Extract from Cucurbita pepo improves BPH symptoms without affecting sexual function: a 24-month noninterventional study.

PURPOSE: To assess the symptoms, quality of life and sexual well-being in patients with lower urinary tract symptoms due to benign prostatic hyperplasia LUTS/BPH treated with pumpkin seed soft extract (PSE) in routine practice. METHODS: This noninterventional study included 130 men treated for up to 24 months. The International Prostate Symptom Score (IPSS) and related quality of life, Aging Males' Symptoms Scale (AMS), and International Index of Erectile Function (IIEF-5) were recorded. Descriptive statistical methods were applied. The mean with 95% confidence interval (CI) was calculated for the primary end point (change in IPSS after 12-month treatment). RESULTS: Analysis at 12 months included 83 patients [mean (SD) age 65.2 (8.7) years and IPSS (15.6 (3.4), IPSS-QoL 3.4 (0.9)]. AMS and IIEF-5 indicated mild or mild to moderate disorder regarding sexual well-being and erectile dysfunction, respectively. After 12 months, the mean IPSS change from baseline was - 4.7 (95% CI - 5.4 to - 3.9), with 83% (95% CI 65.3 to 84.1) and 53% (95% CI 42.3 to 63.7) of the patients achieving reductions by at least 3 and 5 points, respectively. The proportion of patients with IPSS-QoL below 3 points (mostly satisfied) was 11% (9/83) at baseline and rose to 62% (51/83) and 73% (40/55) at 12 and 24 months, respectively. AMS and IIEF-5 scores did not indicate a negative impact on sexual function during treatment. CONCLUSION: In men with a moderate LUTS suggestive of BPH, a low progression risk and an active sex life, treatment with pumpkin seed soft extract provided symptomatic relief, improved IPSS-QoL, and maintained sexual well-being. TRIAL REGISTRATION: DRKS00010729, June 22, 2016.

Neuroanatomy of dyslexia: An allometric approach.

Despite evidence for a difference in total brain volume between dyslexic and good readers, no previous neuroimaging study examined differences in allometric scaling (i.e. differences in the relationship between regional and total brain volumes) between dyslexic and good readers. The present study aims to fill this gap by testing differences in allometric scaling and regional brain volume differences in dyslexic and good readers. Object-based morphometry analysis was used to determine grey and white matter volumes of the four lobes, the cerebellum and limbic structures in 130 dyslexic and 106 good readers aged 8-14 years. Data were collected across three countries (France, Poland and Germany). Three methodological approaches were used as follows: principal component analysis (PCA), linear regression and multiple-group confirmatory factor analysis (MGCFA). Difference in total brain volume between good and dyslexic readers was Cohen's d = 0.39. We found no difference in allometric scaling, nor in regional brain volume between dyslexic and good readers. Results of our three methodological approaches (PCA, linear regression and MGCFA) were consistent. This study provides evidence for total brain volume differences between dyslexic and control children, but no evidence for differences in the volumes of the four lobes, the cerebellum or limbic structures, once allometry is taken into account. It also finds no evidence for a difference in allometric relationships between the groups. We highlight the methodological interest of the MGCFA approach to investigate such research issues.

The influence of semantic associations on sentence production in schizophrenia: an fMRI study.

One of the most prominent symptoms of schizophrenia is thought disorder, which manifests itself in language production difficulties. In patients with thought disorders the associations are loosened and sentence production is impaired. The determining behavioral and neural mechanisms of sentence production are still an important subject of recent research and have not yet been fully understood. The aim of the current study was to examine the influence of associative relations and distractor modalities on sentence production in healthy participants and participants with schizophrenia. Therefore, reaction times and neural activation of 12 healthy subjects and 13 subjects with schizophrenia were compared in an adapted picture word interference paradigm (PWI). No significant group differences were found, neither on the behavioral nor on the neural level. On the behavioral level, for the entire group incremental sentence processing was found, i.e. processing of the second noun only starts after the first noun was processed. At the neural level, activation was discovered in the bilateral caudate nuclei and the cerebellum. Those activations could be related to response enhancement and suppression as well as to the modulation of cognitive processes.

