[Risk of Reduced Earning Capacity Pension due to Cardiovascular Diseases after Medical Rehabilitation: An Event History Analysis based on German Statutory Pension Insurance Data]. / Das Risiko für Erwerbsminderungsrente bei Herz-Kreislauf-Erkrankungen nach medizinischen Rehabilitationen: Eine ereignisdatenanalytische Studie auf Basis von Daten der Deutschen Rentenversicherung.

AIM: Not much is known on risks for reduced earning capacity pensions (RECP) for patients with specific diseases. Our study focusses on individuals who have completed a course of rehabilitation due to cardiovascular disease. METHODS: This study is based on a scientific use file from the German statutory pension insurance that covers completed rehabilitations between 2006-2013. Using survival analysis, we modeled the transition into RECP in general and for specific diagnostic groups. We used Kaplan-Meier-estimates and age-standardized and sex-specific transition rates. Multivariate Cox Proportional Hazard models are used to identify the most important socio-demographic risk factors for RECP. RESULTS: Patients who completed rehabilitation after cerebral infarction, cardiomyopathy or cerebrovascular diseases were most likely to transition into RECP due to these diseases. The most important socio-demographic risk factors for RECP were low educational attainments, part-time or no employment and living in Eastern Germany. CONCLUSION: Especially patients with cerebral infarction, cardiomyopathy or cerebrovascular diseases require successful medical rehabilitation. In case of multimorbid patients, these diagnoses require special attention. Also, the reintegration into the labor market of people from lower social strata after medical rehabilitation to avoid RECP appears to be especially difficult.

Real-time adaptive optics testbed to investigate point-ahead angle in pre-compensation of Earth-to-GEO optical communication.

We explore adaptive optics (AO) pre-compensation for optical communication between Earth and geostationary (GEO) satellites in a laboratory experiment. Thus, we built a rapid control prototyping breadboard with an adjustable point-ahead angle where downlink and uplink can operate both at 1064 nm and 1550 nm wavelength. With our real-time system, beam wander resulting from artificial turbulence was reduced such that the beam hits the satellite at least 66% of the time as compared to merely 3% without correction. A seven-fold increase of the average Strehl ratio to (28 ± 15)% at 18 µrad point-ahead angle leads to a considerable reduction of the calculated fading probability. These results make AO pre-compensation a viable technique to enhance Earth-to-GEO optical communication.

Analysis of quantitative trait loci in mice suggests a role of Enoph1 in stress reactivity.

Significant progress in elucidating the genetic etiology of anxiety and depression has been made during the last decade through a combination of human and animal studies. In this study, we aimed to discover genetic loci linked with anxiety as well as depression in order to reveal new candidate genes. Therefore, we initially tested the behavioral sensitivity of 543 F2 animals derived from an intercross of C57BL/6J and C3H/HeJ mice in paradigms for anxiety and depression. Next, all animals were genotyped with 269 microsatellite markers with a mean distance of 5.56 cM. Finally, a Quantitative Trait Loci (QTL) analysis was carried out, followed by selection of candidate genes. The QTL analysis revealed several new QTL on chromosome 5 with a common core interval of 19 Mb. We further narrowed this interval by comparative genomics to a region of 15 Mb. A database search and gene prioritization revealed Enoph1 as the most significant candidate gene on the prioritization list for anxiety and also for depression fulfilling our selection criteria. The Enoph1 gene, which is involved in polyamine biosynthesis, is differently expressed in parental strains, which have different brain spermidine levels and show distinct anxiety and depression-related phenotype. Our result suggests a significant role in polyamines in anxiety and depression-related behaviors.

Quantitative trait loci contributing to physiological and behavioural ethanol responses after acute and chronic treatment.

