Integrating multimodal and multiscale connectivity blueprints of the human cerebral cortex in health and disease

The brain is composed of disparate neural populations that communicate and interact with one another. Although fiber bundles, similarities in molecular architecture, and synchronized neural activity all reflect how brain regions potentially interact with one another, a comprehensive study of how all these interregional relationships jointly reflect brain structure and function remains missing. Here, we systematically integrate 7 multimodal, multiscale types of interregional similarity ("connectivity modes") derived from gene expression, neurotransmitter receptor density, cellular morphology, glucose metabolism, haemodynamic activity, and electrophysiology in humans. We first show that for all connectivity modes, feature similarity decreases with distance and increases when regions are structurally connected. Next, we show that connectivity modes exhibit unique and diverse connection patterns, hub profiles, spatial gradients, and modular organization. Throughout, we observe a consistent primacy of molecular connectivity modes-namely correlated gene expression and receptor similarity-that map onto multiple phenomena, including the rich club and patterns of abnormal cortical thickness across 13 neurological, psychiatric, and neurodevelopmental disorders. Finally, to construct a single multimodal wiring map of the human cortex, we fuse all 7 connectivity modes and show that the fused network maps onto major organizational features of the cortex including structural connectivity, intrinsic functional networks, and cytoarchitectonic classes. Altogether, this work contributes to the integrative study of interregional relationships in the human cerebral cortex.

The maternal brain is more flexible and responsive at rest: effective connectivity of the parental caregiving network in postpartum mothers

The field of neuroscience has largely overlooked the impact of motherhood on brain function outside the context of responses to infant stimuli. Here, we apply spectral dynamic causal modelling (spDCM) to resting-state fMRI data to investigate differences in brain function between a group of 40 first-time mothers at 1-year postpartum and 39 age- and education-matched women who have never been pregnant. Using spDCM, we investigate the directionality (top-down vs. bottom-up) and valence (inhibition vs excitation) of functional connections between six key left hemisphere brain regions implicated in motherhood: the dorsomedial prefrontal cortex, ventromedial prefrontal cortex, posterior cingulate cortex, parahippocampal gyrus, amygdala, and nucleus accumbens. We show a selective modulation of inhibitory pathways related to differences between (1) mothers and non-mothers, (2) the interactions between group and cognitive performance and (3) group and social cognition, and (4) differences related to maternal caregiving behaviour. Across analyses, we show consistent disinhibition between cognitive and affective regions suggesting more efficient, flexible, and responsive behaviour, subserving cognitive performance, social cognition, and maternal caregiving. Together our results support the interpretation of these key regions as constituting a parental caregiving network. The nucleus accumbens and the parahippocampal gyrus emerging as 'hub' regions of this network, highlighting the global importance of the affective limbic network for maternal caregiving, social cognition, and cognitive performance in the postpartum period.

Identification of a Stress-Sensitive Anorexigenic Neurocircuit From Medial Prefrontal Cortex to Lateral Hypothalamus

BACKGROUND

A greater understanding of how the brain controls appetite is fundamental to developing new approaches for treating diseases characterized by dysfunctional feeding behavior, such as obesity and anorexia nervosa.

METHODS

By modeling neural network dynamics related to homeostatic state and body mass index, we identified a novel pathway projecting from the medial prefrontal cortex (mPFC) to the lateral hypothalamus (LH) in humans (n = 53). We then assessed the physiological role and dissected the function of this mPFC-LH circuit in mice.

RESULTS

In vivo recordings of population calcium activity revealed that this glutamatergic mPFC-LH pathway is activated in response to acute stressors and inhibited during food consumption, suggesting a role in stress-related control over food intake. Consistent with this role, inhibition of this circuit increased feeding and sucrose seeking during mild stressors, but not under nonstressful conditions. Finally, chemogenetic or optogenetic activation of the mPFC-LH pathway is sufficient to suppress food intake and sucrose seeking in mice.

CONCLUSIONS

These studies identify a glutamatergic mPFC-LH circuit as a novel stress-sensitive anorexigenic neural pathway involved in the cortical control of food intake.

