Cognitive control modulates preferential sensory processing of affective stimuli

Adaptive human behavior crucially relies on the ability of the brain to allocate resources automatically to emotionally significant stimuli. This ability has consistently been demonstrated by studies showing preferential processing of affective stimuli in sensory cortical areas. It is still unclear, however, whether this putatively automatic mechanism can be modulated by cognitive control processes. Here, we use functional magnetic resonance imaging (fMRI) to investigate whether preferential processing of an affective face distractor is suppressed when an affective distractor has previously elicited a response conflict in a word-face Stroop task. We analyzed this for three consecutive stages in the ventral stream of visual processing for which preferential processing of affective stimuli has previously been demonstrated: the striate area (BA 17), category-unspecific extrastriate areas (BA 18/19), and the fusiform face area (FFA). We found that response conflict led to a selective suppression of affective face processing in category-unspecific extrastriate areas and the FFA, and this effect was accompanied by changes in functional connectivity between these areas and the rostral anterior cingulate cortex. In contrast, preferential processing of affective face distractors was unaffected in the striate area. Our results indicate that cognitive control processes adaptively suppress preferential processing of affective stimuli under conditions where affective processing is detrimental because it elicits response conflict

Safety and Efficiency of Rotational Atherectomy in Chronic Total Coronary Occlusion-One-Year Clinical Outcomes of an Observational Registry.

The study sought to assess the procedural success of rotational atherectomy (RA) in coronary chronic total occlusion (CTO) and to investigate the in-hospital and one-year outcomes following RA. From 2015 to 2019, patients undergoing percutaneous coronary intervention for CTO (CTO PCI) were retrospectively included into the hospital database. The primary endpoint was procedural success. Secondary endpoints were in-hospital and one-year major adverse cardiovascular and cerebral event (MACCE) rates. During the study period of 5 years, 2.789 patients underwent CTO PCI. Patients treated with RA (n = 193, 6.92%) had a significantly higher procedural success (93.26% vs. 85.10%, p = 0.0002) compared to those treated without RA (n = 2.596, 93.08%). Despite a significantly higher rate of pericardiocentesis (3.11% vs. 0.50%, p = 0.0013) in the RA group, the in-hospital and one-year MACCE rate was similar in both groups (4.15% vs. 2.77%, p = 0.2612; 18.65% vs. 16.72%, p = 0.485). In conclusion, RA is associated with higher procedural success for CTO PCI, but has higher risks for pericardial tamponade than CTO PCI without the need for RA. Nevertheless, in-hospital and one-year MACCE rates did not differ in-between both groups

Repräsentative Analyse der Lebenslagen einkommensstarker Haushalte

Die Studie von 2002 liefert eine Expertise für die Armuts- und Reichtumsberichterstattung der Bundesregierung auf Basis einer repräsentativen Erhebung einkommensstarker Haushalte. Die Datenbasis zur Analyse der Lebenslage, der Einkommen und der Vermögensbildung von Haushalten im oberen Einkommensbereich umfasst eine Zufallstichprobe von 1.224 Haushalten mit 2.671 Befragungspersonen, die über ein Haushaltsnettoeinkommen von 3.835 EUR und mehr verfügen, bzw. 505 Haushalte mit 1.130 Personen mit einem Haushaltsnettoeinkommen von 5.113 EUR und mehr. Die telefonische Befragung der einkommensstarken Haushalte wurde im Rahmen der SOEP-Befragung des Jahres 2002 durchgeführt. Die empirischen Ergebnisse zu den Lebenslagen gliedern sich in folgende Aspekte: (1) Struktur und Lebenslage von Hocheinkommensbeziehern, (2) subjektive Indikatoren, (3) Hocheinkommen und Gesundheit, (4) die individuelle Vermögensbilanz von Hocheinkommensbeziehern, (5) Spezifika einkommensstarker Haushalte, (6) Verteilung des Vermögens auf die Gruppen nach Hausnettoeinkommen sowie (7) Hocheinkommensbezieherhaushalte in der äquivalenzgewichteten Perspektive. (ICG2