The aim of the present study was the identification of gene loci that contribute to the development and manifestation of behaviours related to acute and chronic alcohol exposure, as well as to alcohol withdrawal. For this purpose, we performed a serial behavioural phenotyping of 534 animals from the second filial (F2) generation of a C57BL/6J and C3H/HeJ mice intercross in paradigms with relevance to alcohol dependence. First, ethanol-induced hypothermia was determined in ethanol-naive animals. The mice then received an ethanol solution for several weeks as their only fluid source. Ethanol tolerance, locomotor activity and anxiety-related behaviours were evaluated. The ethanol was next withdrawn and the withdrawal severity was assessed. The ethanol-experienced animals were finally analysed in a two-bottle choice paradigm to determine ethanol preference and stress-induced changes in ethanol preference. The genotypes of these mice were subsequently assessed by microsatellite marker mapping. We genotyped 264 markers with an average marker distance of 5.56 cM, which represents a high-density whole genome coverage. Quantitative trait loci (QTL) were subsequently identified using univariate analysis performed with the R/qtl tool, which is an extensible, interactive environment for mapping QTL in experimental crosses. We found QTL that have already been published, thus validating the serial phenotyping protocol, and identified several novel loci. Our analysis demonstrates that the various responses to ethanol are regulated by independent groups of genes.

Visual cues that predict intuitive risk perception in the case of HIV.

Field studies indicate that people may form impressions about potential partners' HIV risk, yet lack insight into what underlies such intuitions. The present study examined which cues may give rise to the perception of riskiness. Towards this end, portrait pictures of persons that are representative of the kinds of images found on social media were evaluated by independent raters on two sets of data: First, sixty visible cues deemed relevant to person perception, and second, perceived HIV risk and trustworthiness, health, and attractiveness. Here, we report correlations between cues and perceived HIV risk, exposing cue-criterion associations that may be used to infer intuitively HIV risk. Second, we trained a multiple cue-based model to forecast perceived HIV risk through cross-validated predictive modelling. Trained models accurately predicted how 'risky' a person was perceived (r = 0.75) in a novel sample of portraits. Findings are discussed with respect to HIV risk stereotypes and implications regarding how to foster effective protective behaviors.

Prevalence of Morbidity at Extreme Old Age in Germany: An Observational Study Using Health Claims Data.

We assessed the prevalence of morbidity in long-lived individuals according to age and age at death and explored the association between dementia and other diseases and surviving to age 90 and 100. Using health claims data from the largest German health insurer from 2004 to 2013, we followed birth cohorts from 1908 to 1913 from age 95 until death or survival to age 100 (n=2,865) and compared them with birth cohorts from 1918 to 1923 and their survival from age 85 to age 90 (n=17,013). We observed their exact date of death and main categories of morbidity based on International Classification of Diseases, Tenth Revision, diagnoses. For all diseases studied, when differentiated according to age at death, prevalence continued to increase with age. Nonagenarians and centenarians had significantly lower disease prevalence at each age. Dementia was associated with the highest risk of dying before becoming a centenarian (hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.50-1.78), followed closely by the residual category other chronic heart disease (HR=1.42, 95% CI=1.30-1.56). Results were even stronger for the younger cohort. Our study shows that exceptionally long-lived individuals are different in terms of good health. Survival at these high ages depends primarily on the absence of dementia and chronic heart disease, with acute heart disease and pneumonia playing important roles as diseases leading directly to death.

Impact of transcatheter aortic valve implantation on the risk of mortality in patients with severe aortic valve diseases: a health insurance-based analysis.

Background: Transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for aortic valve patients who are inoperable or have a prohibitively high surgical risk for surgical aortic valve replacement (SAVR). Most studies compare the efficacy of TAVI and SAVR, yet the assessment of TAVI for this group of patients requires more study. Methods: This quasiexperimental study compares TAVI cases (ages of 75-90 years, n=187) ex-post with a control group without implantation (n=728, 4:1 ratio intended). The control group was drawn randomly on the condition that it matches the TAVI cases based on age at aortic valve disease incidence, gender and comorbidity index. The mortality risk is analysed from incident diagnosis. Data were taken from three random samples of health claims data in Germany's largest public health insurance (Allgemeine Ortskrankenkassen) and cover the years 2004-2013 (n=750 000). Results: Compared with the medically treated control group with 6+ comorbidities, medically treated patients with fewer comorbidities have half the mortality risk (HR 0.48, 95% CI 0.34 to 0.69, p<0.001). TAVI patients with fewer than six comorbidities show a mortality risk half that (HR 0.23, 95% CI 0.09 to 0.63, p=0.004). TAVI patients with 6+ comorbidities do not benefit from TAVI compared with the control group with 6+ comorbidities (HR 0.99, 95% CI 0.71 to 1.36, p=0.93). Conclusion: TAVI is an effective therapy for aortic valve disease patients with few comorbidities; it is not effective for patients with a high comorbidity burden. Careful assessment of the individual patient in terms of comorbidities is important for a beneficial outcome.