Diabetes disturbs functional adaptation of the remote myocardium after ischemia/reperfusion

Diabetes mellitus type 2 is associated with adverse clinical outcome after myocardial infarction. To better understand the underlying causes we here investigated sarcomere protein function and its calcium-dependent regulation in the non-ischemic remote myocardium (RM) of diabetic mice (db/db) after transient occlusion of the left anterior descending coronary artery. Before and 24 h after surgery db/db and non-diabetic db/+ underwent magnetic resonance imaging followed by histological and biochemical analyses of heart tissue. Intracellular calcium transients and sarcomere function were measured in isolated cardiomyocytes. Active and passive force generation was assessed in skinned fibers and papillary muscle preparations. Before ischemia and reperfusion (I/R), beat-to-beat calcium cycling was depressed in diabetic cardiomyocytes. Nevertheless, contractile function was preserved owing to increased myofilament calcium sensitivity and higher responsiveness of myocardial force production to β-adrenergic stimulation in db/db compared to db/+. In addition, protein kinase C activity was elevated in db/db hearts leading to strong phosphorylation of the titin PEVK region and increased titin-based tension of myofilaments. I/R impaired the function of whole hearts and RM sarcomeres in db/db to a larger extent than in non-diabetic db/+, and we identified several reasons. First, the amplitude and the kinetics of cardiomyocyte calcium transients were further reduced in the RM of db/db. Underlying causes involved altered expression of calcium regulatory proteins. Diabetes and I/R additively reduced phospholamban S16-phosphorylation by 80% (P < 000.1) leading to strong inhibition of the calcium ATPase SERCA2a. Second, titin stiffening was only observed in the RM of db/+, but not in the RM of db/db. Finally, db/db myofilament calcium sensitivity and force generation upon β-adrenergic stimulation were no longer enhanced over db/+ in the RM. The findings demonstrate that impaired cardiomyocyte calcium cycling of db/db hearts is compensated by increased myofilament calcium sensitivity and increased titin-based stiffness prior to I/R. In contrast, sarcomere function of the RM 24 h after I/R is poor because both these compensatory mechanisms fail and myocyte calcium handling is further depressed.

Inhibitory Control Development: A Network Neuroscience Perspective

As one of the core executive functions, inhibition plays an important role in human life through development. Inhibitory control is defined as the ability to suppress actions when they are unlikely to accomplish valuable results. Contemporary neuroscience has investigated the underlying neural mechanisms of inhibitory control. The controversy started to arise, which resulted in two schools of thought: a modulatory and a network account of inhibitory control. In this systematic review, we survey developmental mechanisms in inhibitory control as well as neurodevelopmental diseases related to inhibitory dysfunctions. This evidence stands against the modulatory perspective of inhibitory control: the development of inhibitory control does not depend on a dedicated region such as the right inferior frontal gyrus (rIFG) but relies on a more broadly distributed network.

[Spinal anesthesia for patients harboring a neurostimulator]

This article presents the case of an 82-year-old male patient with an implanted spinal cord stimulation system, who presented to our premedication consultation for a planned knee joint replacement. Spinal anesthesia was preferred because of the previous illnesses. In accordance with the recommendation of the treating pain physician for the puncture site, an uncomplicated L4/5 puncture was performed, and the surgery was performed with the patient under adequate spinal anesthesia. The system was checked postoperatively with regular findings.

Hypothalamic effective connectivity at rest is associated with body weight and energy homeostasis

Hunger and satiety drive eating behaviours via changes in brain function. The hypothalamus is a central component of the brain networks that regulate food intake. Animal research parsed the roles of the lateral hypothalamus (LH) and medial hypothalamus (MH) in hunger and satiety respectively. Here, we examined how hunger and satiety change information flow between human LH and MH brain networks, and how these interactions are influenced by body mass index (BMI). Forty participants (16 overweight/obese) underwent two resting-state functional MRI scans whilst being fasted and sated. The excitatory/inhibitory influence of information flow between the MH and LH was modelled using spectral dynamic causal modelling. Our results revealed two core networks interacting across homeostatic state and weight: subcortical bidirectional connections between the LH, MH and the substantia nigra pars compacta (prSN), and cortical top-down inhibition from frontoparietal and temporal areas. During fasting, we found higher inhibition between the LH and prSN, whereas the prSN received greater top-down inhibition from across the cortex. Individuals with higher BMI showed that these network dynamics occur irrespective of homeostatic state. Our findings reveal fasting affects brain dynamics over a distributed hypothalamic-midbrain-cortical network. This network is less sensitive to state-related fluctuations among people with obesity.

