Evidence for the late MMN as a neurophysiological endophenotype for dyslexia.

Dyslexia affects 5-10% of school-aged children and is therefore one of the most common learning disorders. Research on auditory event related potentials (AERP), particularly the mismatch negativity (MMN) component, has revealed anomalies in individuals with dyslexia to speech stimuli. Furthermore, candidate genes for this disorder were found through molecular genetic studies. A current challenge for dyslexia research is to understand the interaction between molecular genetics and brain function, and to promote the identification of relevant endophenotypes for dyslexia. The present study examines MMN, a neurophysiological correlate of speech perception, and its potential as an endophenotype for dyslexia in three groups of children. The first group of children was clinically diagnosed with dyslexia, whereas the second group of children was comprised of their siblings who had average reading and spelling skills and were therefore "unaffected" despite having a genetic risk for dyslexia. The third group consisted of control children who were not related to the other groups and were also unaffected. In total, 225 children were included in the study. All children showed clear MMN activity to/da/-/ba/contrasts that could be separated into three distinct MMN components. Whilst the first two MMN components did not differentiate the groups, the late MMN component (300-700 ms) revealed significant group differences. The mean area of the late MMN was attenuated in both the dyslexic children and their unaffected siblings in comparison to the control children. This finding is indicative of analogous alterations of neurophysiological processes in children with dyslexia and those with a genetic risk for dyslexia, without a manifestation of the disorder. The present results therefore further suggest that the late MMN might be a potential endophenotype for dyslexia

Katamnestische Untersuchung und Entwicklung eines Screening-Fragebogens bei Patienten mit Asperger-Syndrom und Patienten mit tiefgreifenden Entwicklungsstörungen

Diese Langzeituntersuchung an erwachsenen Asperger-Autisten zeigt, dass die untersuchten Patienten relativ gut adaptiert sind, trotz deutlicher Defizite in der Lebensbewältigung. Die Auswertung eines eigens entwickelten Screeningfragebogens für erwachsene Asperger-Autisten sowie deren Eltern und Betreuer zeigte signifikante Unterschiede im Antwortverhalten zwischen unterschiedlichen Patientengruppen und lässt die Fragebögen prinzipiell als Screeninginstrument geeignet erscheinen

Application of the screening method to monitor influenza vaccine effectiveness among the elderly in Germany

Background: Elderly people are at increased risk for severe influenza illness and constitute therefore a major target-group for seasonal influenza vaccination in most industrialized countries. The aim of this study was to estimate influenza vaccine effectiveness (VE) among individuals aged 60+ years over three seasons and to assess if the screening method is a suitable tool to monitor influenza VE in this particular target-group in Germany. Methods: We identified laboratory-confirmed influenza cases aged 60+ years through the national communicable disease reporting system for seasons 2010/11, 2011/12 and 2012/13. Vaccination coverage (VC) data were retrieved from a database of health insurance claims representing ~85% of the total German population. We applied the screening method to calculate influenza subtype-specific VE and compared our results with VE estimates from other observational studies in Europe. Results: In total, 7,156 laboratory-confirmed influenza cases were included. VE against all influenza types ranged between 49% (95% confidence interval [CI]: 39–56) in 2011/12 and 80% (95% CI: 76-83%) in 2010/11. In 2010/11 subtype-specific VE against influenza A(H1N1)pdm and B was 76% and 84%, respectively. In the following seasons, VE against influenza A(H1N1)pdm, A(H3N2) and B was 87%, -9% , 74% (2011/12), and 74%, 39%, 73% (2012/13). VE was higher among hospitalized compared to non-hospitalized influenza A cases. Seventeen observational studies from Europe reporting subtype-specific VE among the elderly were identified for the respective seasons (all applying the test-negative design) and showed comparable subtype-specific VE estimates. Conclusions: According to our study, influenza vaccination provided moderate protection against laboratory-confirmed influenza A(H1N1)pdm and B in individuals aged 60+ but no or only little protection against A(H3N2). Higher VE among hospitalized cases might indicate higher protection against severe influenza disease. Based on the available data, the screening method allowed us to assess subtype-specific VE in hospitalized and non-hospitalized elderly persons. Since controlling for several important confounders was not possible, the applied method only provided crude VE estimates. However, given the precise VC-data and the large number of cases, the screening method provided results being in line with VE estimates from other observational studies in Europe that applied a different study design

Epidemiologie Vancomycin-resistenter Enterokokken in Krankenhäusern in Deutschland

