Deferred imitation tasks have shown that manipulations at encoding can enhance infant learning and memory performance within an age, suggesting that brain maturation alone cannot fully account for all developmental changes in early memory abilities. The present study investigated whether changes in the focus of attention during learning might contribute to improving memory abilities during infancy. Infants aged 6, 9, and 12 months, and an adult comparison group, watched a video of a puppet imitation demonstration while visual behavior was recorded on an eye tracker. Overall, infants spent less time attending to the video than adults, and distributed their gaze more equally across the demonstrator and puppet stimulus. In contrast, adults directed their gaze primarily to the puppet. When infants were tested for their behavioral recall of the target actions, “imitators” were shown to have increased attention to the person and decreased attention to the background compared to “non-imitators.” These results suggest that attention during learning is related to memory outcome and that changes in attention may be one mechanism by which manipulations to the learning event may enhance infant recall memory. © 2013 The Authors. Developmental Psychobiology published by Wiley Periodicals, Inc. Although very young infants can encode, store and retrieve information, there are considerable developmental changes in learning and memory abilities across the infancy period . Participants were randomly assigned to an experimental or control condition (n = 16 of each age group in each condition). Infants were typically developing and were tested within 10 days of their 6-, 9-, and 12-month birthday. An additional 56 infants  were tested but excluded due to: calibration failure (n = 18), looking at the video for less than 5 s (n = 17), exhibiting positional biases on more than one of the recognition tests (n = 13) and fussiness during the experiment (n = 8). Calibration failure for the infant participants was primarily due to movement during calibration and not looking for long enough at each calibration point. Eighteen additional adults were also tested but excluded due to calibration failure as the result of eye makeup or bright blue irises which made pupil detection difficult. This overall attrition rate of 36.6% is consistent with previous studies employing a similar methodology , 32 nine-month-old infants , 32 twelve-month-old infants , and 32 undergraduate psychology students  featured a female adult demonstrating a series of target actions on a gray rabbit hand puppet while standing in front of a distinctive background see . The pupM for each complete demonstration = 10.87 s, range = 10.32–11.60 s), after which the experimenter waved goodbye. All participants saw six demonstrations of the target actions, consistent with Barr et al. , shaking the mitten three times to ring the bell inside (step 2), and replacing the mitten (step 3). The target actions were repeated six times in succession  was designed to provide participants in the control condition with a similar, but unrelated viewing experience. The video featured an imitation demonstration, but all features were different from the experimental video: a second female model demonstrated a sequence of actions with an unrelated rattle stimulus , the demonstrator’s face (15.2° × 13.3°) and the room background (16.6° × 10.5°) which featured on the experimental video were used as stimuli for the recognition memory test see . Each phParticipants were tested in the developmental laboratory using an SMI iView X (RED III) remote eye tracking system. Participants were seated approximately 60 cm in front of the infrared camera which was situated directly below the center of a 56 cm flat panel monitor. Each infant was seated on their caregiver’s lap and the caregiver was asked not to behaviorally or verbally direct the infant’s attention. The Experimenter tracked participants head movements on the eye tracker camera from behind a black screen. Visual fixation data was sampled from the participant’s left eye at a rate of 50 Hz with a gaze position accuracy of .5–1° using corneal reflection.To calibrate the location of the participant’s gaze, a manual calibration procedure was used. An attention-getter  was shown individually at five points on the screen: one at each of the corners and one in the middle of the screen. Calibration accuracy was checked and repeated as necessary. Following successful calibration, participants were presented with either the experimental or control video depending on group assignment.Immediately after watching the video, a central fixation point appeared which directed the participant’s attention to the center of the screen. A visual recognition test was then presented for each item seen on the video: the puppet, person and background. Each familiar stimulus and the matched unfamiliar stimulus pairing was presented twice in succession for 5 s, with the lateral position of the images reversed on the second trial to control for potential side biases. The visual recognition test was the same duration for all participants, consistent with prior work with 6- to 18-month-old infants . In the current literature, there is no standard definition for fixations, which have been defined as anywhere between 50 and 250 ms  were defined on a screenshot of the video see . AlthougTo assess visual recognition memory, visual attention to the novel and familiar stimulus images was calculated. For each stimulus pair, novel and familiar AOIs were defined around each image; the puppet , person , and background . The proportion of time spent attending to the novel image was then calculated; novel/(novel + familiar). Not all participants contributed useable data to all three recognition tests (see Tab. n = 28) of the videos were double coded by an independent observer who was blind to experimental condition and hypotheses. Inter-observer reliability analysis was 96% (kappa = .92).For the infant age groups, the videotaped imitation sessions were coded for the presence or absence of the target actions . Infants were given a score of 0–3 based on the presence or absence of each action. Not all infants contributed data for the imitation test due to failure to touch the puppet or fussiness during the test session see Tab. . Higher F = 14.82, p = .000, η2 = .65. Overall, adults attended to the video for significantly longer  than all infant age groups . Attention to the video did not differ between the infant age groups .Initial analyses were run on the experimental group data