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Convection in a layer inclined against gravity is a thermally driven non-equilibrium system, in which both buoyancy and shear forces drive spatio-temporally complex flows. As a function of the strength of thermal driving and the angle of inclination, a multitude of convection patterns is observed in experiments and numerical simulations. Several observed patterns have been linked to exact invariant states of the fully nonlinear three-dimensional Oberbeck–Boussinesq equations. These exact equilibria, travelling waves and periodic orbits reside in state space and, depending on their stability properties, are transiently visited by the dynamics or act as attractors. To explain the dependence of observed convection patterns on control parameters, we study the parameter dependence of the state space structure. Specifically, we identify the bifurcations that modify the existence, stability and connectivity of invariant states. We numerically continue exact invariant states underlying spatially periodic convection patterns at
under changing control parameters for a temperature difference between the walls and inclination angle. The resulting state branches cover various inclinations from horizontal layer convection to vertical layer convection and beyond. The collection of all computed branches represents an extensive bifurcation network connecting 16 different invariant states across control parameter values. Individual bifurcation structures are discussed in detail and related to the observed complex dynamics of individual convection patterns. Together, the bifurcations and associated state branches indicate at what control parameter values which invariant states coexist. This provides a nonlinear framework to explain the multitude of complex flow dynamics arising in inclined layer convection.
Thermal convection in an inclined layer between two parallel walls kept at different fixed temperatures is studied for fixed Prandtl number
. Depending on the angle of inclination and the imposed temperature difference, the flow exhibits a large variety of self-organized spatio-temporal convection patterns. Close to onset, these patterns have been explained in terms of linear stability analysis of primary and secondary flow states. At a larger temperature difference, far beyond onset, experiments and simulations show complex, dynamically evolving patterns that are not described by stability analysis and remain to be explained. Here we employ a dynamical systems approach. We construct stable and unstable exact invariant states, including equilibria and periodic orbits of the fully nonlinear three-dimensional Oberbeck–Boussinesq equations. These invariant states underlie the observed convection patterns beyond their onset. We identify state space trajectories that, starting from the unstable laminar flow, follow a sequence of dynamical connections between unstable invariant states until the dynamics approaches a stable attractor. Together, the network of dynamically connected invariant states mediates temporal transitions between coexisting invariant states and thereby supports the observed complex time-dependent dynamics in inclined layer convection.
To assess the relative validity of a FFQ developed for the Pelotas Birth Cohort Studies.
Participants completed a ninety-two-food-item FFQ and then answered two 24-h recalls (24HR), one in-person interview and a second one by telephone, administered 14–28 d apart. Median and relative differences of energy, fifteen nutrients and eleven food groups were estimated based on the FFQ and the average of two 24HR. Nutrients were log-transformed and energy-adjusted using residual method. Validity was assessed by crude, energy-adjusted and de-attenuated Pearson and Lin’s concordance correlation coefficients. Agreement of quartiles and weighted κ were performed. Differences in energy and nutrient estimations between methods were plotted in Bland–Altman graphs.
Pelotas, southern Brazil.
Two hundred fifty-four participants randomly selected from the 1993 Pelotas Birth Cohort during the 22-year follow-up (2015).
The FFQ overestimated energy and most nutrients and food groups compared with the two 24HR. Energy-adjusted and de-attenuated Pearson correlation coefficients ranged from 0·21 to 0·66. The highest energy-adjusted and de-attenuated concordance correlation coefficients were observed for Ca (0·48), niacin (0·32), Na (0·29), vitamin C (0·28) and riboflavin (0·25). The percentage of nutrients classified into the same and opposite quartiles ranged from 36·5 to 60·3 %, and from 4·8 to 19·1 %, respectively. Weighted κ was moderate for Ca (0·51), beans and legumes (0·50) and milk and dairies (0·49).
The FFQ provides a reasonable dietary intake assessment for habitual food consumption. However, the relative validity was weak for specific nutrients and food groups.
The use of product-service systems business models is increasing in today's economy. Because the products that provide the service to the customers incur cost during their lifetime, the method of lifecycle costing finds wide-spread use. However, this paper shows the current methods have some inaccuracies when determining lifecycle costs. The methods do not consider the required number of products necessary to provide the offered service to the customers. This paper describes a new framework for lifecycle costing that includes these cost components.
