Body fat distribution and risk of incident ischemic stroke in men and women aged 50 to 74 years from the general population: the KORA Augsburg cohort study

It remains controversial whether measures of general or abdominal adiposity are better risk predictors for ischemic stroke. Furthermore, so far it is unclear whether body fat mass index (BFMI) and fat free mass index (FFMI) are risk predictors for ischemic stroke. This study examined the sex-specific relevance of body mass index (BMI), BROCA Index, waist circumference (WC), waist-height ratio (WHtR), BFMI and FFMI for the development of ischemic stroke in a Caucasian population.The prospective population-based cohort study was based on 1917 men and 1832 women (aged 50 to 74 years) who participated in the third (1994/95) or fourth (1999/2001) MONICA/KORA Augsburg survey. Subjects were free of stroke at baseline. Standardized anthropometric and bioelectric impedance measurements were obtained at baseline. Hazard ratios (HR) were estimated from Cox proportional hazard models.During a median follow-up of 9.3 years 128 ischemic strokes occurred in men and 81 in women, respectively. Coded as quartiles WC and WHtR were significantly associated with incident stroke in multivariable analyses in women (comparing the 4th vs. the bottom quartile), but none of the adiposity measures was significantly associated with incident stroke in multivariable adjusted analyses in men. When anthropometric measures were used as continuous variables, these findings were confirmed. After multivariable adjustment the associations between obesity measures and incident ischemic stroke were statistically significant only for WC (HR 1.39, 95%CI 1.12-1.72) and WHtR in women (HR 1.39, 95%CI 1.12-1.73) per increase of 1 standard deviation. In both sexes the measures BFMI and FFMI were no independent predictors for incident ischemic stroke.Abdominal obesity measures are independent predictors of incident ischemic stroke in women but not in men from the general adult population. Thus, it may be of particular importance for women to prevent central obesity in order to reduce their risk of ischemic stroke

Wenn Spotify den Ton angibt: Audiostreaming-Dienste und die Frage nach der persönlichen Autonomie

In der Studie wird die wahrgenommene persönliche Autonomie von aktiven Spotify-Nutzer:innen beim Treffen von Entscheidungen auf der Plattform untersucht. Ferner spielt auch das grundsätzliche Hörverhalten von Audioinhalten eine Rolle. Ausgangslage der Untersuchung sind Theorien aus der Medien- und Kommunikationswissenschaft, Psychologie, Philosophie und Ethik. In dieser Verzahnung unterschiedlicher Disziplinen wurde das Thema in dieser Form bisher nur wenig erforscht. Mithilfe von Tiefeninterviews sowie von qualitativen Inhaltsanalysen können drei zu Beginn aufgestellte Leitfragen beantwortet werden. Diese beziehen sich auf die Bedeutung Spotifys im Leben der Nutzer:innen sowie auf Kenntnisse zur wahrgenommenen Autonomie bei der Nutzung der App und deren Bewertung. Es kann festgestellt werden, dass Spotify eine bedeutende Rolle im Leben seiner Nutzer:innen zukommt. Diese nutzen den Musikstreaming-Dienst zur Beeinflussung ihrer Stimmung, zum Vertreiben von Langeweile sowie zum Hervorrufen von als positiv empfundenen Erinnerungen. Zudem geben alle Proband:innen an, Spotify als ihren Hauptdienst für Audiostreaming zu nutzen; die meisten von ihnen zahlen für den Premium-Account. Obwohl Spotify als Mittel zum Zweck gilt, können sich die befragten Nutzer:innen nach aktuellem Stand keinen Wechsel des Anbieters vorstellen. Bei der Nutzung selbst ist den meisten befragten Proband:innen bewusst, dass Spotify Algorithmen nutzt, die ihnen Audioinhalte vorschlagen. Diese werden von allen Befragten genutzt, was auf eine eingeschränkte Autonomie der Nutzer:innen hindeutet, jedoch aufgrund der gewählten Methode nicht vollständig bestätigt werden kann. Gleichzeitig fühlen sie sich in einer Position der Kontrolle über ihre Entscheidungen, da sie durch Klicken und Downloaden von Audioinhalten selbstbestimmt handeln können. Auch die in Bezug auf Spotify bekannte Problematik, dass Daten gesammelt und unter anderem zu Werbezwecken genutzt werden, löst bei den Befragten nur wenig Skepsis aus. Alles in allem schafft Spotify es, das Vertrauen der Nutzer:innen im Umgang mit Daten sowie ihrer eigenen Autonomie zu gewinnen. Über Algorithmen und Datensammlungen wird von den Befragten hinweggesehen, sofern Spotify weiterhin als alltäglicher Stimmungsmacher funktioniert und vielfältige Funktionalitäten anbietet, die die Nutzenden als wichtig erachten