Erratum: Using Diffuse Scattering to Observe X-Ray-Driven Nonthermal Melting [Phys. Rev. Lett. 126, 015703 (2021)]

This corrects the article DOI: 10.1103/PhysRevLett.126.015703.

Metabolic and functional connectivity provide unique and complementary insights into cognition-connectome relationships

A major challenge in current cognitive neuroscience is how functional brain connectivity gives rise to human cognition. Functional magnetic resonance imaging (fMRI) describes brain connectivity based on cerebral oxygenation dynamics (hemodynamic connectivity), whereas [18F]-fluorodeoxyglucose functional positron emission tomography (FDG-fPET) describes brain connectivity based on cerebral glucose uptake (metabolic connectivity), each providing a unique characterization of the human brain. How these 2 modalities differ in their contribution to cognition and behavior is unclear. We used simultaneous resting-state FDG-fPET/fMRI to investigate how hemodynamic connectivity and metabolic connectivity relate to cognitive function by applying partial least squares analyses. Results revealed that although for both modalities the frontoparietal anatomical subdivisions related the strongest to cognition, using hemodynamic measures this network expressed executive functioning, episodic memory, and depression, whereas for metabolic measures this network exclusively expressed executive functioning. These findings demonstrate the unique advantages that simultaneous FDG-PET/fMRI has to provide a comprehensive understanding of the neural mechanisms that underpin cognition and highlights the importance of multimodality imaging in cognitive neuroscience research.

Neural network modelling reveals changes in directional connectivity between cortical and hypothalamic regions with increased BMI

BACKGROUND/OBJECTIVES

Obesity has been ascribed to corticostriatal regions taking control over homeostatic areas. To test this assumption, we applied an effective connectivity approach to reveal the direction of information flow between brain regions and the valence of connections (excitatory versus inhibitory) as a function of increased BMI and homeostatic state.

SUBJECTS/METHODS

Forty-one participants (21 overweight/obese) underwent two resting-state fMRI scans: after overnight fasting (hunger) and following a standardised meal (satiety). We used spectral dynamic causal modelling to unravel hunger and increased BMI-related changes in directed connectivity between cortical, insular, striatal and hypothalamic regions.

RESULTS

During hunger, as compared to satiety, we found increased excitation of the ventromedial prefrontal cortex over the ventral striatum and hypothalamus, suggesting enhanced top-down modulation compensating energy depletion. Increased BMI was associated with increased excitation of the anterior insula over the hypothalamus across the hunger and satiety conditions. The interaction of hunger and increased BMI yielded decreased intra-cortical excitation from the dorso-lateral to the ventromedial prefrontal cortex.

CONCLUSIONS

Our findings suggest that excess weight and obesity is associated with persistent top-down excitation of the hypothalamus, regardless of homeostatic state, and hunger-related reductions of dorso-lateral to ventromedial prefrontal inputs. These findings are compatible with eating without hunger and reduced self-regulation views of obesity.

Neural underpinnings of food choice and consumption in obesity

BACKGROUND/OBJECTIVES

Obesity is associated with unhealthy food choices. Food selection is driven by the subjective valuation of available options, and the perceived and actual rewards accompanying consumption. These cognitive operations are mediated by brain regions including the ventromedial prefrontal cortex (vmPFC), dorsal anterior cingulate cortex (dACC), and ventral striatum (vStr). This study investigated the relationship between body mass index (BMI) and functional activations in the vmPFC, dACC, and vStr during food selection and consumption.

SUBJECTS/METHODS

After overnight fasting, 26 individuals (BMI: 18-40 kg/m²) performed a food choice task while being scanned with functional magnetic resonance imaging (fMRI). Each trial involved selecting one beverage from a pair of presented options, followed by delivery of a 3 mL aliquot of the selected option using an MR-compatible gustometer. We also tracked subjective preference for each beverage throughout the experiment.

RESULTS

During food choice, individuals with greater BMI had less activation in the dorsolateral prefrontal cortex when selecting a high-value option and less vmPFC activation upon its consumption. Independent of BMI, during food choice the dACC and anterior insula elicited higher activation when a less preferred beverage was selected. Activation of the dACC and a broader frontoparietal network was also observed when deciding between options more similar in value. During consumption, receipt of a more preferred beverage was associated with greater vmPFC response, and attenuation of the dACC.