[Graduates of the Model Study Courses in the Health Professions in North Rhine-Westphalia: Employment Characteristics and Competencies in Professional Practice]. / Verbleib der Absolventinnen und Absolventen der Modellstudiengänge in den Gesundheitsfachberufen in Nordrhein-Westfalen: Ergebnisse zu Beschäftigungsmerkmalen und Kompetenzen in der Berufspraxis.

AIM: The aim of this article was to present key results of the graduates' survey VAMOS. The study examined the professional status of the graduates of 12 model study courses in the health professions in North Rhine-Westphalia. The focus of the article was on the employment characteristics of the current main jobs and the application of the academic competencies in everyday professional life. METHODS: In the early summer of 2018 (April to June), 515 graduates of the model study courses in nursing (N=244), physiotherapy (N=97), speech therapy (N=95), occupational therapy (N=47), and midwifery (N=32) were included in an online cross-sectional survey. Graduating classes between the winter semester 2013/2014 and the summer semester 2017 were included. In addition, employers (N=109) were interviewed who hired graduates from the model study courses. RESULTS: The main jobs of the graduates were mostly located in hospitals and outpatient therapy practices. Eight out of ten graduates (84%) performed tasks in direct contact with patients as the main part of their employment. In 71% of these cases, the regular tasks were combined with extended activities in comparison to colleagues without an academic degree. On average, the graduates felt confident in all competency dimensions examined in this study. In all dimensions, employers perceived a "competence advantage" for graduates compared to colleagues without an academic degree. CONCLUSION: The results of this graduate survey support the current recommendation to have the study programs in the five health care professions governed by professional laws and to enable the programs to be carried out at universities.

Cucurbita pepo-Rhus aromatica-Humulus lupulus Combination Reduces Overactive Bladder Symptoms in Women - A Noninterventional Study.

This prospective, noninterventional, multicenter 12-wk study in women with overactive bladder investigated the effectiveness of Granu Fink femina, a herbal combination of seed oil from Uromedic pumpkin (cultivar of Cucurbita pepo), Rhus aromatica (fragrant sumach) bark extract, and Humulus lupulus (hop) cone extract in a clinical setting. Patients documented overactive bladder symptoms and quality of life using questionnaires as well as diaries recording day- and nighttime micturition frequencies, urine leakages during physical activity or at sneezing or coughing, and use of incontinence pads. The full analysis set included 117 women (age: 21 - 78 y). Urination frequency decreased significantly with improvement during daytime in 49, 71, and 77 (out of 99) patients and at night in 45, 63, and 70 (out of 100) patients after 1, 6, and 12 wk, respectively. The mean frequency of leakages and used pads decreased significantly from 0.9 leakages and 2.0 pads at baseline to 0.4 leakages and 1.4 pads after 12 wk. In all measured aspects of overactive bladder-related quality of life, (coping, concern, sleep, social), statistically significant improvement was reached after 1 wk, with further improvement at 6 and 12 wk. Ninety-nine percent of the physicians and 95.4% of the patients rated tolerability as "very good" or "good". Treatment with Granu Fink femina progressively improved overactive bladder symptoms and related quality of life with significant improvements already after 1 wk. Based on these effects and the observed excellent tolerability profile, Granu Fink femina may be considered a valuable therapeutic option for overactive bladder.

[Impairments of language and communication in schizophrenia]. / Beeinträchtigungen von Sprache und Kommunikation bei Schizophrenie.

Disorganized speech is one of the key symptoms of schizophrenia. This article provides an overview of those areas of speech and communication impaired in patients with schizophrenia. Moreover, the state of the art of behavioral interventions is summarized. In conclusion, more well-controlled speech-language therapy studies are required in order to improve participation and communication-related quality of life in schizophrenia.

Cross-cultural consistency and diversity in intrinsic functional organization of Broca's Region.

