The Burden of Disease Due to Road Traffic Noise in Hesse, Germany.

Road-traffic-noise exposition is widespread in Germany and can have harmful health effects. As guidance for informed decision-making, we estimated the environmental burden of disease attributable to road-traffic noise in Hesse, Germany as disability-adjusted life-years (DALYs). Using detailed road-traffic-noise exposure data provided by the Hessian Agency for Nature Conservation, Environment, and Geology (HLNUG), we calculated the DALYs due to road-traffic noise > 40 dB(A) L24h (unweighted average 24 h noise level) and other noise metrics for endpoints with known dose-response functions and evidence in the literature (NORAH-study on disease risks and WHO reviews): cardiovascular disease, depressive disorders, road-traffic annoyance, and sleep disturbance. We calculated the population-attributable fractions (PAF) for road-noise-related cardiovascular disease (hypertensive heart disease, ischemic heart disease, and stroke) and depressive disorders in the population using published relative risk estimates. We multiplied the PAFs with the Hessian proportion of the 2015 WHO DALY estimates for Germany in people aged ≥ 40 years. For high annoyance and high sleep disturbance, we used published dose-response functions to determine the burden for residents of all ages. For Hesse, we found a total of 26,501 DALYs attributable to road-traffic noise or 435 DALY per 100,000 persons for the reference year, 2015. Further, we estimated that a hypothetic uniform road-traffic-noise reduction of 3 dB would prevent 23% of this burden of disease.

Neuronal Correlates of Product Feature Attractiveness.

Decision-making is the process of selecting a logical choice from among the available options and happens as a complex process in the human brain. It is based on information processing and cost-analysis; it involves psychological factors, specifically, emotions. In addition to cost factors personal preferences have significant influence on decision making. For marketing purposes, it is interesting to know how these emotions are related to product acquisition decision and how to improve these products according to the user's preferences. For our proof-of-concept study, we use magneto- and electro-encephalography (MEG, EEG) to evaluate the very early reactions in the brain related to the emotions. Recordings from these methods are comprehensive sources of information to investigate neural processes of the human brain with good spatial- and excellent temporal resolution. Those characteristics make these methods suitable to examine the neurologic process that gives origin to human behavior and specifically, decision making. Literature describes some neuronal correlates for individual preferences, like asymmetrical distribution of frequency specific activity in frontal and prefrontal areas, which are associated with emotional processing. Such correlates could be used to objectively evaluate the pleasantness of product appearance and branding (i.e., logo), thus avoiding subjective bias. This study evaluates the effects of different product features on brain activity and whether these methods could potentially be used for marketing and product design. We analyzed the influence of color and fit of sports shirts, as well as a brand logo on the brain activity, specifically in frontal asymmetric activation. Measurements were performed using MEG and EEG with 10 healthy subjects. Images of t-shirts with different characteristics were presented on a screen. We recorded the subjective evaluation by asking for a positive, negative or neutral rating. The results showed significantly different responses between positively and negatively rated shirts. While the influence of the presence of a logo was present in behavioral data, but not in the neurocognitive data, the influence of shirt fit and color could be reconstructed in both data sets. This method may enable evaluation of subjective product preference.

Three-Dimensional Biomechanical Analysis of Rearfoot and Forefoot Running.

BACKGROUND: In the running community, a forefoot strike (FFS) pattern is increasingly preferred compared with a rearfoot strike (RFS) pattern. However, it has not been fully understood which strike pattern may better reduce adverse joint forces within the different joints of the lower extremity. PURPOSE: To analyze the 3-dimensional (3D) stress pattern in the ankle, knee, and hip joint in runners with either a FFS or RFS pattern. STUDY DESIGN: Descriptive laboratory study. METHODS: In 22 runners (11 habitual rearfoot strikers, 11 habitual forefoot strikers), RFS and FFS patterns were compared at 3.0 m/s (6.7 mph) on a treadmill with integrated force plates and a 3D motion capture analysis system. This combined analysis allowed characterization of the 3D biomechanical forces differentiated for the ankle, knee, and hip joint. The maximum peak force (MPF) and maximum loading rate (LR) were determined in their 3 ordinal components: vertical, anterior-posterior (AP), and medial-lateral (ML). RESULTS: For both strike patterns, the vertical components of the MPF and LR were significantly greater than their AP or ML components. In the vertical axis, FFS was generally associated with a greater MPF but significantly lower LR in all 3 joints. The AP components of MPF and LR were significantly lower for FFS in the knee joint but significantly greater in the ankle and hip joints. The ML components of MPF and LR tended to be greater for FFS but mostly did not reach a level of significance. CONCLUSION: FFS and RFS were associated with different 3D stress patterns in the ankle, knee, and hip joint, although there was no global advantage of one strike pattern over the other. The multimodal individual assessment for the different anatomic regions demonstrated that FFS seems favorable for patients with unstable knee joints in the AP axis and RFS may be recommended for runners with unstable ankle joints. CLINICAL RELEVANCE: Different strike patterns show different 3D stress in joints of the lower extremity. Due to either rehabilitation after injuries or training in running sports, rearfoot or forefoot running should be preferred to prevent further damage or injuries caused by inadequate biomechanical load. Runners with a history of knee joint injuries may benefit from FFS whereas RFS may be favorable for runners with a history of ankle joint injuries.

