Ludwig-Maximilians-Universität München
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The development of children’s and adults’ use of kinematic cues for visual anticipation and verbal prediction of action
Get PDFExpectations about how others’ actions unfold in the future are crucial for our everyday social interactions. The current study examined the development of the use of kinematic cues for action anticipation and prediction in 3-year-olds, 4-year-olds, 10-year-olds, and adults in two experiments. Participants observed a hand repeatedly reaching for either a close or far object. The motor kinematics of the hand varied depending on whether the hand reached for the close or far object. We assessed whether participants would use kinematic cues to visually anticipate (Experiment 1; N=98) and verbally predict (Experiment 2; N=80) which object the hand was going to grasp. We found that only adults, but not 3- to 10-year-olds, based their visual anticipations on kinematic cues (Experiment 1). This speaks against claims that action anticipations are based on simulating others’ motor processes and instead provides evidence that anticipations are based on perceptual mechanisms. Interestingly, 10-year-olds used kinematic cues to correctly verbally predict the target object, and 4-year-olds learned to do so over the trials (Experiment 2). Thus, kinematic cues are used earlier in life for explicit action predictions than for visual action anticipations. This adds to a recent debate on whether or not an implicit understanding of others’ actions precedes their ability to verbally reason about the same actions
Perivascular space and white matter hyperintensities in Alzheimer’s disease: associations with disease progression and cognitive function
Get PDFBackground: Alzheimer’s disease (AD) is the leading cause of dementia, characterized by the accumulation of amyloid-beta (Aβ) and neurofibrillary tangles. Recent studies emphasize the role of vascular factors, including the glymphatic system, in AD pathogenesis, particularly in Aβ clearance. The diffusion tensor image analysis along the perivascular space (DTI-ALPS; ALPS-Index) has emerged as a novel, non-invasive method to evaluate the glymphatic system in vivo, showing glymphatic insufficiency in AD. This study aimed to investigate alterations in the function of the glymphatic system in individuals with AD versus healthy controls (HC), and to explore its association with Aβ, cerebrovascular disease (CVD), white matter hyperintensities (WMH), and cognitive function.
Methods: DTI MRI data from three independent study cohorts (ActiGliA: AD n = 16, Controls n = 18; DELCODE: AD n = 54, Controls n = 67; ADNI: AD n = 43, Controls n = 49) were used to evaluate the perivascular space (PVS) integrity; a potential biomarker for glymphatic activity. The DTI-Along the Perivascular Space technique was used to measure water diffusion along PVS providing an index to assess the efficiency of the glymphatic system’s waste clearance function. WMH load was quantified in FLAIR MRI using the lesion segmentation tool. We quantified WMHs volume within our defined region of interest (ROI) and excluded participants with any WMHs to avoid confounding the ALPS-Index. Associations with cerebrospinal fluid (CSF) AD hallmark biomarkers, cognitive performance (MMSE) and clinical severity (CDR) were assessed.
Results: AD patients had a significantly lower ALPS-Index vs. healthy controls (ActiGliA: AD: mean = 1.22, SD = 0.12; Controls: mean = 1.36, SD = 0.14, p = 0.004; DELCODE: AD: mean = 1.26, SD = 0.18; Controls: mean = 1.34, SD = 0.2, p = 0.035; ADNI: AD: mean = 1.08, SD = 0.24; Controls: mean = 1.19, SD = 0.13, p = 0.008). The ALPS-Index was associated with CSF Aβ concentration, WMH number and MMSE and CDR. WMH, found in the ROIs correlated negatively with the ALPS-Index.