OBJECTIVES/GOALS: The purpose of this study was to investigate how suggestibility and social susceptibility relate to alcohol use in young adult non-dependent alcohol users, and the role of trait anxiety in this relationship. We hypothesized that greater trait anxiety would be associated with higher levels of alcohol misuse, and this would be mediated by suggestibility. METHODS/STUDY POPULATION: Study participants enrolled in the NIAAA screening and assessment protocol completed questionnaires on suggestibility, anxiety, and alcohol use. The Multidimensional Iowa Suggestibility Scale (MISS) is a 95-question self-report assessment of suggestibility. Trait anxiety is assessed with the State Trait Anxiety Inventory-Trait (STAI-T). Alcohol measures included the Alcohol Use Disorder Identification Test (AUDIT). Structured Clinical Interviews for DSM-IV or DSM-5 disorders were conducted, and non-dependent participants (N = 113) were considered. A median split was conducted (median age = 35.1 years), with the focus of this study on the younger individuals (N = 55). RESULTS/ANTICIPATED RESULTS: Initial analyses showed that suggestibility, alcohol misuse, and trait anxiety all had significant positive correlations with one another. To better understand the relationship of peer influence, specifically, with drinking and anxiety, MISS subscale of Peer Conformity was analyzed. MISS total score and Peer Conformity were positively correlated with AUDIT Total as well as STAI-T Score. STAI-T Score was additionally positively correlated with AUDIT Total (all p2 = 0.222). We also looked at Peer Conformity in place of MISS Total (R2 = 0.213). In both models, only suggestibility measures were significant predictors of harmful alcohol use (p<0.01). DISCUSSION/SIGNIFICANCE OF IMPACT: In young social drinkers, there were significant positive associations between suggestibility, risky alcohol use, and trait anxiety. These results suggest that suggestibility may be a modifiable risk factor for risky alcohol consumption. Future directions include using mediation models to explore the associations between suggestibility, anxiety, and alcohol misuse.
We aimed to assess the validity of maternal recall of exclusive breastfeeding (EBF) at 3 months obtained 12 months after childbirth.
A population-based birth cohort study. The gold standard is maternal report of EBF at the age of 3 months (yes or no) and age of introduction of other foods in the infant’s diet. EBF was considered when the mother reported that no liquid, semi-solid or solid food was introduced up to that moment. The variable to be validated was obtained at 12 months after childbirth when the mother was asked about the age of food introduction. The prevalence of EBF at 3 months, and sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and accuracy of 12-month recall with 95 % CI were calculated.
3700 mothers of participants of the Pelotas 2004 Birth Cohort.
The prevalence of EBF at 3 months was 27·8 % (95 % CI 26·4, 29·3) and 49·0 % (95 % CI 47·4, 50·6) according to gold standard and maternal recall, respectively. The sensitivity of maternal recall at 12 months was 98·3 % (95 % CI 97·4, 99·0), specificity 70·0 % (95 % CI 68·2, 71·7), PPV 55·8 % (95 % CI 53·4, 58·1), NPV 99·1 % (95 % CI 98·6, 99·5) and accuracy 77·9 % (95 % CI 76·6, 79·2). When the analyses were stratified by maternal and infant characteristics, the sensitivity remained around 98 %, and the specificity ranged from 64·4 to 81·8 %.
EBF recalled at the end of the first year of infant’s life is a valid measure to be used in epidemiological investigations.
Primary objective was to evaluate the influence of atomoxetine on standard variables of a computer-based Continuous Performance Test (cb-CPT) that reflects executive function and inhibitory control in children with ADHD.
Two-arm, 8-week, placebo-controlled, randomized, double-blind study in ADHD patients (6-12yrs). Atomoxetine was initiated at 0.5 mg/kg qd for 1 week, followed by 7 weeks on the target dose of 1.2 mg/kg qd. Primary outcome were the q-scores of the cb-CPT standard variables after 8 weeks using mixed models for repeated measurement. Additionally, ADHD-RS scores, WREMB (Weekly Ratings of Evening and Morning Behavior) and CGI-S-ADHD were assessed (weeks 0,1,2,4,6,8).