Extremity injuries and dementia disproportionately increase the risk for long-term care at older age in an analysis of German Health Insurance routine data for the years 2006 to 2010.

BACKGROUND: Extremity injuries (EI) and dementia are important causes of long-term care (LTC), but they can also cause each other and are often present concurrently. Mobility-limiting EI can increase the risk of dementia, and dementia increases the risk for falls, which are often the cause of EI. When EI and dementia are present together, they can increase their negative effect on long-term care risk. This study aims to assess the strength of this interaction and the role of different body regions and severities of EI regarding LTC risk. METHODS: We use Cox proportional-hazard models on LTC as dependent variable. EI (primarily fractures) and dementia (all types) are the central independent variables. We control for age, sex, rehabilitation and 18 relevant comorbidities. Analyses are based on health claims records for 2004-2010 for a random sample of about 122.000 insurants of Germany's largest public health insurance "AOK" aged 65+, about 25.000 of whom entered LTC. RESULTS: Without concurrent dementia, non-severe EI (NSEI) of the lower and both extremities and all kinds of severe EI (SEI) increase LTC risk (HR: hazard ratio with 95% confidence interval. Lower NSEI: HR = 1.09 [1.05-1.14]; both NSEI: HR = 1.36 [1.29-1.44]. Lower SEI: HR = 1.67 [1.57-1.79]; upper SEI: HR = 1.27 [1.19-1.37]; both SEI: HR = 1.94 [1.81-2.07]). Dementia alone increases LTC risk more than fourfold (HR = 4.23 [4.11-4.35]). Taking the interaction of EI and dementia into account, the concurrent presence of EI and dementia tends to increase the LTC risk more than expected for lower as well as upper NSEI and SEI. Summarily, when lower or upper EI and dementia are both present, the LTC risk tends to be higher than expected, suggesting synergistic effects. CONCLUSIONS: EI and dementia are important independent risk factors for long-term care. When lower or upper EI and dementia are present together, the resulting long-term care risk is increased disproportionately. Since the concurrent presence of both conditions increases the risk for care need, and a working treatment for dementia is not in sight, preventing EI, lessening the impact of EI and improving the outlook after an EI could help to reduce LTC need in the coming decades.

How Target and Perceiver Gender Affect Impressions of HIV Risk.

BACKGROUND: People do not use condoms consistently but instead rely on intuition to identify sexual partners high at risk for human immunodeficiency virus (HIV) infection. The present study examined gender differences of intuitive impressions about HIV risk. METHODS: Male and female perceivers evaluated portraits of unacquainted male and female targets regarding their risk for HIV, trait characteristics (trust, responsibility, attractiveness, valence, arousal, and health), and willingness for interaction. RESULTS: Male targets were perceived as more risky than female targets for both perceiver genders. Furthermore, male perceivers reported higher HIV risk perception for both male and female targets than female perceivers. Multiple regression indicated gender differences in the association between person characteristics and HIV risk. In male targets, only trustworthiness predicts HIV risk. In female targets, however, HIV risk is related to trustworthiness, attractiveness, health, valence (for male perceivers), and arousal (for female perceivers). CONCLUSION: The present findings characterize intuitive impressions of HIV risk and reveal differences according to both target and perceiver gender. Considering gender differences in intuitive judgments of HIV risk may help devise effective strategies by shifting the balance from feelings of risk toward a more rational mode of risk perception and the adoption of effective precautionary behaviors.

Neural correlates of risk perception: HIV vs. leukemia.

Field studies on HIV risk perception suggest that people may rely on impressions they have about the safety of their partner. Previous studies show that individuals perceived as "risky" regarding HIV elicit a differential brain response in both earlier (~200-350 ms) and later (~350-700 ms) time windows compared to those perceived as safe. This raises the question whether this event-related brain potential (ERP) response is specific to contagious life-threatening diseases or a general mechanism triggered by life-threatening but non-contagious diseases. In the present study, we recorded dense sensor EEG while participants (N = 36) evaluated photographs of unacquainted individuals for either HIV or leukemia risk. The ERP results replicated previous findings revealing earlier and later differential brain responses towards individuals perceived as high risk for HIV. However, there were no significant ERP differences for high vs. low leukemia risk. Rather than reflecting a generic response to disease, the present findings suggest that intuitive judgments of HIV risk are at least in part specific to sexually transmitted diseases.