Thirst and the state-dependent representation of incentive stimulus value in human motive circuitry

Abstract Depletion imposes both need and desire to drink, and potentiates the response to need-relevant cues in the environment. The present fMRI study aimed to determine which neural structures selectively increase the incentive value of needrelevant stimuli in a thirst state. Towards this end, participants were scanned twice-either in a thirst or no-thirst statewhile viewing pictures of beverages and chairs. As expected, thirst led to a selective increase in self-reported pleasantness and arousal by beverages. Increased responses to beverage when compared with chair stimuli were observed in the cingulate cortex, insular cortex and the amygdala in the thirst state, which were absent in the no-thirst condition. Enhancing the incentive value of need-relevant cues in a thirst state is a key mechanism for motivating drinking behavior. Overall, distributed regions of the motive circuitry, which are also implicated in salience processing, craving and interoception, provide a dynamic body-state dependent representation of stimulus value

Risk factor paradox: No prognostic impact of arterial hypertension and smoking in patients with ventricular tachyarrhythmias

Background: Data regarding the outcome of patients with ventricular tachyarrhythmias related to arterial hypertension (AHT) and smoking is limited. The study sought to assess the prognostic impact of AHT and smoking on survival in patients presenting with ventricular tachyarrhythmias. Methods: All consecutive patients surviving ventricular tachycardia (VT) and ventricular fibrillation (VF) upon admission to the University Medical Center Mannheim (UMM), Germany from 2002 to 2016 were included and stratified according to AHT and smoking by propensity score matching. The primary prognostic endpoint was all-cause mortality at 30 months.Results: A total of 988 AHT-matched patients (494 each, with and without AHT) and a total of 872 smoking-matched patients (436 each, with and without smoking) were included. The rates of VT and VF were similar in both groups (VT: AHT 60% vs. no AHT 60%; smokers 61% vs. non-smokers 62%; VF: AHT 35% vs. no AHT 38%; smokers 39% vs. non-smokers 38%). Neither AHT nor smoking were associated with the primary endpoint of long-term all-cause mortality at 30 months (long-term mortality rates: AHT/no AHT, 26% vs. 28%; log-rank p = 0.525; smoking/non-smoking, 22% vs. 25%; log-rank p = 0.683).Conclusions: Paradoxically, neither AHT nor smoking were associated with differences of long-term all-cause mortality in patients presenting with ventricular tachyarrhythmias

Hepatic p53 is regulated by transcription factor FOXO1 and acutely controls glycogen homeostasis

The tumor suppressor p53 is involved in the adaptation of hepatic metabolism to nutrient availability. Acute deletion of p53 in the mouse liver affects hepatic glucose and triglyceride metabolism. However, long-term adaptations upon the loss of hepatic p53 and its transcriptional regulators are unknown. Here we show that short-term, but not chronic, liver-specific deletion of p53 in mice reduces liver glycogen levels, and we implicate the transcription factor forkhead box O1 protein (FOXO1) in the regulation of p53 and its target genes. We demonstrate that acute p53 deletion prevents glycogen accumulation upon refeeding, whereas a chronic loss of p53 associates with a compensational activation of the glycogen synthesis pathway. Moreover, we identify fasting-activated FOXO1 as a repressor of p53 transcription in hepatocytes. We show that this repression is relieved by inactivation of FOXO1 by insulin, which likely mediates the upregulation of p53 expression upon refeeding. Strikingly, we find that high-fat diet-induced insulin resistance with persistent FOXO1 activation not only blunted the regulation of p53 but also the induction of p53 target genes like p21 during fasting, indicating overlapping effects of both FOXO1 and p53 on target gene expression in a context-dependent manner. Thus, we conclude that p53 acutely controls glycogen storage in the liver and is linked to insulin signaling via FOXO1, which has important implications for our understanding of the hepatic adaptation to nutrient availability

Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias

Objectives: The study sought to assess the prognostic impact of type 2 diabetes in patients presenting with ventricular tachyarrhythmias on admission. Background: Data regarding the prognostic outcome of diabetics presenting with ventricular tachyarrhythmias is limited. Methods: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Patients with type 2 diabetes (diabetics) were compared to non-diabetics applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint of long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index, all-cause mortality at 30 days, all-cause mortality in patients surviving index hospitalization at 2 years (i.e. “after discharge”) and rehospitalization due to recurrent ventricular tachyarrhythmias at 2 years. Results: In 2411 unmatched high-risk patients with ventricular tachyarrhythmias, diabetes was present in 25% compared to non-diabetics (75%). Rates of VT (57% vs. 56%) and VF (43% vs. 44%) were comparable in both groups. Multivariable Cox regression models revealed diabetics associated with the primary endpoint of long-term all-cause mortality at 2 years (HR = 1.513; p = 0.001), which was still proven after propensity score matching (46% vs. 33%, log rank p = 0.001; HR = 1.525; p = 0.001). The rates of secondary endpoints were higher for in-hospital death at index, all-cause mortality at 30 days, as well as after discharge, but not for cardiac death at 24 h or rehospitalization due to recurrent ventricular tachyarrhythmias. Conclusion: Presence of type 2 diabetes is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission

Prognostic impact of age and gender on patients with electrical storm

Background: Electrical storm (ES) is a severe and life-threatening heart rhythm disorder. Age and male gender have been identified as independent risk factors for cardiovascular diseases. However, data regarding the prognostic impact of age and gender on ES patients is limited. Methods: The present study included retrospectively consecutive patients presenting with ES from 2002 to 2016. Patients 67 years old or older were compared to patients younger than 67, males were also compared to females. Receiver operating characteristic analyses were performed to find the optimum age cut-off value. The primary endpoint was all-cause mortality at 3 years. The secondary endpoints were in-hospital mortality, rehospitalization rates, electrical storm recurrences (ES-R), and major adverse cardiac events (MACE) at 3 years. Results: Eighty-seven ES patients with implantable cardioverter-defibrillators were included. Age ≥ 67 years was associated with increased all-cause mortality at 3 years (48% vs. 20%, hazard ratio = 3.046; 95% confidence interval 1.316–7.051; p = 0.008; log-rank p = 0.006). MACE, in-hospital mortality, rehospitalization rates, and ES-R were not affected by age. Even after multivariate adjustment, age ≥ 67 years was associated with increased long-term mortality at 3 years, besides left ventricular ejection fraction < 35%. In contrast, gender was not associated with the primary and secondary endpoints. Conclusions: Patients 67 years old and older presenting with ES are associated with poor long-term prognosis at 3 years. Increased long-term mortality was still evident after multivariate adjustment. In contrast, gender was not associated with the primary and secondary endpoints

Statin therapy is associated with improved survival in patients with ventricular tachyarrhythmias

Objectives: The study sought to assess the impact of statin therapy on survival in patients presenting with ventricular tachyarrhythmias. Background: Data regarding the outcome of patients with statin therapy presenting with ventricular tachyarrhythmias is limited. Methods: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) or fibrillation (VF) from 2002 to 2016. Patients with statin were compared to patients without statin therapy (non-statin). The primary prognostic endpoint was long-term all-cause death at 3 years. Uni- and multivariable Cox regression analyses were applied in propensity-score matched cohorts. Results: A total of 424 matched patients was included. The rates of VT and VF were similar in both groups (VT: statin 71% vs. non-statin 68%; VF: statin 29% vs. 32%; p = 0.460). Statin therapy was associated with lower all-cause mortality at long-term follow-up (mortality rates 16% versus 33%; log rank, p = 0.001; HR = 0.438; 95% CI 0.290–0.663; p = 0.001), irrespective of the underlying type of ventricular tachyarrhythmia (VT/VF), left ventricular ejection fraction (LVEF) > 35%, presence of an activated implantable cardioverter defibrillator (ICD), cardiogenic shock or cardiopulmonary resuscitation (CPR). Conclusion: Statin therapy is independently associated with lower long-term mortality in patients presenting with ventricular tachyarrhythmias on admission. Trial registration: Clinicaltrials.gov, NCT02982473 , 11/29/2016, Retrospectively registered