CONCLUSIONS

An individual's preference for a food option modulates the brain activity associated with choosing and consuming it. The relationship between food preference and underlying brain activity is altered in obesity, with reduced engagement of cognition-related regions when presented with a highly valued option, but a blunted response in reward-related regions upon consumption.

Review: Managing sheep and goats for sustainable high yield production

This review discusses the most relevant aspects of nutritional, reproductive and health management, the three pillars of flock efficiency, production and sustainability regarding the intensification of production in sheep and goats. In small ruminants, reproductive management is dependent on seasonality, which in turn depends on breed and latitude. Nutrition represents the major cost for flocks and greatly affects their health, the quality of their products and their environmental impact. High-yielding sheep and goats have very high requirements and dietary intake, requiring nutrient-dense diets and sophisticated nutritional management that should always consider the strong interrelationships among nutrition, immunity, health, reproduction, housing and farm management. The reproductive pattern is to a great extent assisted by out-of-season breeding, facilitating genetic improvement schemes, and more recently by advanced reproductive technologies. Heath management aims to control or eradicate economic and zoonotic diseases, ensuring animal health and welfare, food safety and low ecosystem and environmental impacts in relation to chemical residues and pathogen circulation. In highly producing systems, nutrition, genetic and hazard factors assume a complex interrelationship. Genomic and management improvement research and technological innovation are the keys to sustain sheep and goat production in the future.

Measuring the structure and equation of state of polyethylene terephthalate at megabar pressures

We present structure and equation of state (EOS) measurements of biaxially orientated polyethylene terephthalate (PET, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$({\hbox {C}}_{10} {\hbox {H}}_8 {\hbox {O}}_4)_n$$\end{document}(C10H8O4)n, also called mylar) shock-compressed to (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$155 \pm 20$$\end{document}155±20) GPa and (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$6000 \pm 1000$$\end{document}6000±1000) K using in situ X-ray diffraction, Doppler velocimetry, and optical pyrometry. Comparing to density functional theory molecular dynamics (DFT-MD) simulations, we find a highly correlated liquid at conditions differing from predictions by some equations of state tables, which underlines the influence of complex chemical interactions in this regime. EOS calculations from ab initio DFT-MD simulations and shock Hugoniot measurements of density, pressure and temperature confirm the discrepancy to these tables and present an experimentally benchmarked correction to the description of PET as an exemplary material to represent the mixture of light elements at planetary interior conditions.

The Hunger Games: Homeostatic State-Dependent Fluctuations in Disinhibition Measured with a Novel Gamified Test Battery

Food homeostatic states (hunger and satiety) influence the cognitive systems regulating impulsive responses, but the direction and specific mechanisms involved in this effect remain elusive. We examined how fasting, and satiety, affect cognitive mechanisms underpinning disinhibition using a novel framework and a gamified test-battery. Thirty-four participants completed the test-battery measuring three cognitive facets of disinhibition: attentional control, information gathering and monitoring of feedback, across two experimental sessions: one after overnight fasting and another after a standardised meal. Homeostatic state was assessed using subjective self-reports and biological markers (i.e., blood-derived liver-expressed antimicrobial protein 2 (LEAP-2), insulin and leptin). We found that participants who experienced greater subjective hunger during the satiety session were more impulsive in the information gathering task; results were not confounded by changes in mood or anxiety. Homeostatic state did not significantly influence disinhibition mechanisms linked to attentional control or feedback monitoring. However, we found a significant interaction between homeostatic state and LEAP-2 on attentional control, with higher LEAP-2 associated with faster reaction times in the fasted condition only. Our findings indicate lingering hunger after eating increases impulsive behaviour via reduced information gathering. These findings identify a novel mechanism that may underpin the tendency to overeat and/or engage in broader impulsive behaviours.

Using Diffuse Scattering to Observe X-Ray-Driven Nonthermal Melting

We present results from the SPring-8 Angstrom Compact free electron LAser facility, where we used a high intensity (∼10^{20}  W/cm^{2}) x-ray pump x-ray probe scheme to observe changes in the ionic structure of silicon induced by x-ray heating of the electrons. By avoiding Laue spots in the scattering signal from a single crystalline sample, we observe a rapid rise in diffuse scattering and a transition to a disordered, liquidlike state with a structure significantly different from liquid silicon. The disordering occurs within 100 fs of irradiation, a timescale that agrees well with first principles simulations, and is faster than that predicted by purely inertial behavior, suggesting that both the phase change and disordered state reached are dominated by Coulomb forces. This method is capable of observing liquid scattering without masking signal from the ambient solid, allowing the liquid structure to be measured throughout and beyond the phase change.