final results of the observational EXPLAIN-FXS study

Background As data on the phenotype, characteristics and management of patients with Fragile X Syndrome (FXS) are limited, we aimed to collect such data in Germany in experienced centres involved in the treatment of such patients. Methods EXPLAIN-FXS is a prospective observational (non- interventional) study (registry) performed between April 2013 and January 2016 at 18 sites in Germany. Requirements for patient participation included confirmed diagnosis of FXS by genetic testing (>200 CGG repeats) and written informed consent. Patients were followed for up to 2 years. Results Seventy- five patients (84.0 % males, mean age 16.7 ± 14.5 years, ranging from 2 - 82 years) were analysed. The mean 6-item score, determined according to Giangreco (J Pediatr 129:611-614, 1996), was 6.9 ± 2.5 points. At least one neurological finding each was noted in 53 patients (69.7 %). Specifically, ataxia was noted in 5 patients (6.6 %), lack of fine motor skills in 40 patients, (52.6 %), muscle tonus disorder in 4 patients (5.3 %), and other neurological disorders in 39 patients (51.3 %). Spasticity was not noted in any patient. Seizures were reported in 6 patients (8.1 %), anxiety disorders in 22 patients (30.1 %), depression in 7 patients (9.6 %), ADHD/ADD in 36 patients (49.3 %), impairment of social behavior in 39 patients (53.4 %), and other comorbidities in 23 patients (31.5 %). The mean Aberrant Behaviour Checklist Community Edition (ABC-C) score on behavioral symptoms, obtained in 71 patients at first documentation, was 48.4 ± 27.8 (median 45.0, range 5-115). The mean visual analogue scale (VAS) score, obtained in 59 patients at first documentation, was 84.9 ± 14.6 points (median 90; range 50 – 100). Conclusions This report describes the largest cohort of patients with FXS in Europe. The reported observations indicate a substantial burden of disease for patients and their caregivers. Based on these observations, an early expert psychiatric diagnosis is recommended for suspected FXS patients. Further recommendations include multimodal and multi-professional management that is tailored to the individual patient’s needs. Trial registration The ClinTrials.gov identifier is NCT01711606. Registered on 18 October 2012

Ask Smart to Get Smart: Mathematische Ausgaben generativer KI-Sprachmodelle verbessern durch gezieltes Prompt Engineering

Der Beitrag beschäftigt sich mit den derzeitigen mathematischen Fähigkeiten des generativen KI-Spachmodells ChatGPT in Bezug auf das Lösen mathematischer Probleme. Um für den schulischen Nutzen des Modells die Zuverlässigkeit und Nachvollziehbarkeit von mathematischen Ausgaben zu optimieren, stellen wir im Beitrag unterschiedliche Prompt-Techniken vor und untersuchen ihren Effekt in Modellvalidierungen anhand einer arithmetischen und einer algebraischen Problemlöseaufgabe

Zygosity Determination in Twin Studies: a Validation of Zygosity Questionnaires Using DNA in the German TwinLife Study

Lenau F, Hahn E, Peters A-L, Gottschling J, Thiel W, Spinath FM. Zygosity Determination in Twin Studies: a Validation of Zygosity Questionnaires Using DNA in the German TwinLife Study. TwinLife Working Paper Series. Vol 01. Bielefeld: Project TwinLife "Genetic and social causes of life chances" (Universität Bielefeld / Universität des Saarlandes); 2017.Zygosity determination using similarity ratings is frequently applied in twin studies. A correct determination of zygosity is essential for the estimation of heritability and environmental influences on phenotypes. Therefore, the present study examined the validity of two similarity questionnaires used in the German TwinLife study, in which data from 4,097 twin pairs and their families were assessed: twin children’s zygosities were determined with the Zygosity Questionnaire for Young Twins, which was administered in parent-report form. For adolescent twins, the Self Report Zygosity Questionnaire was used. For the present validation analyses, DNA samples of N = 328 twin pairs were collected via buccal swabs. In this DNA subsample, questionnaires were filled out by parents for n = 212 (aged 4 to 12 years) twin pairs while self-reports were collected from n = 116 adolescent twins (16 to 23 years of age). Using DNA-based zygosity as criteria, correct classification rates of 97% for parent- and 92% for self-reports were established and cross-validated. Additionally, classification rates based on a single item and variants of questionnaire based zygosity determination used in other twin studies were calculated and compared. Implications of incorrectly classified zygosity on genetic and environmental estimates in twin studies are discussed

Association of sleep disturbances within 4weeks prior to incident acute myocardial infarction and long-term survival in male and female patients: an observational study from the MONICA/KORA Myocardial Infarction Registry

Background: Sleep-related investigations in acute myocardial infarction (AMI) patients are rare. The aim of this study was to examine sex-specific associations of patient-reported sleep disturbances within 4weeks before AMI and long-term survival. Methods: From a German population-based, regional AMI registry, 2511 men and 828 women, aged 28-74years, hospitalized with a first-time AMI between 2000 and 2008 and still alive after 28days, were included in the study (end of follow-up: 12/2011). Frequency of any sleep disturbances within 4weeks before AMI was inquired by a 6-categorical item summarized to never', sometimes' and nightly'. Cox regression models were calculated.Results: Over the median follow-up time of 6.1years (IQR: 4.1) sleep disturbances were reported by 32.3% of male and 48.4% of female patients. During the observation period, 318 men (12.7%) and 131 women (15.8%) died. Men who sometimes' had sleep disturbances showed a 56% increased mortality risk compared to those without complaints in an age-adjusted model (HR 1.56;95%-CI 1.21-2.00). Additional adjustment for confounding variables attenuated the effect to 1.40 (95%-CI 1.08-1.81). Corresponding HRs among women were 0.97 (95%-CI 0.65-1.44) and 0.99 (95%-CI 0.66-1.49). HRs for patients with nightly sleep disturbances did not suggest any association for both sexes. Conclusions: Our study found that nightly sleep disturbances have no influence on long-term survival in male and female AMI patients. Contrary to women, men who reported sometimes sleep disturbances had a higher mortality. Further investigations on this topic taking into account the role of obstructive sleep apnoea are needed

Hepatitis delta infection among persons living with HIV in Europe

Background and aims: A high prevalence of hepatitis delta virus (HDV) infection, the most severe form of viral hepatitis, has been reported among persons living with HIV (PLWH) in Europe. We analysed data from a large HIV cohort collaboration to characterize HDV epidemiological trends across Europe, as well as its impact on clinical outcomes. Methods: All PLWH with a positive hepatitis B surface antigen (HBsAg) in the Swiss HIV Cohort Study and EuroSIDA between 1988 and 2019 were tested for anti-HDV antibodies and, if positive, for HDV RNA. Demographic and clinical characteristics at initiation of antiretroviral therapy were compared between HDV-positive and HDV-negative individuals using descriptive statistics. The associations between HDV infection and overall mortality, liver-related mortality as well as hepatocellular carcinoma (HCC) were assessed using cumulative incidence plots and cause-specific multivariable Cox regression. Results: Of 2793 HBsAg-positive participants, 1556 (56%) had stored serum available and were included. The prevalence of HDV coinfection was 15.2% (237/1556, 95% confidence interval [CI]: 13.5%-17.1%) and 66% (132/200) of HDV-positive individuals had active HDV replication. Among persons who inject drugs (PWID), the prevalence of HDV coinfection was 50.5% (182/360, 95% CI: 45.3%-55.7%), with similar estimates across Europe, compared to 4.7% (52/1109, 95% CI: 3.5%-5.9%) among other participants. During a median follow-up of 10.8 years (interquartile range 5.6-17.8), 82 (34.6%) HDV-positive and 265 (20.1%) HDV-negative individuals died. 41.5% (34/82) of deaths were liver-related in HDV-positive individuals compared to 17.7% (47/265) in HDV-negative individuals. HDV infection was associated with overall mortality (adjusted hazard ratio 1.6; 95% CI 1.2-2.1), liver-related death (2.9, 1.6-5.0) and HCC (6.3, 2.5-16.0). Conclusion: We found a very high prevalence of hepatitis delta among PWID across Europe. Among PLWH who do not inject drugs, the prevalence was similar to that reported from populations without HIV. HDV coinfection was associated with liver-related mortality and HCC incidence