N=128 patients were randomized, N=125 evaluated (atomoxetine/placebo: 63/62). Baseline characteristics were comparable (77.6% boys; 40.0% patients with ODD/CD; 24.8% prior stimulant treatment; mean (±SD) age 9.0±1.79yrs; mean ADHD-RS total score 36.99±11.56). At Week 8, all primary outcomes (cb-CPT q-scores) were significantly reduced vs. placebo (all p< 0.001) for mean (effect size [ES] 0.41), variance (ES=0.71), and normalized variance (ES=0.50) of “Reaction time”, “Number of microevents” (ES=1.00), “Commission errors” (ES=0.50), “Omission errors” (ES=0.70), “Distance of movement” (ES=0.90) and “Area of movement” (ES=1.08), “Time active” (ES=0.69), and “Motion simplicity” (ES=0.38). Secondary endpoints at Week 8 improved significantly in favor of atomoxetine: ADHD-RS: total score ES=1.30, p< 0.001; hyperactive/impulsive subscore ES=1.37, p< 0.001; inattentive subscore ES=1.07, p< 0.001). WREMB: total score ES=1.00, p< 0.001; morning subscore ES=0.59, p=0.002.; evening subscore ES=1.02, p< 0.001. CGI-S-ADHD: ES=1.11; p< 0.001.
Atomoxetine for 8 weeks significantly reduced ADHD symptoms as measured by the objective cb-CPT.
Aim was to evaluate influencing factors of response and symptomatic remission in first-episode schizophrenia patients treated with risperidone or haloperidol.
229 first-episode schizophrenic patients were examined within a double blind controlled trial of the German Study Group on first-episode schizophrenia with biweekly PANSS ratings. Response was defined according to the definition by Lieberman et al. (2003) and symptomatic remission as the severity component of the consensus remission criteria by the Remission in Schizophrenia Working Group. Sociodemographic, psychopathological and functional variables as well as the treatment applied were evaluated regarding their potential predictive validity for treatment outcome. Univariate tests, logistic regression and CART-analyses were consulted as statistical methods.
126 patients (55%) achieved response and 118 patients (52%) symptomatic remission at discharge with no significant differences between the risperidone (51%) and haloperidol (49%) treated patients. Better baseline functioning, early treatment response, less depressive symptoms and a shorter duration of untreated psychosis were revealed significant predictors of response. Patients with symptomatic remission also had a significantly shorter duration of untreated psychosis and significantly less depressive symptoms at baseline. Logistic regression and CART-analyses revealed low general psychopathology, early treatment response and a high score in the Strauss-Carpenter-Prognostic-Scale at admission to be significantly positive predictive for symptomatic resolution.
Early treatment response, depressive symptoms and the level of psychosocial functioning were revealed to significantly predict outcome, with no significant differences between risperidone and haloperidol. The importance of an early adequate symptom control and the implementation of early intervention programs is highlighted.
Attempts to reduce high utilisation of psychiatric inpatient care by targeting the critical time of hospital discharge have been rare. In Germany, until now no such intervention has been implemented, let alone subjected to a clinical trial.
“Effectiveness and Cost-Effectiveness of Needs-Oriented Discharge Planning and Monitoring for High Utilisers of Psychiatric Services” (NODPAM) is a multicentre RCT conducted in five psychiatric hospitals in Germany (Günzburg, Düsseldorf, Regensburg, Greifswald, and Ravensburg). Subjects asked to provide informed consent to participate have to be of adult age with a primary diagnosis of schizophrenia or affective disorder, and a defined high utilisation of psychiatric care during two years prior to the current admission. Subjects are asked to provide detailed outcome data at four measurement points during a period of 18 months. Recruitment (which started in April 06) is still ongoing. Thus, baseline data of about 350 participants will be presented.
Recruitment has been quite successful and the study has been generally well accepted by participating patients and their clinicians in in- and outpatient treatment settings. Subjects showed substantial initial impairment on outcome measures (e.g. needs, psychopathology, quality of life, and level of functioning) and high utilisation of mental health care. Further results on conduct and feasibility of the trial will be presented.
The first phase of this mulicentre trial was promising. The potential of this study to strengthen the integration of mental health care provision in Germany will be discussed.
Recent investigations into motor cortex excitability with paired pulse transcranial magnetic stimulation technique (ppTMS), have shown inhibition deficits in ADHD which correlate with the clinical symptomatology. Methylphenidate effects on cortical excitability in adults with ADHD are contradictory. Therefore, we use long-acting methylphenidate (LA-Mph) to consider cortical excitability effects under stable medication conditions.
