Different Whole-Brain Functional Connectivity Correlates of Reactive-Proactive Aggression and Callous-Unemotional Traits in Children and Adolescents with Disruptive Behaviors

Background: Disruptive behavior in children and adolescents can manifest as reactive aggression and proactive aggression and is modulated by callous-unemotional traits and other comorbidities. Neural correlates of these aggression dimensions or subtypes and comorbid symptoms remain largely unknown. This multi-center study investigated the relationship between resting state functional connectivity (rsFC) and aggression subtypes considering comorbidities. Methods: The large sample of children and adolescents aged 8–18 years (n = 207; mean age = 13.30 ± 2.60 years, 150 males) included 118 cases with disruptive behavior (80 with Oppositional Defiant Disorder and/or Conduct Disorder) and 89 controls. Attention-deficit/hyperactivity disorder (ADHD) and anxiety symptom scores were analyzed as covariates when assessing group differences and dimensional aggression effects on hypothesis-free global and local voxel-to-voxel whole-brain rsFC based on functional magnetic resonance imaging at 3 Tesla. Results: Compared to controls, the cases demonstrated altered rsFC in frontal areas, when anxiety but not ADHD symptoms were controlled. For cases, reactive and proactive aggression scores related to global and local rsFC in the central gyrus and precuneus, regions linked to aggression-related impairments. Callous-unemotional trait severity was correlated with ICC in the inferior and middle temporal regions implicated in empathy, emotion, and reward processing. Most observed aggression subtype-specific patterns could only be identified when ADHD and anxiety were controlled for. Conclusions: This study clarifies that hypothesis-free brain connectivity measures can disentangle distinct though overlapping dimensions of aggression in youths. Moreover, our results highlight the importance of considering comorbid symptoms to detect aggression-related rsFC alterations in youths

Aggression subtypes relate to distinct resting state functional connectivity in children and adolescents with disruptive behavior

There is increasing evidence for altered brain resting state functional connectivity in adolescents with disruptive behavior. While a considerable body of behavioral research points to differences between reactive and proactive aggression, it remains unknown whether these two subtypes have dissociable effects on connectivity. Additionally, callous-unemotional traits are important specifiers in subtyping aggressive behavior along the affective dimension. Accordingly, we examined associations between two aggression subtypes along with callous-unemotional traits using a seed-to-voxel approach. Six functionally relevant seeds were selected to probe the salience and the default mode network, based on their presumed role in aggression. The resting state sequence was acquired from 207 children and adolescents of both sexes [mean age (standard deviation) = 13.30 (2.60); range = 8.02-18.35] as part of a Europe-based multi-center study. One hundred eighteen individuals exhibiting disruptive behavior (conduct disorder/oppositional defiant disorder) with varying comorbid attention-deficit/hyperactivity disorder (ADHD) symptoms were studied, together with 89 healthy controls. Proactive aggression was associated with increased left amygdala-precuneus coupling, while reactive aggression related to hyper-connectivities of the posterior cingulate cortex (PCC) to the parahippocampus, the left amygdala to the precuneus and to hypo-connectivity between the right anterior insula and the nucleus caudate. Callous-unemotional traits were linked to distinct hyper-connectivities to frontal, parietal, and cingulate areas. Additionally, compared to controls, cases demonstrated reduced connectivity of the PCC and left anterior insula to left frontal areas, the latter only when controlling for ADHD scores. Taken together, this study revealed aggression-subtype-specific patterns involving areas associated with emotion, empathy, morality, and cognitive control

Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

© 2022 Elsevier Ltd. All rights reserved.[Background] The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes.[Methods] In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines.[Findings] 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05–1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4–30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than treatment with other antifungals.[Interpretation] Although overall mortality in patients with candidaemia was high, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida scores, might increase survival. New antifungals, with similar activity as current echinocandins but with longer half-lives or oral bioavailability, are needed to reduce duration of hospital stay.Scynexis.Peer reviewe