Implicit and Explicit Processes in Risk Perception: Neural Antecedents of Perceived HIV Risk.

Field studies on HIV risk suggest that people may rely on impressions they have about the safety of their partner at the dispense of more objective risk protection strategies. In this study, ERP recordings were used to investigate the brain mechanisms that give rise to such impressions. First, in an implicit condition, participants viewed a series of photographs of unacquainted persons while performing a task that did not mention HIV risk. Second, in an explicit condition, participants estimated the HIV risk for each presented person. Dense sensor EEG was recorded during the implicit and explicit conditions. In the analysis, explicit risk ratings were used to categorize ERP data from the implicit and explicit conditions into low and high HIV risk categories. The results reveal implicit ERP differences on the basis of subsequent ratings of HIV risk. Specifically, the processing of risky individuals was associated with an early occipital negativity (240-300 ms) and a subsequent central positivity between 430 and 530 ms compared to safe. A similar ERP modulation emerged in the explicit condition for the central positivity component between 430 and 530 ms. A subsequent late positive potential component between 550 and 800 ms was specifically enhanced for risky persons in the explicit rating condition while not modulated in the implicit condition. Furthermore, ratings of HIV risk correlated substantially with ratings of trustworthiness and responsibility. Taken together, these observations provide evidence for theories of intuitive risk perception, which, in the case of HIV risk, seem to operate via appearance-based stereotypic inferences.

Bis(pyrazol-1-yl)acetates as tripodal heteroscorpionate ligands in iron chemistry: syntheses and structures of iron(II) and iron(III) complexes with bpza, bdmpza, and bdtbpza ligands.

The molecular structure of the previously reported species "[Fe(bdtbpza)Cl]" has been revealed by X-ray structure determination to be a ferrous dimer [Fe(bdtbpza)Cl](2) (2c) [bdtbpza = bis(3,5-di-tert-butylpyrazol-1-yl)acetate]. The syntheses of ferrous 2:1 complexes [Fe(bpza)(2)] (3a) and [Fe(bdtbpza)(2)] (3c) as well as ferric 1:1 complexes [NEt(4)][Fe(bpza)Cl(3)] (4a) and [NEt(4)][Fe(bdmpza)Cl(3)] (4b) [bpza = bis(pyrazol-1-yl)acetate, bdmpza = bis(3,5-dimethylpyrazol-1-yl)acetate] are reported. Complexes 3a, previously reported [Fe(bdmpza)(2)] (3b), and 3c are high-spin. No spin crossover to the low-spin state was observed in the temperature range of 5-350 K. 4a and 4b are synthesized in one step and in high yield from [NEt(4)](2)[Cl(3)FeOFeCl(3)]. 4a and 4b are iron(III) high-spin complexes. Crystallographic information: 2c (C(24)H(39)ClFeN(4)O(2).CH(2)Cl(2).CH(3)CN) is triclinic, P1, a = 12.171(16) A, b = 12.851(14) A, c = 13.390(13) A, alpha = 98.61(9) degrees, beta = 113.51(11) degrees, gamma = 108.10(5) degrees, Z = 2; 3a (C(8)H(7)Fe(0.5)N(4)O(2)) is monoclinic, P2(1)/n, a = 7.4784(19) A, b = 7.604(3) A, c = 16.196(4) A, beta = 95.397(9) degrees, Z = 4; 3c (C(24)H(39)Fe(0.5)N(4)O(2)) is monoclinic, P2(1)/n, a = 9.939(6) A, b = 18.161(10) A, c = 13.722(8) A, beta = 97.67(7) degrees, Z = 4; 4b (C(20)H(35)Cl(3)FeN(5)O(2)) is monoclinic, C2/c, a = 30.45(6) A, b = 12.33(2) A, c = 16.17(3) A, beta = 118.47(5) degrees, Z = 8.