Die vorliegende Habilitationsschrift beschäftigt sich mit der Epidemiologie Vancomycin-resistenter Enterokokken in Deutschland. Dabei wird gezeigt, dass die VRE-Rate unter Enterokokken-Infektionen in den letzten Jahren in deutschen Krankenhäusern kontinuierlich zugenommen hat. Besonders ausgeprägt ist dieser Anstieg auf Intensivstationen, wo im Jahr 2016 bereits jede sechste Enterokokken-Blutstrominfektion (BSI) durch VRE bedingt war. Dieser kontinuierliche Anstieg wird aufgrund der höheren Liegedauer und einer erhöhten Letalität bei einer Enterokokken-BSI mit Vancomycin-sensiblen und Vancomycin-resistenten E. faecium im Vergleich zu E. faecalis auch enorme Auswirkungen auf die Kosten des Gesundheitssystems haben. Die Ergebnisse dieser Arbeit zeigen weiterhin, dass die zunehmende Anwendung spezifischer Breitspektrumantibiotika aber auch die zunehmende VRE-Prävalenz bei Patienten in Krankenhäusern die Ausbreitung von VRE weiter begünstigen. Dies unterstreicht die Notwendigkeit der Implementierung von Antibiotic Stewardship-Teams und von krankenhaushygienischen Maßnahmen. Aufgrund des komplexen Selektionsprozesses von VRE, der persistierenden Kolonisierung im Gastrointestinaltrakt sowie fehlender effektiver Dekolonisationsmaßnahmen sind die bei MRSA erfolgreichen Präventionsmaßnahmen bei VRE nicht ausreichend und müssen weiter diskutiert und angepasst werden. Um die Epidemiologie von VRE, regionalen Unterschiede und die Ausbreitungswege relevanter klonaler Linien besser zu verstehen, sollte außerdem die mikrobiologische Diagnostik und insbesondere die Genotypisierung von Enterokokken weiter intensiviert werden

implications for HPV vaccination policies

Background In Germany, immunization against human papillomaviruses (HPV) is free of charge for all females aged 12 to 17 years. Since HPV infection rates rise soon after first intercourse, immunization against HPV should be completed before sexual debut. Knowledge of country-specific data on age at first intercourse and related risk factors is important to optimize prevention of HPV and other sexually transmitted infections. Therefore, the primary aim of this study was to describe sexual behavior in young women in Germany. Secondary aims were to identify factors that are (i) associated with younger age at first intercourse and (ii) with HPV vaccine uptake. Methods Between 2010 and 2012, we conducted a cross-sectional study among randomly selected women aged 20 to 25 years in Germany. We used a structured, self-administered questionnaire to collect sociodemographic data, information on sexual habits such as age at first intercourse, and information on HPV vaccine uptake. We used univariate and multivariate logistic regression analyses to identify factors associated with younger age at first intercourse and with HPV vaccine uptake. Results A total of 823 women (response rate: 14.2%) participated, 785 (95.4%) of which reported having had intercourse already. 70% of these women experienced first intercourse before the age of 18 years. However, less than 5% were younger than 14 years at sexual debut. Younger age at first intercourse was independently associated with a higher number of sexual partners, smoking, and past pregnancies. HPV vaccine uptake was associated with higher education, whereas smoking and a migrant background reduced the chance of being vaccinated. Conclusion In Germany, only a small proportion of women experienced first intercourse before the age of 14 years. Younger age at first intercourse was associated with behavior that might increase the risk of HPV infections or other sexually transmitted infections. Therefore, to optimize the HPV vaccination strategy, HPV vaccination series should be completed before the age of 14 years in Germany

Health-related quality of life in adolescents and young adults with high functioning autism-spectrum disorder

Aim: Over the last years, health-related quality of life (HRQOL) has emerged as an important measure not only in somatic medicine but also in psychiatry. To date, there are only few reports on HRQOL in patients with autism-spectrum disorder (ASD). This study aimed at studying HRQOL in ASD patients with an IQ >70, using a self-report HRQOL questionnaire with cross-cultural validity

Les reseaux hvdc multi-terminaux: des defies multipes en genie electrique high voltage direct current grid multiterminals: many challenges in electrical engineering

Electrical installation using high voltage need to be improve to make the exchanges of power under the sea with security and to connect the offshore sources. Alterative grid show limits in those applications. High voltage direct current (HVDC) installation can be a solution to those cases, if some technological and scientist problem are solved. Challenge are in every level of the electrical engineering work, in the whole system, with the material used, and the way their used. This article introduce the main challenges in the domain of electrical engineering to solve in case of the exploitation of a HVDC grid

Проблемы процесса управления в техносферной безопасности

В статье будет рассмотрены проблемы техносферной безопасности через интеграционный подход, как самый эффективный в сфере управления природопользования. Самые важные проблемы будут обобщены в вопросах государственного регулирования, также будут выявлены факторы влияния на эффективность управления данного процесса