As a core language area, Broca's region was consistently activated in a variety of language studies even across different language systems. Moreover, a high degree of structural and functional heterogeneity in Broca's region has been reported in many studies. This raised the issue of how the intrinsic organization of Broca's region effects by different language experiences in light of its subdivisions. To address this question, we used multi-center resting-state fMRI data to explore the cross-cultural consistency and diversity of Broca's region in terms of its subdivisions, connectivity patterns and modularity organization in Chinese and German speakers. A consistent topological organization of the 13 subdivisions within the extended Broca's region was revealed on the basis of a new in-vivo parcellation map, which corresponded well to the previously reported receptorarchitectonic map. Based on this parcellation map, consistent functional connectivity patterns and modularity organization of these subdivisions were found. Some cultural difference in the functional connectivity patterns was also found, for instance stronger connectivity in Chinese subjects between area 6v2 and the motor hand area, as well as higher correlations between area 45p and middle frontal gyrus. Our study suggests that a generally invariant organization of Broca's region, together with certain regulations of different language experiences on functional connectivity, might exists to support language processing in human brain.

Multi-parameter machine learning approach to the neuroanatomical basis of developmental dyslexia.

Despite decades of research, the anatomical abnormalities associated with developmental dyslexia are still not fully described. Studies have focused on between-group comparisons in which different neuroanatomical measures were generally explored in isolation, disregarding potential interactions between regions and measures. Here, for the first time a multivariate classification approach was used to investigate grey matter disruptions in children with dyslexia in a large (N = 236) multisite sample. A variety of cortical morphological features, including volumetric (volume, thickness and area) and geometric (folding index and mean curvature) measures were taken into account and generalizability of classification was assessed with both 10-fold and leave-one-out cross validation (LOOCV) techniques. Classification into control vs. dyslexic subjects achieved above chance accuracy (AUC = 0.66 and ACC = 0.65 in the case of 10-fold CV, and AUC = 0.65 and ACC = 0.64 using LOOCV) after principled feature selection. Features that discriminated between dyslexic and control children were exclusively situated in the left hemisphere including superior and middle temporal gyri, subparietal sulcus and prefrontal areas. They were related to geometric properties of the cortex, with generally higher mean curvature and a greater folding index characterizing the dyslexic group. Our results support the hypothesis that an atypical curvature pattern with extra folds in left hemispheric perisylvian regions characterizes dyslexia. Hum Brain Mapp 38:900-908, 2017. © 2016 Wiley Periodicals, Inc.

How the brain learns how few are "many": An fMRI study of the flexibility of quantifier semantics.

Previous work has shown that the meaning of a quantifier such as "many" or "few" depends in part on quantity. However, the meaning of a quantifier may vary depending on the context, e.g. in the case of common entities such as "many ants" (perhaps several thousands) compared to endangered species such as "many pandas" (perhaps a dozen). In a recent study (Heim et al., 2015 Front. Psychol.) we demonstrated that the relative meaning of "many" and "few" may be changed experimentally. In a truth value judgment task, displays with 40% of circles in a named color initially had a low probability of being labeled "many". After a training phase, the likelihood of acceptance 40% as "many" increased. Moreover, the semantic learning effect also generalized to the related quantifier "few" which had not been mentioned in the training phase. Thus, fewer 40% arrays were considered "few." In the present study, we tested the hypothesis that this semantic adaptation effect was supported by cytoarchitectonic Brodmann area (BA) 45 in Broca's region which may contribute to semantic evaluation in the context of language and quantification. In an event-related fMRI study, 17 healthy volunteers performed the same paradigm as in the previous behavioral study. We found a relative signal increase when comparing the critical, trained proportion to untrained proportions. This specific effect was found in left BA 45 for the trained quantifier "many", and in left BA 44 for both quantifiers, reflecting the semantic adjustment for the untrained but related quantifier "few." These findings demonstrate the neural basis for processing the flexible meaning of a quantifier, and illustrate the neuroanatomical structures that contribute to variable meanings that can be associated with a word when used in different contexts.

How reliable are gray matter disruptions in specific reading disability across multiple countries and languages? Insights from a large-scale voxel-based morphometry study.