Conclusions: This study highlights the potential of the DTI-ALPS-Index as a biomarker for glymphatic dysfunction in AD. It underscores the importance of considering vascular factors and the glymphatic system in the pathogenesis and diagnosis of AD as WMHs in the ROI could cause disturbances and inaccurate indices
Illusion der Schönheit
Get PDFDie Reichweite des Kinos war in den 30er Jahren des letzten Jahrhunderts enorm. Und so bot sich mit dem Medium Film eine Möglichkeit, ganze Gesellschaften mit Botschaften zu erreichen. Dessen waren sich auch politische Akteure bewusst, die Filme nutzten, um ihre politisch-ideologischen Inhalte zu vermitteln. Während das in manchen Filmen durchaus offensichtlich geschieht, ist es bei anderen Filmen sehr viel subtiler, fast versteckt. Diese Arbeit untersucht drei solcher teils subtil arbeitenden Filme aus unterschiedlichen politischen Systemen: „Der Zirkus“ (Regie: Grigorij Aleksandrov, UdSSR 1936), „La Grande Illusion“ (Regie: Jean Renoir, Frankreich 1937) und die „Olympia“-Filme (Regie: Leni Riefenstahl, Deutschland 1938). Dabei wird herausgearbeitet, wie alle Filme übergreifend mit denselben filmisch-dramaturgischen Strukturen agieren, um die jeweils hinter ihnen stehende Ideologie in einer Art und Weise darzustellen, die durch mal unterschwellige, mal offensichtliche Verschönerungen das politische Gedankengut positiv konnotiert vermittelt
Factors influencing the speed of correction speed of distal tibial valgus deformity in children with percutaneous epiphyseodesis using transphyseal screw
Get PDFIntroduction
The distal tibial valgus deformity in children mimics a hindfoot valgus and is observed in several conditions of both non-neurogenic and neurogenic origin. The deformity can only be detected with radiological examination and can be safely and effectively corrected in children with medial percutaneous epiphysiodesis using transphyseal screws (PETS). The aims of the study are: 1. to determine the correction rates of the distal tibial valgus deformity due to different pathologies, 2. to examine the correction rate in relation to the age at implantation, severity of the initial deformity and the duration of implantation, 3. and types of foot deformities associated with the deformity.
Materials and methods
A retrospective study was done on children who underwent a PETS for a distal tibial valgus deformity. The lateral distal tibia angle 89° ± 3° on ankle mortice x-rays was taken as normal. An analysis of variance and covariance was done to investigate differences in parameters between aetiologies and relations between parameters respectively.
Results
Following exclusion of 191 limbs, 155 limbs in 104 children were included the study, 5 groups could be identified: Idiopathic, ICP (cerebral palsy), MMC (Meningomyelocele), Dysmelia, MHE (multiple hereditary exostosis). The mean age at implantation of all patients was 10.9 ± 1.4 years. The average correction of 0.45° ± 0.08°/month with no significant differences in the correction rates between groups. However, the correction rates were dependent on the age, the initial deformity and the duration of treatment. The incidence of a valgus foot deformity was 86.4 %.
Conclusion
The correction rates of the distal tibial valgus deformity following PETS are variable and depend, on the age at implantation, duration of treatment and initial deformity. The spectrum of foot deformities associated with distal tibial valgus deformity, especially a high prevalence of valgus foot deformity warrants an ankle mortice x-ray
AI-enabled clinical decision support tools for mental healthcare: A product review
Get PDFThe review seeks to promote transparency in the availability of regulated AI-enabled Clinical Decision Support Systems (AI-CDSS) for mental healthcare. From 84 potential products, seven fulfilled the inclusion criteria. The products can be categorized into three major areas: diagnosis of autism spectrum disorder (ASD) based on clinical history, behavioral, and eye-tracking data; diagnosis of multiple disorders based on conversational data; and medication selection based on clinical history and genetic data. We found five scientific articles evaluating the devices' performance and external validity. The average completeness of reporting, indicated by 52 % adherence to the Consolidated Standards of Reporting Trials Artificial Intelligence (CONSORT-AI) checklist, was modest, signaling room for improvement in reporting quality. Our findings stress the importance of obtaining regulatory approval, adhering to scientific standards, and staying up-to-date with the latest changes in the regulatory landscape. Refining regulatory guidelines and implementing effective tracking systems for AI-CDSS could enhance transparency and oversight in the field
Evaluation of therapy support through a standardized nursing consultation for patients undergoing oral tumor therapy in gynecological oncology within the prospective CAMPA initiative
Get PDFPurpose
The increase of oral tumor therapies (OTT) poses new challenges in patient care. Within CAMPA (Care improvement for advanced or metastatic breast and ovarian cancer patients treated with PARP-inhibitors), additional nursing support for patients treated with PARP-inhibitors was developed.