A Perspective on Candidate Neural Underpinnings of Binge Eating Disorder: Reward and Homeostatic Systems

People with Binge Eating Disorder (BED) exhibit heightened sensitivity to rewarding stimuli and elevated activity in reward-related brain regions, including the orbitofrontal cortex (OFC), ventral striatum (VS) and insula, during food-cue exposure. BED has also been associated with altered patterns of functional connectivity during resting-state. Investigating neural connectivity in the absence of task stimuli provides knowledge about baseline communication patterns that may influence the behavioural and cognitive manifestation of BED. Elevated resting-state functional connectivity (rsFC) between reward-related brain regions may contribute to uncontrolled eating bouts observed in BED, through heightened food-cue sensitivity and food-craving. The impact of homeostatic state on rsFC of the reward system has not yet been investigated in people with BED. Homeostatic dysfunction is a key driver of excessive food consumption in obesity, whereby rsFC between rewardrelated brain regions does not attenuate during satiety. Future studies should investigate BED related differences in rsFC within the reward system during hunger and satiety, in order to determine whether individuals with BED display an abnormal neural response to changes in homeostatic state. This knowledge would further enhance current understandings of the mechanisms contributing to BED, potentially implicating both reward and homeostatic dysfunctions as drivers of BED.

Effective brain connectivity at rest is associated with choice-induced preference formation

Preferences can change as a consequence of making hard decisions whereby the value of chosen options increases and the value of rejected options decreases. Such choice-induced preference changes have been associated with brain areas detecting choice conflict (anterior cingulate cortex, ACC), updating stimulus value (dorsolateral prefrontal cortex, dlPFC) and supporting memory of stimulus value (hippocampus and ventromedial prefrontal cortex, vmPFC). Here we investigated whether resting-state neuronal activity within these regions is associated with the magnitude of individuals' preference updates. We fitted a dynamic causal model (DCM) to resting-state neuronal activity in the spectral domain (spDCM) and estimated the causal connectivity among core regions involved in preference formation following hard choices. The extent of individuals' choice-induced preference changes were found to be associated with a diminished resting-state excitation between the left dlPFC and the vmPFC, whereas preference consistency was related to a higher resting-state excitation from the ACC to the left hippocampus and vmPFC. Our results point to a model of preference formation during which the dynamic network configurations between left dlPFC, ACC, vmPFC and left hippocampus at rest are linked to preference change or stability.

Demonstration of X-ray Thomson scattering as diagnostics for miscibility in warm dense matter

The gas and ice giants in our solar system can be seen as a natural laboratory for the physics of highly compressed matter at temperatures up to thousands of kelvins. In turn, our understanding of their structure and evolution depends critically on our ability to model such matter. One key aspect is the miscibility of the elements in their interiors. Here, we demonstrate the feasibility of X-ray Thomson scattering to quantify the degree of species separation in a 1:1 carbon-hydrogen mixture at a pressure of ~150 GPa and a temperature of ~5000 K. Our measurements provide absolute values of the structure factor that encodes the microscopic arrangement of the particles. From these data, we find a lower limit of [Formula: see text]% of the carbon atoms forming isolated carbon clusters. In principle, this procedure can be employed for investigating the miscibility behaviour of any binary mixture at the high-pressure environment of planetary interiors, in particular, for non-crystalline samples where it is difficult to obtain conclusive results from X-ray diffraction. Moreover, this method will enable unprecedented measurements of mixing/demixing kinetics in dense plasma environments, e.g., induced by chemistry or hydrodynamic instabilities.

Are German family practitioners and psychiatrists sufficiently trained to diagnose and treat patients with alcohol problems?

Background

Harmful alcohol consumption in Germany is a serious public health problem: About 7.7 million adults in Germany can be classified as risky alcohol consumers, about 74,000 deaths per year are related to alcohol consumption, and about 1.8 million adults in Germany (18–64 years) are classified as alcohol dependent. A treatment rate of 9% of all alcohol dependent patients in Germany implies a lack of supply and misuse of medical care. The aim of the study was to examine whether family practitioners (FPs) and psychiatrists have sufficient skills to diagnose and treat patients with alcohol problems.