Repetitive dynamic stereo test improved processing time in young athletes.

BACKGROUND: Current studies revealed the importance of perceptual training for the treatment of amblyopia. To improve stereo vision on a higher level, visual tasks have to be completed within a limited time window like in repetitive visual function tests. "Processing time" as the reaction time in which the absence or presence of depth was identified correctly, is of better predictive value for perceiving the depth than the stereo threshold only. OBJECTIVE: To examine the long-term effects of repetitive dynamic testing of stereopsis on processing time. METHODS: 15 male soccer athletes (13.3±3.2 years) underwent twelve sessions of a 15 minutes repetitive dynamic stereovision training over a period of six weeks, presented on a polarized 3D-TV in a four-alternative forced choice setup. We measured the response time of correct identified visual tasks of 11, 22, 44, 55, 66, 77 and 88arcsecs disparity before, after six sessions, after twelve sessions and after six month without testing. As response time is the sum of stereo processing time plus the motor reaction time, we defined the difference between the response times at 11 and 88arcsecs as "stereo processing time at 11arcsecs". A Wilcoxon Signed Rank Test was conducted between the testing sessions to evaluate significant changes in response time and stereo processing time. RESULTS: After six sessions the mean stereo processing time at 11arcsecs decreased significantly from 804.4 ms to 403.7 ms (Z = -2.499, p = 0.012). Six months after the last training the stereo processing time at 11arcsecs remained at the level of the last session. CONCLUSION: Our results suggest that repetitive testing of stereovision is effective in improving processing time of stereoscopic tasks in young male athletes significantly long-term.

High precision hyperfine measurements in Bismuth challenge bound-state strong-field QED.

Electrons bound in highly charged heavy ions such as hydrogen-like bismuth 209Bi82+ experience electromagnetic fields that are a million times stronger than in light atoms. Measuring the wavelength of light emitted and absorbed by these ions is therefore a sensitive testing ground for quantum electrodynamical (QED) effects and especially the electron-nucleus interaction under such extreme conditions. However, insufficient knowledge of the nuclear structure has prevented a rigorous test of strong-field QED. Here we present a measurement of the so-called specific difference between the hyperfine splittings in hydrogen-like and lithium-like bismuth 209Bi82+,80+ with a precision that is improved by more than an order of magnitude. Even though this quantity is believed to be largely insensitive to nuclear structure and therefore the most decisive test of QED in the strong magnetic field regime, we find a 7-σ discrepancy compared with the theoretical prediction.

Speed dependent effects of laterally wedged insoles on gait biomechanics in healthy subjects.

Laterally wedged insoles have been shown to be effective for the reduction of the knee adduction moment and other biomechanical variables that are associated with the pathogenesis of knee osteoarthritis. However, inconclusive results such as adverse effects in individual subjects or even no group-wise wedge effects have been presented in different studies and it has been suggested to identify variables that potentially confound the wedge effect. The main objective of this study was the investigation of interaction effects of lateral wedges with walking speed, as different self-selected speeds have mainly been used in previous studies. Twenty-two healthy subjects completed gait analysis trials on an instrumented treadmill. They walked in different speed conditions (0.9, 1.1, 1.3, 1.5m/s) with a neutral and a laterally wedged insole. Kinematics were acquired using infrared cinematography with reflective markers attached to the lower body. From the stance phase we extracted biomechanical parameters that are associated with knee joint loading and osteoarthritis severity. No interaction effect of lateral wedges and speed was observed for most biomechanical parameters except for the ankle eversion range of motion. The main effects of wedges were reductions of the external knee adduction moment and of the knee adduction angular impulse. All biomechanical variables changed with increasing speed. Only the lateral offset of the center of pressure did not respond to wedge or to speed changes. Our results suggest that different self-selected speeds do not confound the effect of laterally wedged insoles.

Effect of walking speed on gait sub phase durations.