Methods
Additional nursing support (1 year) was evaluated in breast and gynecooncological cancer patients at an academic and a non-academic outreach center. From 02/22 to 02/24, quality of life, contacts, adherence, documentation of drug intake, hospitalization, and adverse events were evaluated, using CANKADO-ePRO and validated questionnaires reviewed by the Ethics Committee of Medical Faculty, LMU Munich. Satisfaction with care was recorded from 03/23 to 02/24. Supporting materials and interprofessional checklists were explored.
Results
The collective (n = 50) included 41 patients with ovarian, 4 with fallopian tube and 5 with breast cancer. Adherence measured by continuous documentation of medication intake was high among patients (78.0%). Quality of life improved from 68.6% to 81.4%, strongly correlating with decreasing numbers of side effects (p = 0.003) (Spearman |ρ| = 0.93). Satisfaction with care was very high (4.97 out of 5 points). 94.6% agreed that nursing consultation was essential for therapy safety compared to the doctor's consultation alone (p < 0.05). The reduction in time and care effort was significant (p < 0.05), having its maximum within the first three months.
Conclusion
Standardized nursing consultation was highly appreciated with an important contribution to adherence and improvement in quality of life. Delegation of therapy management to nurses reduces time effort and increases their responsibility, improving interprofessional care at academic and non-academic institutions.
Trial registration
Clinical Trials Registry, LMU university hospital, Germany, Healthcare research project, number: 21–0848
A Study Into Systemic and Oral Levels of Proinflammatory Biomarkers Associated With Endpoints After Active Non‐Surgical Periodontal Therapy
Get PDFAim:
To analyse whether some selected inflammatory biomarkers collected from venous blood and gingival crevicular fluid (GCF) were associated with the outcome of non-surgical periodontal therapy.
Materials and Methods:
Two-hundred and nine patients affected by periodontitis were enrolled in the study, who had undergone steps I and II therapy as well as a non-surgical re-instrumentation (NSRI) of periodontal pockets after 6 months. Serum (SE), plasma (PL) and GCF samples were quantitatively analysed for the following inflammatory biomarkers: active matrix metalloproteinase-8 (aMMP-8), prostaglandin E2 (PGE2) and surfactant protein D (SP-D). Therapy outcomes were evaluated using a ‘treat-to-target’ endpoint (T2T) at the patient level, defined as ≤ 4 sites with pocket depth ≥ 5 mm.
Results:
Patients presented with 23 ± 6 teeth (mean ± SD) at baseline. After steps I and II therapy, 41.6% of the patients reached T2T and after NSRI 47.4%. Univariate analysis identified a potential association between high levels of PL-SP-D and more favourable treatment outcomes. Multivariate binary logistic regression adjusted for sex, mean baseline probing depth, diabetes and current smoking status confirmed an independent relationship between baseline PL-SP-D and the T2T after steps I and II therapy (aOR 0.432, p = 0.011), implying that a higher level PL-SP-D at baseline is associated with a > 50% reduced risk of failing T2T. However, no such association was found for PL-SP-D and NSRI.