Systematic evaluation of the effects of LA-Mph on motor cortex excitability in adult patients with ADHD with the ppTMS technique.
Investigation of the putative influence of LA-Mph on motor inhibition and facilitation in adults with ADHD.
Thirteen drug naïve adult ADHD patients were included in this ppTMS study. Measurements took place before and under treatment with LA-Mph (30–54 mg daily dose). Statistical analyses were performed to investigate treatment effects and correlations with clinical symptomatology.
LA-Mph significantly decreased the relative short intracortical motor inhibition (SICI) magnetically evoked potential (MEP) amplitude at 3ms interstimulus interval (conditioned/ unconditioned MEP amplitude: 0.84 ± 0.76 drug-free vs. 0.29 ± 0.19 with LA-Mph; p = 0.020). The relative intracortical facilitation (ICF) MEP amplitude at 11ms interstimulus interval (conditioned/ unconditioned MEP amplitude: 1.51 ± 0.92 drug-free vs. 1.79 ± 0.95 with LA-Mph) was not significantly increased. The decrease of the relative SICI MEP amplitude with LA-Mph correlated significantly with the improvement of the psychopathological ADHD self-rating total scores (p = 0.034) and hyperactivity/impulsivity subscores (p = 0.029). These results show that in adult patients with ADHD, LA-Mph significantly improves motor disinhibition without influencing motor facilitation.
LA-Mph might have differential stabilizing effects on motor hyperexcitability in adults with ADHD and correlates with the clinical improvements.
Lateral gaze aversions which follow reflective or thought provoking questions are called conjugated lateral eye movements (CLEMs). This response was studied in 20 schizophrenic patients, 20 depressive patients and 20 healthy controls. Frontal and parietal EEG measures were recorded simultaneously with the question/answer task. There were no differences in CLEMs among the 3 groups. Schizophrenic and depressive patients demonstrated a significantly reduced EEG-power on the left and an increased power on the right in comparison with healthy controls. This may point to a functional interhemispheric ‘disconnection’ in patients. Comparative correlations revealed EEG-power increase during the occurrence of contralateral CLEMs in the whole 10 min task.
In an interim evaluation on baseline data of the German PADRE observational study the correlation between physician- and patient assessment of emotional and physical symptoms of depressed patients was evaluated.
This multicenter, prospective, 6-month observational study focused on adult outpatients with a depressive episode as diagnosed according to ICD-10 criteria, chosen by their physician to start new anti-depressive treatment with duloxetine. Correlations between the applied depression and/or pain scales were calculated via Spearman's correlation coefficient. Symptoms were evaluated via clinician rated 'Inventory for Depressive Symptomatology' ([IDS-C], total score, including item 25), patient rated 5-item scale 'KUSTA', (rating mood, activity, tension-relaxation, sleep and appetite on visual analog scales [VAS]), and patient rated VAS for 'Pain'.
All participating physicians are psychiatrists/neurologists. 2.748 patients (71% female, mean age 52.7 yrs) were evaluated. Any pain symptoms were documented in 88.9% of patients at baseline. When comparing patient- with physician-assessments, correlation of PPS scales was low to moderate and varied for different pain types: IDS-C item 25 (="somatic disorders") vs. overall pain-VAS: r=0.421 (95% CI 0.390, 0.452), IDS-C item 25 vs. abdominal pain: r=0.189; IDS-C item 25 vs. chest-pain: r=0.179. When comparing IDS-C total vs. the KUSTA items, correlation was moderate in all cases (e.g.: r= -0.510 for IDS total vs. KUSTA mood).
Only a low to moderate correlation was observed between physician- and patient assessment for PPS in depressed patients. Therefore, patient pain ratings should explicitly be included in the assessment of depressed patients.
Psychiatric patients are more often tobacco smokers than the general population. These finding indicate a causal relation between tobacco smoking and occurrence of psychiatric diseases. Therefore in the study presented psychiatric comorbidity of smokers and non smokers were investigated in ”healthy“ probands being either smokers or non smokers.