Gait phase durations are important spatiotemporal parameters in different contexts such as discrimination between healthy and pathological gait and monitoring of treatment outcomes after interventions. Although gait phases strongly depend on walking speed, the influence of different speeds has rarely been investigated in literature. In this work, we examined the durations of the stance sub phases and the swing phase for 12 different walking speeds ranging from 0.6 to 1.7 m/s in 21 healthy subjects using infrared cinematography and an instrumented treadmill. We separated the stance phase into loading response, mid stance, terminal stance and pre-swing phase and we performed regression modeling of all phase durations with speed to determine general trends. With an increasing speed of 0.1m/s, stance duration decreased while swing duration increased by 0.3%. All distinct stance sub phases changed significantly with speed. These findings suggest the importance of including all distinct gait sub phases in spatiotemporal analyses, especially when different walking speeds are involved.

Using a motion capture system for spatial localization of EEG electrodes.

Electroencephalography (EEG) is often used in source analysis studies, in which the locations of cortex regions responsible for a signal are determined. For this to be possible, accurate positions of the electrodes at the scalp surface must be determined, otherwise errors in the source estimation will occur. Today, several methods for acquiring these positions exist but they are often not satisfyingly accurate or take a long time to perform. Therefore, in this paper we describe a method capable of determining the positions accurately and fast. This method uses an infrared light motion capture system (IR-MOCAP) with 8 cameras arranged around a human participant. It acquires 3D coordinates of each electrode and automatically labels them. Each electrode has a small reflector on top of it thus allowing its detection by the cameras. We tested the accuracy of the presented method by acquiring the electrodes positions on a rigid sphere model and comparing these with measurements from computer tomography (CT). The average Euclidean distance between the sphere model CT measurements and the presented method was 1.23 mm with an average standard deviation of 0.51 mm. We also tested the method with a human participant. The measurement was quickly performed and all positions were captured. These results tell that, with this method, it is possible to acquire electrode positions with minimal error and little time effort for the study participants and investigators.

Methodological aspects of EEG and body dynamics measurements during motion.

EEG involves the recording, analysis, and interpretation of voltages recorded on the human scalp which originate from brain gray matter. EEG is one of the most popular methods of studying and understanding the processes that underlie behavior. This is so, because EEG is relatively cheap, easy to wear, light weight and has high temporal resolution. In terms of behavior, this encompasses actions, such as movements that are performed in response to the environment. However, there are methodological difficulties which can occur when recording EEG during movement such as movement artifacts. Thus, most studies about the human brain have examined activations during static conditions. This article attempts to compile and describe relevant methodological solutions that emerged in order to measure body and brain dynamics during motion. These descriptions cover suggestions on how to avoid and reduce motion artifacts, hardware, software and techniques for synchronously recording EEG, EMG, kinematics, kinetics, and eye movements during motion. Additionally, we present various recording systems, EEG electrodes, caps and methods for determinating real/custom electrode positions. In the end we will conclude that it is possible to record and analyze synchronized brain and body dynamics related to movement or exercise tasks.

ICA-based reduction of electromyogenic artifacts in EEG data: comparison with and without EMG data.

Analysis of electroencephalography (EEG) recorded during movement is often aggravated or even completely hindered by electromyogenic artifacts. This is caused by the overlapping frequencies of brain and myogenic activity and the higher amplitude of the myogenic signals. One commonly employed computational technique to reduce these types of artifacts is Independent Component Analysis (ICA). ICA estimates statistically independent components (ICs) that, when linearly combined, closely match the input (sensor) data. Removing the ICs that represent artifact sources and re-mixing the sources returns the input data with reduced noise activity. ICs of real-world data are usually not perfectly separated, actual sources, but a mixture of these sources. Adding additional input signals, predominantly generated by a single IC that is already part of the original sensor data, should increase that IC's separability. We conducted this study to evaluate this concept for ICA-based electromyogenic artifact reduction in EEG using EMG signals as additional inputs. To acquire the appropriate data we worked with nine human volunteers. The EEG and EMG were recorded while the study volunteers performed seven exercises designed to produce a wide range of representative myogenic artifacts. To evaluate the effect of the EMG signals we estimated the sources of each dataset once with and once without the EMG data. The ICs were automatically classified as either `myogenic' or `non-myogenic'. We removed the former before back projection. Afterwards we calculated an objective measure to quantify the artifact reduction and assess the effect of including EMG signals. Our study showed that the ICA-based reduction of electromyogenic artifacts can be improved by including the EMG data of artifact-inducing muscles. This approach could prove beneficial for locomotor disorder research, brain-computer interfaces, neurofeedback, and most other areas where brain activity during movement has to be analyzed.

