress. For a successful intervention on children with a specific language impairment it seems to be very important to identify parental stressors and to treat and support parents too.

Purpose: To compare the effect of erbium:YAG laser photocapsulotomy (ELC), continuous curvilinear capsulorhexis (CCC), and high-frequency capsulotomy (HFC) on anterior capsule edges using light microscopy (LM) and transmission electron microscopy (TEM)., Setting: Department of Ophthalmology, Department of Histology and Embryology II, University of Vienna, Vienna, Austria., Methods: Five anterior capsule membranes were obtained experimentally by ELC, which was performed with the Oertli MicroLaser photoemulsification tip in eyes from 5 human cadavers. Thirty anterior capsule membranes were obtained during cataract surgery by CCC (n = 15) or, in cases with poor or missing red fundus reflexes, by HFC (n = 15). Continuous curvilinear capsulorhexis was performed conventionally with a manual, bent, 27-gauge cannula, and HFC was performed according to Klöti. Membranes were processed and examined by LM and TEM according to standard procedures., Results: The edges obtained by ELC showed mild signs of denaturation and mechanical disruption, tears, and micro-tears. Lens capsule edges obtained by CCC were smooth with no irregularities in any specimen; the edges were beveled anteriorly to posteriorly with no evidence of tearing. Edges produced by HFC were considerably wider; the surfaces showed distinct denaturation, preformed tears, and micro-tears. The edges were surrounded by a nonhomogeneous mass, which consisted mainly of denatured lens capsule material., Conclusions: Of the 3 techniques, CCC produced the mildest tissue damage. The histological damage at ELC edges was relatively mild and intermediate compared with that seen at CCC and HFC edges. These observations suggest that ELC is an appropriate option for anterior capsulotomy in cataract surgery.

Objectives: To investigate decision making by patients on the day before cataract surgery and to evaluate to what extent the informed consent process influences the patients' decision regarding consent., Methods: On the day before surgery, 70 patients (mean +/- SD age, 70.3 +/- 10.3 years) underwent a standardized informed consent procedure. They were also invited to answer 15 questions established in interdisciplinary cooperation among clinical psychologists, lawyers, and ophthalmologists., Main Outcome Measures: We assessed presurgical information and personal estimation of risks in cataract surgery; the patient-physician relationship regarding surgery-related decisions; and evaluations of the informed consent procedure and the patients' decision., Results: Questionnaire answers indicated that 28 (40%) of the 70 participating patients arrived for surgery without any information; 16 (23%) believed that there were surgical procedures without risks; and 53 (76%) estimated that there were no risks for their cataract surgery. A physician-dominated decision for surgery was preferred by 31 patients (44%); 16 (26%) wanted to decide together with their ophthalmologist. Possible risks of a sight-threatening complication did not influence 54 patients' (77%) decisions, and 55 patients (78%) said the informed consent process did not influence their decision. The remaining 15 (22%) stated that the informed consent process positively confirmed their decision., Conclusions: Informed consent 1 day preoperatively does not seem to influence the decision for cataract surgery. Cognitive dissonance as part of a decision-making process makes changes in an already chosen option unlikely. The resulting limited decisive potential is very important for credibility in a trial and has to be considered in ophthalmologic surgery.

Objective: The objective of the study was to explore the univariate and multivariate differences in behavioural problems among children with disorders in expressive or mixed receptive-expressive language development and children with unimpaired language development., Method: Ninety-four children with language development disorders (LDD) between the ages of 4 and 6 years and 94 children (matched by age and sex) without disorders of language development were compared concerning behavioural problems, as measured by the German version of the Child Behavior Checklist/4-18., Results: Thirty-two children (34%) with LDD showed behavioural problems in the clinical range, whereas only 6 control subjects (6%) had scores in this range. Univariate group comparisons between patients and control subjects showed significant differences in all 8 syndromes and the scale "other problems," with patients having higher scores. Multivariate stepwise discriminant analysis showed a significant discriminant function by the scales "other problems," "social problems," "anxious-depressed," "thought problems," "attention problems," and "delinquent problems.", Conclusions: In general, our results agree with several studies that report that children with speech and language disorders are at special risk for developing behavioural problems. Neurodevelopmental immaturity may be one factor underlying both the disorder in language development and the behavioural problems.