Methods

A total of 6324 FPs and psychiatrists in the states of Saxony and Rhineland-Palatinate in Germany were invited to participate in this survey. Nine hundred seventy-four participants (90.3%/FPs) could be included in the statistical analysis (response rate: 14.3%/FPs, 21.6%/psychiatrists). Data was analysed descriptively and logistical regressions were used to identify predictors for physicians’ ability to feel adequately trained to diagnose and treat patients with alcohol problems.

Results

In comparison to psychiatrists, less FPs reported feeling sufficiently trained to counsel patients with alcohol problems (81.5% vs. 44.8%). Regression analysis revealed that FPs who felt not adequately trained had less experience with patients with alcohol dependence (OR 7.4), had attended fewer hours on alcohol addiction in continuing medical education (OR 4.8), and were more likely to be female (OR 1.9). A minimum of 10 h of training was associated with improved self-assessed competence.

Conclusion

Harmful drinking is a serious public health problem, and patients with alcohol dependence represent a large and demanding patient group in primary health care setting. Our study shows that the lack of training is a severe barrier in the work with this patient group in the primary care setting.

Infektiöse Lahmheiten beim Schaf – Therapie möglichkeiten in der tierärztlichen Praxis

Infektiöse Klauenerkrankungen des Schafes sind unter den Aspekten des Tierschutzes, der Diagnose und der Behandlung problematisch. Neben den Einzeltiererkrankungen und Lahmheiten im Zusammenhang mit Allgemeinerkrankungen stellen insbesondere die auf Herdenbasis auftretenden infektiösen Klauenerkrankungen wie die Moderhinke den behandelnden Tierarzt aus mehreren Gründen vor Probleme. In dem Artikel werden die verschiedenen Klauenerkrankungen kurz dargestellt und Hinweise zum Vorgehen bei der Therapie infektiöser Klauenkrankheiten des Schafes, zur Auswahl der Behandlungsmethode und zum Einsatz von Medikamenten gegeben. Die verschiedenen Behandlungsmaßnahmen wie Klauenschnitt, Klauenbäder, lokale und systemische antibiotische Therapie sowie die prophylaktische Impfung werden beschrieben und unter Berücksichtigung internationaler Forschungsergebnisse diskutiert. Bei der Auswahl der Medikamente zeigt sich, dass aufgrund fehlender Zulassungen in Deutschland der behandelnde Tierarzt beinahe regelmäßig gezwungen ist, Arzneimittel umzuwidmen. Die Problematik der medikamentösen Versorgung der kleinen Wiederkäuer als „minor species“ wird verdeutlicht und mit dem Aufruf an die involvierten Stellen verbunden, an einer Verbesserung dieser für alle Seiten unbefriedigenden Situation mitzuarbeiten.

Empfehlung für die Haltung von Schafen und Ziegen der Deutschen Gesellschaft für die Krankheiten der kleinen Wiederkäuer, Fachgruppe der DVG

Es werden Empfehlungen für die verschiedenen Haltungsformen auf der Basis der gesetzlichen Rahmenbedingungen für die Haltung von Schafen und Ziegen zusammengefasst. Berücksichtigung finden dabei die Wanderschäferei, die Hüte- und Koppelschafhaltung sowie die Alpung. Intensiv wird auf die Belange der Weidehaltung, der Stallhaltung, der Versorgung mit Futter und Wasser, der Geburt, der Lämmeraufzucht und der Gesundheitsvorsorge eingegangen. Dabei werden die Rahmenbedingungen sowohl für die extensive als auch für die intensive Haltung und Nutzung von Schafen und Ziegen abgesteckt. Die speziesspezifischen Kompensationsmöglichkeiten, deren Grenzen und Anzeichen der Dekompensation werden exemplarisch aufgezeigt. Durch die Einhaltung dieser Empfehlungen sollen den in unserer Obhut gehaltenen Nutztieren die „fünf Freiheiten (13)” zuverlässig gewährt werden: 1. Freisein von Hunger und Durst, 2. Freisein von Unbehagen, 3. Freisein von Schmerz, Verletzungen und Krankheiten, 4. Freisein zum Ausleben normaler Verhaltensweisen und 5. Freisein von Angst und Leiden.