The neural basis of specific reading disability (SRD) remains only partly understood. A dozen studies have used voxel-based morphometry (VBM) to investigate gray matter volume (GMV) differences between SRD and control children, however, recent meta-analyses suggest that few regions are consistent across studies. We used data collected across three countries (France, Poland, and Germany) with the aim of both increasing sample size (236 SRD and controls) to obtain a clearer picture of group differences, and of further assessing the consistency of the findings across languages. VBM analysis reveals a significant group difference in a single cluster in the left thalamus. Furthermore, we observe correlations between reading accuracy and GMV in the left supramarginal gyrus and in the left cerebellum, in controls only. Most strikingly, we fail to replicate all the group differences in GMV reported in previous studies, despite the superior statistical power. The main limitation of this study is the heterogeneity of the sample drawn from different countries (i.e., speaking languages with varying orthographic transparencies) and selected based on different assessment batteries. Nevertheless, analyses within each country support the conclusions of the cross-linguistic analysis. Explanations for the discrepancy between the present and previous studies may include: (1) the limited suitability of VBM to reveal the subtle brain disruptions underlying SRD; (2) insufficient correction for multiple statistical tests and flexibility in data analysis, and (3) publication bias in favor of positive results. Thus the study echoes widespread concerns about the risk of false-positive results inherent to small-scale VBM studies.

Kindergarteners' performance in a sound-symbol paradigm predicts early reading.

The current study examined the role of serial processing of newly learned sound-symbol associations in early reading acquisition. A computer-based sound-symbol paradigm (SSP) was administered to 243 children during their last year of kindergarten (T1), and their reading performance was assessed 1 year later in first grade (T2). Results showed that performance on the SSP measured before formal reading instruction was associated with later reading development. At T1, early readers performed significantly better than nonreaders in learning correspondences between sounds and symbols as well as in applying those correspondences in a serial manner. At T2, SSP performance measured at T1 was positively associated with reading performance. Importantly, serial application of newly learned correspondences at T1 explained unique variance in first-grade reading performance in nonreaders over and above other verbal predictors, including phonological awareness, verbal short-term memory, and rapid automatized naming. Consequently, the SSP provides a promising way to study aspects of reading in preliterate children.

Neural correlates of semantic associations in patients with schizophrenia.

Patients with schizophrenia have semantic processing disturbances leading to expressive language deficits (formal thought disorder). The underlying pathology has been related to alterations in the semantic network and its neural correlates. Moreover, crossmodal processing, an important aspect of communication, is impaired in schizophrenia. Here we investigated specific processing abnormalities in patients with schizophrenia with regard to modality and semantic distance in a semantic priming paradigm. Fourteen patients with schizophrenia and fourteen demographically matched controls made visual lexical decisions on successively presented word-pairs (SOA = 350 ms) with direct or indirect relations, unrelated word-pairs, and pseudoword-target stimuli during fMRI measurement. Stimuli were presented in a unimodal (visual) or crossmodal (auditory-visual) fashion. On the neural level, the effect of semantic relation indicated differences (patients > controls) within the right angular gyrus and precuneus. The effect of modality revealed differences (controls > patients) within the left superior frontal, middle temporal, inferior occipital, right angular gyri, and anterior cingulate cortex. Semantic distance (direct vs. indirect) induced distinct activations within the left middle temporal, fusiform gyrus, right precuneus, and thalamus with patients showing fewer differences between direct and indirect word-pairs. The results highlight aberrant priming-related brain responses in patients with schizophrenia. Enhanced activation for patients possibly reflects deficits in semantic processes that might be caused by a delayed and enhanced spread of activation within the semantic network. Modality-specific decreases of activation in patients might be related to impaired perceptual integration. Those deficits could induce and increase the prominent symptoms of schizophrenia like impaired speech processing.

Communicative impairment and its neural correlates in Alzheimer's disease and frontotemporal dementia.