Parenting Stress Index and specific language impairment

Ziel der vorliegenden Studie ist eine differenzierte Erfassung des Stresserlebens bei Müttern von Kindern mit einer Sprachentwicklungsstörung anhand eines standardisierten Fragebogens. 63 Mütter sprachentwicklungsgestörter Kinder im Alter von 3;0 bis 6;5 Jahren wurden an der Klinischen Abteilung Phoniatrie-Logopädie der Wiener Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten konsekutiv rekrutiert. Das Stresserleben der Mütter wurde anhand des „Parenting Stress Index – PSI“ von Abidin (1995) erfasst und die Ergebnisse wurden mit den Werten jener Mütter einer nach Geschlecht und Alter parallelisierten Kontrollgruppe verglichen. Es zeigen sich signifikante Mittelwertsunterschiede zwischen den Müttern der klinischen Gruppe und jenen der Kontrollgruppe, in fast allen Skalen des PSI erweisen sich die Stress-Scores der Mütter sprachentwicklungsgestörter Kinder höher als jene der Mütter der Kontrollgruppe. 68% der Mütter der klinischen Stichprobe sind einem überdurchschnittlichen Stresserleben ausgesetzt, während nur 1,5% der Mütter sprachlich unauffälliger Kinder eine über dem Normbereich liegende Stressbelastung aufweisen. Es zeigt sich, dass die Erfassung des Ausmaßes der elterlichen Belastung und die Identifizierung einzelner Stressoren bei Müttern sprachentwicklungsgestörter Kinder eine wichtige Aufgabe darstellen. Für eine erfolgreiche Intervention bei Kindern mit einer Sprachentwicklungsstörung sollten auch die Mütter unbedingt vermehrt betreut und unterstützt werden.(DIPF/Orig.)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 compaired 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.(DIPF/Orig.

neuropsychiatrie / Maternal bonding behavior, adult intimate relationship, and quality of life

Continuity and discontinuity in the development of social relationships have been investigated by reviewing the course of social bonds and by analyzing the effects of a sound intimate relationship in adulthood in conjunction with recalled maternal bonding on the quality of life among students. A questionnaire-based study of 207 students was conducted. Perceptions of maternal bonding were designated as being representative of one of the two contrasting bonding types “optimal maternal bonding” and “affectionless maternal control” assessed by the Parental Bonding Instrument (PBI) and combined with perceptions of a sound intimate adult relationship measured by the Family Assessment Measure III Dyadic Relationships Scale (FAM-III-D). Quality of life and general health data were determined by using the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Students who reported “optimal maternal bonding” had intimate relationships in adulthood that were of significantly higher quality than those who recalled “affectionless maternal control”. Students who recalled “optimal maternal bonding” and described their intimate relationship as sound showed significantly higher scores in all domains of quality of life and indicated having better general health than those who reported “affectionless maternal control” and a sound intimate relationship. A sound intimate relationship in adulthood does not appear to compensate the impact of a recalled maternal bonding behavior in terms of affectionless control, on quality of life. Furthermore, results seem to support the hypothesis of continuity of the development of social relationships among psychologically well individuals based on the association between maternal bonding and later intimate relationships.(VLID)357503

Echinocandin resistance and population structure of invasive Candida glabrata isolates from two university hospitals in Germany and Austria.

Echinocandin resistance in Candida glabrata is emerging and is associated with the presence of FKS mutations. In this study, we analysed the antifungal susceptibility, presence of FKS mutations and clonality of C. glabrata blood culture isolates from two hospitals in Germany and Austria. Susceptibility testing of 64 C. glabrata bloodstream isolates from two university hospitals was performed with broth microdilution method according to EUCAST. In addition, all isolates were screened for FKS mutations. Molecular fingerprinting was performed by microsatellite PCR with three separate primer pairs and semiautomated repetitive sequenced-based PCR (rep-PCR). One C. glabrata isolate from Germany (1.5%) was echinocandin resistant, with a corresponding mutation in FKS2 gene hot spot 1. The discriminatory power of microsatellite PCR was higher than that of rep-PCR (Simpson Index of 0.94 vs. 0.88); microsatellite PCR created 31 separate genotypes, whereas rep-PCR created 17. Predominant genotypes or clusters of isolates from Germany and Austria were present, with no epidemiological evidence of nosocomial transmissions. Although we found a low incidence of echinocandin resistance in C. glabrata in our settings, further surveillance projects in central Europe are warranted for monitoring future epidemiological trends. The genetic population structure of C. glabrata demonstrates overrepresented geographical clusters

Spatially Resolved Diffusion of Aluminum in 4H-SiC During Postimplantation Annealing

The fabrication of power semiconductor devices based on 4H-silicon carbide (SiC) typically includes doping by ion implantation and postimplantation annealing to activate the implanted dopants. The high-temperature annealing process can initiate various diffusion mechanisms that alter the initial implantation profile in terms of spatial distribution and doping concentration. To investigate the diffusion of aluminum, the main p-dopant in 4H-SiC, samples are prepared by ion implantation and subsequent annealing at 1650 °C for 30 min. Secondary ion mass spectrometry (SIMS) measurements before and after the annealing process are performed to monitor the aluminum concentration. A significant amount of aluminum moves toward the surface and into the lateral direction, which is shown to be directly related to the implantation-induced point defects. Transmission electron microscopy (TEM) images support the discussion of diffusion mechanisms and their dependence on the defect type.ISSN:0018-9383ISSN:1557-964