Endogenous formation of preferences: Choices systematically change willingness-to-pay for goods

Standard decision theory assumes that choices result from stable preferences. This position has been challenged by claims that the act of choosing between goods may alter preferences. To test this claim, we investigated in three experiments whether choices between equally valued snack food items can systematically shape preferences. We directly assessed changes in participants' willingness-to-pay for these items, some of which could be bought at an auction after the experiment, while others could not. We found that chosen items were valued higher, and nonchosen items were valued lower; yet this postdecisional refinement of preferences was only observed for choices and valuations that were relevant, that is, incentive-compatible for items that were available for consumption. Supplementary analyses revealed that incentive-incompatible elicitations of preferences were unreliable and may have masked potential effects of choices on preferences. In conclusion, we propose that preferences can change endogenously, that is, in the absence of external feedback or information, but rather as a function of previous relevant choices. (PsycINFO Database Record

[Preferred Medical Specialties of Medical Students in Contrast to the Need for General Practitioners in Saxony]

Aim of the study: Especially in the rural areas of Germany, there are not enough general practitioners (GPs) for primary care. Preferred medical specialties of medical students can help get an estimate of the number of future GPs. This study compares this estimate to the current need for GPs in Saxony. Methods: 587 medical students at the second, sixth and tenth semester were invited to take part in an anonymous cross-sectional study regarding their specialty preferences at the Technical University Dresden. Based on the data of the medical requirements for Saxony, 4 model calculations were generated for comparison of the estimated numbers of future GPs and the current need for GPs. Results: The most commonly preferred medical specialties were surgery (19.1%), internal medicine (12.9%), pediatrics (11.6%) and general practice (9.9%). A significant increase in specialist preference for GP was observed from the sixth (4.9%) to the tenth semester (14.0%). The model calculations show that approximately 29% to 111% of the open positions for GPs could be filled by the potential new GPs from Dresden. Conclusion: Currently, medical students planning to become GPs cannot meet the corresponding need for GPs. Future studies should include the points of view of students, continuing education assistants, GPs and patients.

[Amendments to the Drinking Water Ordinance: Legionellae in Hot Water Systems - Data from the Public Health Authority Frankfurt am Main, Germany]

BACKGROUND

The first and second amendment to the Drinking Water Ordinance came in to force in the years 2011 and 2012 causing additional tasks and responsibilities for operators of commercial large-scale systems, usually hot water systems in large residential buildings, and for the local health authorities. This article describes the experiences of the health authority in Frankfurt/Main with these new regulations. Some of the revisions in the first amendment of the ordinance (TrinkwV 2001 (2011)) were omitted in the second revision (TrinkwV 2001 (2012)) such as the obligation to notify for large-scale systems. Furthermore, the intervals between the obligatory inspections were extended from 1 to 3 years and merely exceedances of the legal limits were to be notified in contrast to the previous obligation to notify all values.

RESULTS

On the basis of the TrinkwV 2001 (2011) a large additional staff requirement had been estimated (13/21 positions). After the TrinkwV 2001 (2012) the tasks can be accomplished by less than 2 employees. While the notification obligation was still in force, the health authority received 4,461 notifications of large-scale systems, since then a further 477 have been notified. Of a total of 1,335 initial analyses, 794 (60%) exceeded the technical action value and in 113 properties with values exceeding 10,000/100 ml a usage restriction was necessary.

CONCLUSIONS

Due to the suspension of the notification obligation to report any result of the analyses performed the assessment of the reports on large-scale systems has become difficult. An appropriate assessment of the implementation of the regulation is not possible, since the total number of large-scale systems is not known and a failure to report may result from a measured value below the technical action value as well as from a not inspected system. The large number of usage restrictions is an indication for the necessity to inspect and if required to treat and restore the system.

Psychological and interactional characteristics of patients with somatoform disorders: Validation of the Somatic Symptoms Experiences Questionnaire (SSEQ) in a clinical psychosomatic population

OBJECTIVE

The new DSM-5 Somatic Symptom Disorder (SSD) emphasizes the importance of psychological processes related to somatic symptoms in patients with somatoform disorders. To address this, the Somatic Symptoms Experiences Questionnaire (SSEQ), the first self-report scale that assesses a broad range of psychological and interactional characteristics relevant to patients with a somatoform disorder or SSD, was developed. This prospective study was conducted to validate the SSEQ.