OBJECTIVE: Communication skills can deteriorate in neurodegenerative diseases such as Alzheimer's disease (AD) and frontotemporal dementia (FTD); however, their clinical assessment and treatment in patient care can be challenging. In the present study, we aimed to quantify the distinctive communication resources and barriers reported by patients and their relatives in AD and FTD and associated these communicative characteristics with clinical parameters, such as the degree of cognitive impairment and atrophy in language-associated brain areas. METHODS: We assessed self-reported communication barriers and resources in 33 individuals with AD and FTD through an interview on daily-life communication, using the Aachener KOMPASS questionnaire. We correlated reported communication barriers and resources with atrophy from high-resolution 3T brain magnetic resonance imaging, neuropsychological assessment, and neurodegenerative markers from cerebrospinal fluid. RESULTS: Communicative impairment was higher in FTD compared to AD. Increased reported communication barriers in our whole sample were associated with the atrophy rate in the left middle temporal lobe, a critical site within the neuronal language network, and with depressive symptoms as well as the semantic word fluency from neuropsychological assessment. The best model for prediction of communicative impairment included the diagnosis (AD or FTD), semantic word fluency, and depressive symptoms. CONCLUSIONS: Our study demonstrates that communication barriers and resources can be successfully assessed via a structured interview based on self-report and report of patients' relatives in practice and are reflected in neuroimaging specific for AD and FTD as well as in further clinical parameters specific for these neurodegenerative diseases. This can potentially open new treatment options for clinical practice and patient care.

SpEx: a German-language dataset of speech and executive function performance.

This work presents data from 148 German native speakers (20-55 years of age), who completed several speaking tasks, ranging from formal tests such as word production tests to more ecologically valid spontaneous tasks that were designed to mimic natural speech. This speech data is supplemented by performance measures on several standardised, computer-based executive functioning (EF) tests covering domains of working-memory, cognitive flexibility, inhibition, and attention. The speech and EF data are further complemented by a rich collection of demographic data that documents education level, family status, and physical and psychological well-being. Additionally, the dataset includes information of the participants' hormone levels (cortisol, progesterone, oestradiol, and testosterone) at the time of testing. This dataset is thus a carefully curated, expansive collection of data that spans over different EF domains and includes both formal speaking tests as well as spontaneous speaking tasks, supplemented by valuable phenotypical information. This will thus provide the unique opportunity to perform a variety of analyses in the context of speech, EF, and inter-individual differences, and to our knowledge is the first of its kind in the German language. We refer to this dataset as SpEx since it combines speech and executive functioning data. Researchers interested in conducting exploratory or hypothesis-driven analyses in the field of individual differences in language and executive functioning, are encouraged to request access to this resource. Applicants will then be provided with an encrypted version of the data which can be downloaded.

Success rates of intensive aphasia therapy: real-world data from 448 patients between 2003 and 2020.

BACKGROUND: Aphasia is a devastating consequence after stroke, affecting millions of patients each year. Studies have shown that intensive speech and language therapy (SLT) is effective in the chronic phase of aphasia. Leveraging a large single-center cohort of persons with aphasia (PWA) including patients also in the subacute phase, we assessed treatment effects of intensive aphasia therapy in a real-world setting. METHODS: Data were collected at the Aachen aphasia ward in Germany between 2003 and 2020. Immediate treatment responses across different language domains were assessed with the Aachen Aphasia Test (AAT) using single-case psychometrics, conducted before and after 6-7 weeks of intensive SLT (10 h per week, median (IQR) dosage = 68 (61-76)). We adjusted for spontaneous recovery in subacute patients. Differential treatment effects between subgroups of chronicity and predictors of therapy response were investigated. RESULTS: A total of 448 PWA were included (29% female, median (IQR) age = 54 (46-62) years, median (IQR) time post-onset = 11 (6-20) months) with 12% in the early subacute, 15% in the late subacute and 74% in the chronic phase of aphasia. The immediate responder rate was 59%. Significant improvements in all AAT subtests und subscales were observed hinting at broad effectiveness across language domains. The degree of therapy-induced improvement did not differ between the chronicity groups. Time post-onset, dosage of therapy and aphasia severity at the beginning of treatment were predictors of immediate treatment response. DISCUSSION: Intensive therapy protocols for aphasia after stroke are yielding substantial responder rates in a routine clinical setting including a wide range of patients.

Three-dimensional cellular ultrastructure resolved by X-ray microscopy.