Comparison of the AMICA and the InfoMax algorithm for the reduction of electromyogenic artifacts in EEG data.

Electromyogenic or muscle artifacts constitute a major problem in studies involving electroencephalography (EEG) measurements. This is because the rather low signal activity of the brain is overlaid by comparably high signal activity of muscles, especially neck muscles. Hence, recording an artifact-free EEG signal during movement or physical exercise is not, to the best knowledge of the authors, feasible at the moment. Nevertheless, EEG measurements are used in a variety of different fields like diagnosing epilepsy and other brain related diseases or in biofeedback for athletes. Muscle artifacts can be recorded using electromyography (EMG). Various computational methods for the reduction of muscle artifacts in EEG data exist like the ICA algorithm InfoMax and the AMICA algorithm. However, there exists no objective measure to compare different algorithms concerning their performance on EEG data. We defined a test protocol with specific neck and body movements and measured EEG and EMG simultaneously to compare the InfoMax algorithm and the AMICA algorithm. A novel objective measure enabled to compare both algorithms according to their performance. Results showed that the AMICA algorithm outperformed the InfoMax algorithm. In further research, we will continue using the established objective measure to test the performance of other algorithms for the reduction of artifacts.

Localization of scopolamine induced electrocortical brain activity changes, in healthy humans at rest.

To prevent the participants of parabolic flights from nausea they are optionally treated with subcutaneously injected antiemetic scopolamine. The range of side effects of this substance include reductions of the α-2 frequency band. Previous studies, however, have given no information as to which generator centers are responsible for this effect. The objective of this study therefore, is to identify the cortex area that may be responsible for this effect. Six participants were subcutaneously administered 0.7 mg of scopolamine. EEG was recorded for 10 minutes before to 20 minutes after injection. Data preprocessing followed including filtering and artifact minimization. A statistical analysis was performed with sLORETA/eLORETA software for each subject over a time window from 3 minutes before to 17-20 minutes after scopolamine injection. Results show, that in the BA7, the precuneus, on both hemispheres suffered a α-2 activity decrease in absolute power. The identified brain cortex center is an important hub with high connectivity and centrality values within the neural network. It contributes to the control of movement and to space orientation. Therefore, an activity alteration in this area can possibly explain the antiemetic effect of scopolamine and open a window to understand the origin of motion sickness.

The effects of 6-week-decoupled bi-pedal cycling on submaximal and high intensity performance in competitive cyclists and triathletes.

Aim of this work was to examine the effects of decoupled two-legged cycling on (1) submaximal and maximal oxygen uptake, (2) power output at 4 mmol L(-1) blood lactate concentration, (3) mean and peak power output during high intensity cycling (30 s sprint) and (4) isometric and dynamic force production of the knee extensor and flexor muscles. 18 highly trained male competitive male cyclists and triathletes (age 24 ± 3 years; body height 179 ± 11 cm; body mass 78 ± 8 kg; peak oxygen uptake 5,070 ± 680 mL min(-1)) were equally randomized to exercise on a stationary cycle equipped either with decoupled or with traditional crank system. The intervention involved 1 h training sessions, 5 times per week for 6 weeks at a heart rate corresponding to 70% of VO(2peak). VO(2) at 100, 140, 180, 220 and 260 and power output at 4 mmol L(-1) blood lactate were determined during an incremental test. VO(2peak) was recorded during a ramp protocol. Mean and peak power output were assessed during a 30 s cycle sprint. The maximal voluntary isometric strength of the quadriceps and biceps femoris muscles was obtained using a training machine equipped with a force sensor. No differences were observed between the groups for changes in any variable (P = 0.15-0.90; effect size = 0.00-0.30). Our results demonstrate that a 6 week (30 sessions) training block using decoupled crank systems does not result in changes in any physiological or performance variables in highly trained competitive cyclists.

Metabolic changes in vestibular and visual cortices in acute vestibular neuritis.

Five right-handed patients with a right-sided vestibular neuritis were examined twice with fluorodeoxyglucose positron emission tomography while lying supine with eyes closed: once during the acute stage (mean, 6.6 days) and then 3 months later when central vestibular compensation had occurred. Regional cerebral glucose metabolism (rCGM) was significantly increased (p <0.001 uncorrected) during the acute stage in multisensory vestibular cortical and subcortical areas (parietoinsular vestibular cortex in the posterior insula, posterolateral thalamus, anterior cingulate gyrus [Brodmann area 32/24], pontomesencephalic brainstem, hippocampus). Simultaneously, there was a significant rCGM decrease in the visual (Brodmann area 17 to 19) and somatosensory cortex areas in the postcentral gyrus as well as in parts of the auditory cortex (transverse temporal gyrus). Fluorodeoxyglucose positron emission tomography thus allows imaging of the cortical activation pattern that is induced by unilateral peripheral vestibular loss. It was possible to demonstrate that the central vestibular system including the vestibular cortex exhibits a visual-vestibular activation-deactivation pattern during the acute stage of vestibular neuritis similar to that in healthy volunteers during unilateral labyrinthine stimulation. Contrary to experimental vestibular stimulation, the activation of the vestibular cortex was not bilateral but was unilateral and contralateral to the right-sided labyrinthine failure.