Students of medicine or of psychology (mv 25,3 Jahre, SD ± 5,3), 70 healthy smokers and 83 healthy non smokers (both groups without known psychic disorder or treatment) were studied according to psychic axis-1-disorders by Mini-DIPS, a questionare for the DSM IV-or ICD 10 criteria of nicotine dependence, Fagerström-test, craving visual scale, CAGE-test, a questionare for sociodemographic factors, organic and psychic diseases and psychiatric/ psychotherapeutic treatments. Urine analysis of addictive drugs and cotinin levels in urin and saliva were estimated.
From 70 smokers according to DSM IV 40 dependent and 30 non dependent smokers were found. According to Fagerström –test 51 of the 70 were dependent smokers. The urine cotinin level was significantly higher in dependent smokers and correlated with the range of dependence acc. to Fagerström (p <0.001). The saliva cotinin level significantly correlated with the range of craving (p < 0.006). In 12 (9f, 3m) of the 40 dependent smokers phobic and anxiety disorders and high levels of cotinin were found, but not in the groups of non dependent smokers or non smokers.
A relationship of dependent smoking with higher cotinin and craving levels and phobic / anxiety disorders seem to exist, especially in females.
In acquired peripheral demyelinating disease only few publications point out the possibility of simultaneous involvement of the CNS. We describe two patients with chronic polyneuropathy and monoclonal gammopathy of undetermined significance (MGUS) developing a progressive dementia syndrome with extensive cerebral white matter alterations.
The SNAP-25 gene is an integral part of the vesicle docking and fusion machinery that controls the neurotransmitter release from the vesicles of the presynaptic neuron into the synaptic cleft. Several post mortem studies revealed a reduction of SNAP-25 protein in the hippocampus of patients with schizophrenia and bipolar disorder.
38 patients with schizophrenia, bipolar disorder or obsessive-compulsive disorder and 15 healthy controls participated in the study. Proton magnetic resonance spectroscopy in left hippocampus was performed in each individual. Three single nucleotide polymorphisms (SNP) of the SNAP-25 gene were genotyped.
Individuals with the homozygous CC genotype of the DdeI SNP presented a significantly higher ratio of NAA/Cho in the left hippocampus compared to the group of individuals with the homozygous TT genotype.
The present findings are consistent with the view that the SNAP-25 genotype may modulate synaptic plasticity and neurogenesis in the left hippocampus, and that an altered NAA/Cho ratio may be an indicator for this genetic modulation of neuronal function in the hippocampus.
Autism spectrum disorders (ASD) are characterised by repetitive behaviour/interests, an impairment in reciprocal social interaction and communication. This implies the inadequate appreciation of socio-emotional cues and leads to a default in the responses to other people's emotions.
Deficits in empathy have been described for individuals with autism spectrum disorders (ASD).
We aim to investigate the described deficits in empathy in a group of people with ASD on a behavioural and a neuronal level.
We assessed neuronal activity using functional magnetic resonance imaging (fMRI) during three different empathy tasks (“emotion-recognition”, “perspective-taking” and “affective-responsiveness”) of 12 adults with ASD and a matched group of healthy controls.
Subjects with ASD did not have differences in affective responsiveness compared to healthy controls, but in emotion recognition and perspective taking. The reaction time was significantly longer in patients with ASD in all tasks. People with ASD showed a different pattern of brain activation in cortico-limbic areas during the empathy tasks compared to controls
Our findings of individuals with ASD having problems in emotions-recognition and in perspective taking are supported by previous results. These impairments are reflected by a different pattern of neuronal activation in several brain areas of individuals with ASD compared to controls. Although there are no differences in affective responsiveness in the ASD group a marked difference can be seen in the brain activation during this task. These findings might open up new avenues of intervention for individuals with ASD and their often described problems with empathy.
We investigated the contribution of polymorphisms shown to moderate transcription of serotonin transporter (5HTT) and monoamine oxidase A (MAOA) to the development of violence, and furthermore to test for gene x environment interactions. To do so, a cohort of 184 adult male volunteers referred for forensic assessment were assigned to a violent or non-violent group. 45% of violent, but only 30% of non-violent individuals carried the low-activity, short MAOA allele. In the violent group, carriers of low-function variants of 5HTT were found in 77%, as compared to 59%. Logistic regression was performed and the best fitting model revealed a significant, independent effect of childhood environment and MAOA genotype. A significant influence of an interaction between childhood environment and 5HTT genotype was found (Fig. 1). MAOA thus appears to be independently associated with violent crime, while there is a relevant 5HTT x environment interaction.