We developed an X-ray microscope using partially coherent object illumination instead of previously used quasi-incoherent illumination. The design permitted the incorporation of a cryogenic tilt stage, enabling tomography of frozen-hydrated, intact adherent cells. We obtained three-dimensional reconstructions of mouse adenocarcinoma cells at ∼36-nm (Rayleigh) and ∼70-nm (Fourier ring correlation) resolution, which allowed us to visualize the double nuclear membrane, nuclear pores, nuclear membrane channels, mitochondrial cristae and lysosomal inclusions.

Progressive cognitive dysfunction in spinocerebellar ataxia type 3.

BACKGROUND: Although it is well established that there is cognitive dysfunction in spinocerebellar ataxia type 3 (SCA3), it is unknown whether cognition deteriorates with disease progression. We therefore prospectively studied cognitive function in patients with SCA3. METHODS: Eleven patients with SCA3 were assessed using an extensive neuropsychological test battery and retested after 3.5 ± 0.4 years. RESULTS: In addition to ataxia and motor control, verbal learning and verbal and figural memory deteriorated significantly during the follow-up period. An increase in depressive symptoms was not observed. CONCLUSIONS: The observation that memory and learning abilities deteriorated with disease progression suggests that cognitive dysfunction is an integral part of SCA3. Because the applied tests for memory function did not require motor responses, cognitive decline cannot be attributed to progressive cerebellar ataxia. The deterioration of verbal and figural memory can be explained either by extracerebellar pathology or by disruption of cerebellar-cerebral circuitries.

Is the motor or the garage more important to the car? The difference between semantic associations in single word and sentence production.

The aim of the present study was to investigate the impact of part-whole (e.g., car-motor) and functional associations (e.g., car-garage) on single word (Experiment 1) and sentence production (Experiment 2). In Experiment 1, a classical picture-word task was used. In Experiment 2, the same stimuli and distractors were embedded into a sentence. The relation between target and distractor was either part-whole, functional or unrelated. At single word level, part-whole and functional relations facilitate naming. Additionally, the facilitation effect was stronger for part-whole in comparison to functional associations. During sentence production, facilitation shifted to interference. The difference between both relations disappeared. The findings of the different effects between functional and part-whole associations depend on the length of utterances and highlight the divergent impact of associations. The differences between part-whole and functional associations in single word production might reflect a differential organization of associative links at the conceptual level. In contrast, during sentence production the syntactic processing at the lexical level seem to be more important than types of semantic associations at the conceptual level.

Clinical Assessment of Communication-Related Speech Parameters in Dysarthria: The Impact of Perceptual Adaptation.

PURPOSE: In current clinical practice, intelligibility of dysarthric speech is commonly assessed by speech-language therapists (SLTs), in most cases by the therapist caring for the patient being diagnosed. Since SLTs are familiar with dysarthria in general and with the speech of the individual patient to be assessed in particular, they have an adaptation advantage in understanding the patient's utterances. We examined whether and how listeners' assessments of communication-related speech parameters vary as a function of their familiarity with dysarthria in general and with the diagnosed patients in particular. METHOD: Intelligibility, speech naturalness, and perceived listener effort were assessed in 20 persons with dysarthria (PWD). Patients' speech samples were judged by the individual treating therapists, five dysarthria experts who were unfamiliar with the patients, and crowdsourced naïve listeners. Adaptation effects were analyzed using (a) linear mixed models of overall scoring levels, (b) regression models of severity dependence, (c) network analyses of between-listener and between-parameter relationships, and (d) measures of intra- and interobserver consistency. RESULTS: Significant advantages of dysarthria experts over laypeople were found in all parameters. An overall advantage of the treating therapists over nonfamiliar experts was only seen in listening effort. Severity-dependent adaptation effects occurred in all parameters. The therapists' responses were heterogeneous and inconsistent with those of the unfamiliar experts and the naïve listeners. CONCLUSIONS: The way SLTs evaluate communication-relevant speech parameters of the PWD whom they care for is influenced not only by adaptation benefits but also by therapeutic biases. This finding weakens the validity of assessments of communication-relevant speech parameters by the treating therapists themselves and encourages the development and use of alternative methods.