METHODS

The 15-item SSEQ was administered along with a battery of self-report questionnaires to psychosomatic inpatients. Patients were assessed with the Structured Clinical Interview for DSM-IV to confirm a somatoform, depressive, or anxiety disorder. Confirmatory factor analyses, tests of internal consistency and tests of validity were performed.

RESULTS

Patients (n=262) with a mean age of 43.4 years, 60.3% women, were included in the analyses. The previously observed four-factor model was replicated and internal consistency was good (Cronbach's α=.90). Patients with a somatoform disorder had significantly higher scores on the SSEQ (t=4.24, p<.001) than patients with a depressive/anxiety disorder. Construct validity was shown by high correlations with other instruments measuring related constructs. Hierarchical multiple regression analyses showed that the questionnaire predicted health-related quality of life. Sensitivity to change was shown by significantly higher effect sizes of the SSEQ change scores for improved patients than for patients without improvement.

CONCLUSION

The SSEQ appears to be a reliable, valid, and efficient instrument to assess a broad range of psychological and interactional features related to the experience of somatic symptoms.

[Water requirements, water supply and thermoregulation in small ruminants in pasture-based husbandry systems]

Water is an essential source of life and is available to animals as free water, water content of feed, film water (e. g. dew) and metabolic water. The water requirements of small ruminants are influenced by the type of feed, climate, stage of production, type and length of the fleece or hair coat, husbandry factors and the general health of the animal. Differences in water metabolism, drinking behaviour and the efficiency of temperature regulation are further influenced by species, breed, production type, husbandry system, acclimatisation and adaptation. Small ruminants have been, and are still predominantly kept in extensive husbandry systems. They are therefore genetically and phenotypically well adapted to these conditions and possess a range of physiological and behavioural mechanisms to deal with adverse and suboptimal weather conditions. Regarding animal welfare, there is considerable debate in the discussion and assessment of what constitutes a sufficient water supply for small ruminants under different husbandry conditions, often involving differences between theoretical demands and practical experience. This publication reviews and summarises the current literature regarding water requirements, water metabolism and thermoregulatory mechanisms of small ruminants to provide the basis for an informed assessment of extensive husbandry systems in terms of compliance with animal-welfare requirements.

[The Somatic Symptoms Experiences Questionnaire (SSEQ): a new self-report instrument for the assessment of psychological characteristics of patients with somatoform disorder]

Psychological symptoms of somatoform disorders will be part of their new definition in DSM-5. We developed the Somatic Symptoms Experiences Questionnaire (SSEQ) as a self-report questionnaire to assess important psychological characteristics of patients with somatoform disorders. Item selection and identification of factor structure, as well as reliability and validity have been checked in a sample of N=453 psychsomatic outpatients. Results of a principal components analysis with Promax-rotation suggested 4 factors (health worries, illness experience, difficulties in interaction with doctors, impact of illness). Validity analyses confirmed associations between the SSEQ-Scores and the physical disability of patients. Although further assessments of psychometric qualities are needed, the questionnaire appears to be well-suited for future assessment of relevant psychological features of somatoform disorders.

Health-related quality of life, depression, and anxiety in patients with autoimmune hepatitis

BACKGROUND & AIMS

Improving health related quality of life (HrQoL) in patients with chronic diseases such as autoimmune hepatitis (AIH) should be a major treatment goal. However, little is known on the HrQoL in patients with AIH, and the topic is not given attention in current practice guidelines. We therefore conducted a single center study evaluating HrQoL in 103 consecutive outpatients with AIH.

METHODS

Patient-reported HrQoL data were analysed in relation to clinical disease parameters and compared to representative data of the German population as well as control patients.

RESULTS

Based on patient-reported data, a major depressive syndrome (10.8%) was found to be five times more frequent in AIH patients compared to the general population (p<0.001). The rate of severe symptoms of anxiety was also found to be significantly increased compared to the general population (p=0.006). In seven of the eleven patients who scored for a major depressive syndrome a psychiatric comorbidity had not been diagnosed before. Major factors associated with depression and anxiety were concerns with regard to the progression of the liver disease.

CONCLUSIONS

This study identified--for the first time--a high rate of previously unrecognized severe symptoms of depression and anxiety in patients with AIH. Of importance for daily clinical practice, the factors associated with these symptoms may in part be amenable to targeted counselling and adequate treatment of the disease, thereby offering the chance to improve the care and HrQoL of AIH-patients.