The thalamus as the generator and modulator of EEG alpha rhythm: a combined PET/EEG study with lorazepam challenge in humans.

BACKGROUND: Purpose of this study was to investigate the functional relationship between electroencephalographic (EEG) alpha power and cerebral glucose metabolism before and after pharmacological alpha suppression by lorazepam. METHODS: Ten healthy male volunteers were examined undergoing two F18-fluorodeoxyglucose (18-FDG) positron emission tomography (PET) scans with simultaneous EEG recording: 1x placebo, 1x lorazepam. EEG power spectra were computed by means of Fourier analysis. The PET data were analyzed using SPM99, and the correlations between metabolism and alpha power were calculated for both conditions. RESULTS: The comparison lorazepam versus placebo revealed reduced glucose metabolism of the bilateral thalamus and adjacent subthalamic areas, the occipital cortex and temporo-insular areas (P < 0.001). EEG alpha power was reduced in all derivations (P < 0.001). Under placebo, there was a positive correlation between alpha power and metabolism of the bilateral thalamus and the occipital and adjacent parietal cortex (P < 0.001). Under lorazepam, the thalamic and parietal correlations were maintained, whereas the occipital correlation was no longer detectable (P < 0.001). The correlation analysis of the difference lorazepam-placebo showed the alpha power exclusively correlated with the thalamic activity (P < 0.0001). CONCLUSIONS: These results support the hypothesis of a close functional relationship between thalamic activity and alpha rhythm in humans mediated by corticothalamic loops which are independent of sensory afferences. The study paradigm could be a promising approach for the investigation of cortico-thalamo-cortical feedback loops in neuropsychiatric diseases.

Acute alcohol effects on neuronal and attentional processing: striatal reward system and inhibitory sensory interactions under acute ethanol challenge.

The acute influence of ethanol on cerebral activity induces complex psycho-physiological effects that are considerably more pronounced during acute ethanol influx than during maximal blood alcohol concentration (elimination phase). Despite the psychiatric and forensic relevance of these different ethanol effects, the underlying neuronal mechanisms are still unclear. In total, 20 male healthy volunteers were investigated each with three different experimental conditions in a randomized order using an intravenous ethanol challenge (40 g bolus infusion): during influx phase, elimination phase, and under placebo condition. During and after the ethanol (or placebo) infusion, neuropsychological testing of divided attention for visual and auditory stimuli was performed with subsequent 18-FDG PET acquisition. The PET data were analysed using SPM99. Ethanol influx and elimination phase showed focal activations in the bilateral striatum and frontal cortex and deactivations in the occipital cortex. The comparison of influx phase vs elimination phase revealed activations in the anterior cingulate and right prefrontal cortex, relevant deactivations were found in the left superior temporal cortex including Wernicke's area. Neuropsychological testing showed an attentional impairment under ethanol influx compared to ethanol elimination and placebo with an inverse correlation of the attentional performance for auditory stimuli to occipital activity and for visual stimuli to the left temporal (including auditory) cortex. Acute ethanol administration in healthy volunteers stimulates those striatal regions that are considered to have a particular relevance for alcohol craving ('reward system'). Modality specific reciprocal inhibition of sensory cortex activity seems to be relevant for attentional performance during acute alcohol impact.

Prognostic factors determining long-term survival in well-differentiated thyroid cancer: an analysis of four hundred eighty-four patients undergoing therapy and aftercare at the same institution.

OBJECTIVES: Identification of the prognostic factors relevant for long-term survival in differentiated thyroid cancer in a homogenously treated patient cohort in order to allow a better initial risk stratification. METHODS: Four hundred eighty-four (358 females/126 males) patients with differentiated thyroid cancer (330 papillary [68.2%]; 154 follicular [31.8%]) were included. Inclusion criteria consisted of treatment with a uniform therapy scheme and continuous aftercare in the same institution. Initial diagnosis was between 1975-1995 (age at diagnosis, 14-84 years, median, 49.7). Tumor stage: pT1, n = 92; pT2, 211; pT3, 58; pT4, 123. Low-risk: