Dyscalculia from a developmental and differential perspective

Developmental dyscalculia (DD) and its treatment are receiving increasing research attention. A PsychInfo search for peer-reviewed articles with dyscalculia as a title word reveals 31 papers published from 1991–2001, versus 74 papers published from 2002–2012. Still, these small counts reflect the paucity of research on DD compared to dyslexia, despite the prevalence of mathematical difficulties. In the UK, 22% of adults have mathematical difficulties sufficient to impose severe practical and occupational restrictions (Bynner and Parsons, 1997; National Center for Education Statistics, 2011). It is unlikely that all of these individuals with mathematical difficulties have DD, but criteria for defining and diagnosing dyscalculia remain ambiguous (Mazzocco and Myers, 2003). What is treated as DD in one study may be conceptualized as another form of mathematical impairment in another study. Furthermore, DD is frequently—but, we believe, mistakenly- considered a largely homogeneous disorder. Here we advocate a differential and developmental perspective on DD focused on identifying behavioral, cognitive, and neural sources of individual differences that contribute to our understanding of what DD is and what it is not

EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future

Purpose Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. Design Meta-analysis of prevalence data. Participants A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. Methods AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). Main Outcome Measures Prevalence of early and late AMD, BCVA, and number of AMD cases. Results Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%–5.0%) in those aged 55–59 years to 17.6% (95%

Parietal rTMS distorts the mental number line: Simulating 'spatial' neglect in healthy subjects

Patients with left-sided visuospatial neglect, typically after damage to the right parietal lobe, show a systematic bias towards larger numbers when asked to bisect a numerical interval. This has been taken as further evidence for a spatial representation of numbers, perhaps akin to a mental number line with smaller numbers represented to the left and larger numbers to the right. Previously, contralateral neglect-like symptoms in physical line bisection have been induced in healthy subjects with repetitive transcranial magnetic stimulation (rTMS) over right posterior parietal lobe. Here we used rTMS over parietal and occipital sites in healthy subjects to investigate spatial representations in a number bisection task. Subjects were asked to name the midpoint of numerical intervals without calculating. On control trials subjects’ behaviour was similar to performance reported in physical line bisection experiments. Subjects underestimated the midpoint of the numerical interval. Repetitive transcranial magnetic stimulation produced representational neglect-like symptoms in number bisection when applied over right posterior parietal cortex (right PPC). Repetitive TMS over right PPC shifted the perceived midpoint of the numerical interval significantly to the right while occipital TMS had no effect on bisection performance. Our study therefore provides further evidence that subjects use spatial representations, perhaps akin to a mental number line, in basic numerical processing tasks. Furthermore, we showed that the right posterior parietal cortex is crucially involved in spatial representation of numbers

Response-selection-related parietal activation during number comparison

Neuroimaging studies of number comparison have consistently found activation in the intraparietal sulcus (IPS). Recently, it has been suggested that activations in the IPS vary with the distance between the numbers being compared. In number comparison, the smaller the distance between a number and the reference the longer the reaction time (RT). Activations in the right or left IPS, however, have also been related to attentional and intentional selection. It is possible, therefore, that activity in this region is a reflection of the more basic stimulus and response-selection processes associated with changes in RT. This fMRI experiment investigated the effect of numerical distance independently from RT. In addition, activations during number comparison of single-digit and double-digit stimuli were compared. During number comparison blocks, subjects had to indicate whether digits were greater or smaller than a reference (5 or 65). In control blocks, they were asked to perform a perceptual task (vertical line present/absent) on either numerical or nonnumerical stimuli. Number comparison versus rest yielded a large bilateral parietal-posterior frontal network. However, no areas showed more activation during number comparison than during the control tasks. Furthermore, no areas were more active during comparison of numbers separated by a small distance than comparisons of those separated by a large distance or vice versa. A left-lateralized parietal-posterior frontal network varied significantly with RT. Our findings suggest that magnitude and numerical-distance-related IPS activations might be difficult to separate from fundamental stimulus and response-selection processes associated with RT changes. As is the case with other parameters, such as space, magnitude may be represented in the context of response selection in the parietal cortex. In this respect, the representation of magnitude in the human IPS may be similar to the representation of magnitude in other nonhuman primates

