731 research outputs found
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
An ecologic study
Background: Vancomycin-resistant enterococci (VRE) are among the most common
antimicrobial-resistant pathogens causing nosocomial infections. Although
antibiotic use has been identified as a risk factor for VRE, it remains
unclear which antimicrobial agents particularly facilitate VRE selection.
Here, we assessed whether use of specific antimicrobial agents is
independently associated with healthcare-associated (HA) VRE rates in a
university hospital setting in Berlin, Germany . Methods: We conducted the
study between January 2014 and December 2015 at the Charité-university
hospital of Berlin, Germany. From the hospital pharmacy, we extracted data for
all antibacterials for systemic use (anatomical therapeutic chemical
(ATC)-classification J01) and calculated ward specific antibiotic consumption
in defined daily doses (DDDs) per 100 patient-days (PD). We used the
microbiology laboratory database to identify all patients with isolation of
invasive or non-invasive VRE and calculated HA-VRE incidence as nosocomial
VRE-cases per 100 patients and HA-VRE incidence density as nosocomial VRE-
cases per 1000 PD. We defined VRE isolates as hospital-acquired if they were
identified three days or later after hospital admission and otherwise as
community-acquired (CA-VRE). We performed univariable and multivariable
regression analyses to estimate the association of the frequency of HA-VRE per
month with antibiotic use and other parameters such as length of stay, type of
ward or presence of at least one CA-VRE on ward. In a second analysis, we
considered only patients with VRE infections. Results: We included data from
204,054 patients with 948,380 PD from 61 wards. Overall, 1430 VRE-cases were
identified of which 409 (28.6%) were considered hospital-acquired (HA). We
found that carbapenem use in the current month and prior-month use of
glycopeptides increased the risk for HA-VRE by 1% per 1 DDD/100 PD and 3% per
1 DDD/100 PD, respectively. However, when only VRE from clinical samples were
considered, only glycopeptide use showed a statistically significant
association. In both models, detection of at least one patient with CA-VRE on
a ward in the current month significantly increased the risk of HA-VRE,
thereby indicating nosocomial spread of VRE. Conclusions: Our findings suggest
that the risk of HA-VRE is associated with specific antimicrobial agents.
Prudent use of these antimicrobial agents might reduce nosocomial VRE rates.
That appearance of at least one CA-VRE case on the ward increased the risk of
HA-VRE detection highlights the importance of strict hand hygiene practices to
interrupt person-to-person transmission of VRE
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