Conclusion:
Higher baseline PL-SP-D levels might be associated with more favourable treatment outcomes after steps I and II therapy. This may be due to its role in the regulation of neutrophil function. However, further investigation is required to confirm this hypothesis. If proven, PL-SP-D could play a role as a biomarker for identifying individuals who respond differentially to primary therapy
Psychological needs related to civil inattention: A qualitative and quantitative view on public encounters
Get PDFAs described by early sociological research (Goffman, 1963, Behavior in public places: Notes on the social organization of gatherings), a typical behavioural pattern in public encounters between strangers is so-called Civil Inattention (CI). CI describes a ritual of politely communicating having noticed the other while assuring non-communication intentions. A typical example of showing CI is initially looking at the other person but then quickly averting the gaze. As argued earlier, CI fulfils a central role in the smooth functioning of a society. Also, CI gains new relevance in the digital era, in particular regarding privacy needs. Still, previous research on CI often remained on a theoretical or descriptive level, and its psychological functions have not been explored systematically. As an advancement, our study provides a deeper understanding of CI, exploring individual narratives, relevant psychological needs, and contextual factors. We conducted a qualitative interview study (N = 25) followed by an experimental online study (N = 353) with a 2 (presence of CI) × 2 (physical distance) mixed design. It shows that CI adds to well-being and specifically addresses needs for relatedness, security, and autonomy. However, though Study 1 suggested physical distance as a relevant contextual factor, the present experimental manipulation in Study 2 did not show significant effects
Conditional survival of younger patients with mantle cell lymphoma: Results from a randomized phase III trial of the European MCL Network
Get PDFDuring a fatal disease, patients often request updated information on their prognosis. After patients have already survived a certain time, conditional survival captures their future survival probability. We investigated conditional overall and failure-free survival in 473 younger mantle cell lymphoma (MCL) patients from a randomized phase III trial comparing immunochemotherapies R-CHOP and alternating R-CHOP/R-DHAP before autologous transplantation. Using conditional Kaplan–Meier method and Cox regression, we estimated subsequent survival of patients who had survived 1–8 years, considering MIPI, Ki-67, and treatment failure status. Starting at a lower level, R-CHOP patients only showed increasing subsequent survival as they survived longer (5-year conditional survival: 72% and 81% after surviving 1 and 7 years), while R-CHOP/R-DHAP patients had stable future survival over time (77% and 78%). The prognostic value of MIPI diminished after 3 years in R-CHOP patients but remained unchanged after R-CHOP/R-DHAP. Patients with treatment failure had markedly inferior survival compared with those in ongoing remission, regardless of the time survived. The longer patients remained in remission, the longer they would stay free of treatment failures. Our results enable personalized counselling for younger MCL patients by offering dynamic prognosis and underscore the importance of highly effective first-line treatment to improve survival
The role of the adaptive immune system in the initiation and persistence of multiple sclerosis
Get PDFMultiple sclerosis (MS) is an inflammatory, demyelinating disease of the central nervous system (CNS) in which complex networks of interacting immune cells initiate and sustain the disease. The pathogenesis of relapsing MS is driven by adaptive immune cells that become activated outside the CNS compartment and then migrate into the CNS to initiate a presumably autoimmune inflammatory process. Recent technological advances, particularly single-cell analyses, have revealed substantial heterogeneity in T and B cells involved in this stage of the disease. Disease progression involves different mechanisms, with compartmentalized inflammation and chronic activation of CNS-resident cells becoming predominant features. The contribution of tissue-resident adaptive immune cells to the pathology of progressive MS, including tissue-resident CD8+ T cells and B cells in the meningeal compart, is increasingly debated. Here, we will discuss concepts of how adaptive immune cells might initiate and maintain autoimmune inflammation in the CNS, while the responses to autoimmune inflammation of CNS intrinsic cells, including astrocytes, oligodendrocytes, and neurons, are described elsewhere [1], [2], [3], [4], [5] and will not be a particular focus of this overview. Finally, it is the aim of this review to conceptualize the grounds for efficient therapeutic interventions targeting players of the adaptive immune system in relapsing but also in progressive MS