Evaluating the Adoption of the Physical Board Game Ludo for Automated Assessments of Cognitive Abilities

Serious games present a valuable tool for continuous cognitive assessments especially in the case of elderly, where there is a lack of cognitive tools to continuously assess the transitory conditions that occur between normal cognition and cognitive failure. However, designing games for elderly poses distinctive challenges since one has to take into account the limited experience of today's elderly with digital gameplay interfaces like touch screens that are second-nature to younger players. In this paper we present an initial user study with young and healthy subjects where we evaluate a computer-vision based digitalization process that is necessary to turn a physical version of the board game "Ludo" into an automated assessment tool. We further evaluate to which extend this tool presents a valid alternative to assess the strategic cognitive capabilities of a person. We have chosen Ludo in its physical form after careful consideration together with elderly and caregivers since many elderlies know this game from their childhood and thus do not need to learn new game rules or to adapt to digital environment

Den Weizen von der Spreu trennen – Altersbezogene Personalpolitik und Innovationen auf der Betriebsebene

Adopting a dynamic perspective, this paper investigates age-related staffing patterns in German establishments and their effect on innovative performance. First, we investigate how establishments achieve the necessary workforce rejuvenation - from the inflow of younger or from outflows of older workers. In addition, we explore whether certain staffing patterns are more likely to appear under different economic regimes. In a second step, we analyse whether an establishment's innovative performance is related to the staffing patterns it experiences. The analysis of linked-employer-employee data shows that most of the 585 German establishments covered rejuvenate by inflows of younger workers. Half of the establishments also use the outflow of older workers. Furthermore, workforces are more likely to become more age-heterogeneous in growing establishments. Finally, we do not find evidence that a youth-centred human resource strategy (always) fosters innovation.@Dieser Beitrag untersucht die altersbezogene Personalpolitik deutscher Betriebe und deren Einfluss auf die Innovationsfähigkeit. Zuerst wird dargestellt, wie Betriebe verhindern, dass ihre Belegschaften altern. Beispielsweise werden bevorzugt jüngere Beschäftigte eingestellt und ältere Beschäftigte verlassen den Betrieb. Anschließend wird geprüft, ob bestimmte Einstellungs- und Entlassungsstrategien stärker in bestimmten wirtschaftlichen Umständen erfolgen. In einem zweiten Schritt wird analysiert, ob die Innovationsleistung von Betrieben mit deren Personalpolitik zusammenhängt. Die Analyse von verknüpften Beschäftigten-Betriebsdaten zeigt, dass die Mehrheit der untersuchten Betriebe sich durch das Einstellen jüngerer Beschäftigte verjüngt. Die Hälfte dieser Betriebe entlassen zudem Beschäftigte, die älter als der Durchschnitt der Belegschaft sind. Wir finden zudem, dass sich die Altersheterogenität in wachsenden Betrieben erhöht. Schließlich finden wir keine Evidenz dafür, dass eine jugendzentrierte Personalpolitik die Innovationsfähigkeit der Betriebe verbessert.Dieser Beitrag untersucht die altersbezogene Personalpolitik deutscher Betriebe und deren Einfluss auf die Innovationsfähigkeit. Zuerst wird dargestellt, wie Betriebe verhindern, dass ihre Belegschaften altern. Beispielsweise werden bevorzugt jüngere Beschäftigte eingestellt und ältere Beschäftigte verlassen den Betrieb. Anschließend wird geprüft, ob bestimmte Einstellungs- und Entlassungsstrategien stärker in bestimmten wirtschaftlichen Umständen erfolgen. In einem zweiten Schritt wird analysiert, ob die Innovationsleistung von Betrieben mit deren Personalpolitik zusammenhängt. Die Analyse von verknüpften Beschäftigten-Betriebsdaten zeigt, dass die Mehrheit der untersuchten Betriebe sich durch das Einstellen jüngerer Beschäftigte verjüngt. Die Hälfte dieser Betriebe entlassen zudem Beschäftigte, die älter als der Durchschnitt der Belegschaft sind. Wir finden zudem, dass sich die Altersheterogenität in wachsenden Betrieben erhöht. Schließlich finden wir keine Evidenz dafür, dass eine jugendzentrierte Personalpolitik die Innovationsfähigkeit der Betriebe verbessert