to establish whether overall attention to the experimental video differed as a function of age using Dwell times, the sum of all fixations and saccades. A one-way ANOVA revealed a significant difference in overall dwell time to the experimental video according to age group, F = 30.129, p = .000, η2 = .55. Specifically, participants spent a greater proportion of their time attending to the puppet  and person  than the background . There was no difference in the proportion of time spent attending to the puppet and person (p = .703). There was also a significant interaction effect between age and the proportion of time spent attending to each AOI, F = 3.442, p = .004, η2 = .32  during learning. The proportion data was calculated using the total fixation time to each AOI divided by the total fixation time to the experimental video. To determine whether attention to the experimental video differed across age, a two-way (Age × AOI) mixed design ANOVA was conducted on the proportion of fixations. Given that proportion data was used, there was no main effect of age on attention to the video. However, there was a significant main effect of AOI,  .32 see .p = .004), 9- (p = .058), and 12-month-old (p = .013) infants, who spent between 37% and 44% of their time attending to the puppet. In contrast, adults spent less time attending to the background (attending to the background for around 2% of their time) than the infant age groups, who spent between 13% and 20% of their time attending to the background, however this finding reached significance with the 9-month-old infants only . Finally, there was no difference in the proportion of time spent attending to the person (around 31–49%) and no difference in attention to the person, puppet or background between the infant age groups .To further investigate the interaction between age and attention to each AOI, bonferroni post hoc analyses were conducted. Overall, adults spent a greater proportion of time (approximately 67%) attending to the puppet than the 6- , “Shake” , “On”  during the experimental video to determine whether patterns of attention change as a function of the action being demonstrated. Given that the duration of each action differed, the total fixation time to each AOI during each action was calculated as a proportion of the total duration for that action across the six demonstrations. A three-way (Action × AOI × Age) ANOVA was run on the proportion of fixations data within each action. There was a significant main effect of action, F = 29.67, p = .000, η2 = .56. Participants spent a greater proportion of time attending to the “Shake” action , than the “Off”  and “On”  actions. Similarly, participants attended to the “Off” action for a greater proportion of time than the “On” action, p = .001. There was no interaction effect between action and age, F = 1.37, p = .233, η2 = .21. Thus, both the infants and adults attended predominantly to the “Shake” action, followed by attention to the “Off” and “On” actions, respectively.The following set of analyses assessed the spread of attention to each AOI for each action; “Off”  = 23.15, p = .000, η2 = .50. Overall, attention to the puppet remained relatively stable across each action . Similarly, attention to the background remained relatively low across each action . Attention to the person however, increased for the “Shake” action  compared to the “Off”  and “On” actions . Thus, participants increased attention to the person when watching the “Shake” action. There was also a significant three-way interaction effect between action, AOI, and age group, F = 2.95, p = .001, η2 = .31 . For the control group data, one sample t-tests were conducted to establish whether the visual recognition image pairs were equally attractive when both were novel for each age group. For the experimental group data, one sample t-tests were conducted to assess whether participants showed evidence of recognition memory for the “familiar” image in each pair by showing a visual preference for looking at either the familiar or novel image. As shown in Table Next, recognition memory by the experimental groups for the puppet, person, and background from the demonstration video was examined. One sample r = .54, p = .048. In other words, increasing attention at the person during the experimental video was related to increasing looking at the “novel” person during the visual recognition test at 9 months of age. There were no other correlations between attention to each AOI and the proportion of looking during the visual recognition test at each age.To determine whether attention during the experimental video was associated with subsequent proportion of looking at the “novel” stimulus during the visual recognition test, correlation analyses were conducted at each age. For the 9-month-old infants there was a positive correlation between attention to the person AOI during learning and the proportion of looking at the “novel” person during the recognition test, F = .98, p = .379, η2 = .15 or condition, F = .02, p = .889, η2 = .01 and there was no interaction F = .30, p = .741, η2 = .08  between participants ANOVA was conducted on the imitation scores. Overall, imitation scores did not differ across age, F, 81 = .9n = 14) who showed evidence of behavioral recall and the “non imitators” (n = 30) who did not. Overall, dwell time to the experimental video did not differ between the “imitators”  and “non imitators”  = .74, p = .467, r = .11). A two-way ANOVA across Imitation recall group (imitators/non-imitators) and AOI revealed a significant interaction between attention to the person, puppet, and background in the video and whether infants imitated the target actions or not, F = 4.71, p = .012, η2 = .28. Post hoc t-tests revealed that “imitators” looked significantly longer at the person  than “non imitators”  = 2.60, p = .013, r = .37) and spent significantly less time looking at the background  compared to “non imitators”  = −2.54, p = .015, r = .36). There was no difference between the proportion of time spent attending to the puppet by infants who imitated  and those who did not  = −1.24, p = .221, r = .19). Thus, the overall amount of looking to the video was less important for learning than the timing and focus of that looking.The failure to find evidence of infant imitation recall memory can be attributed to the fact that, across age, just 14 out of the 44 infants who completed the imitation test reproduced at least one target action see Tab. . HoweverDuring a video of an imitation demonstration, infants aged 6, 9, and 12 months attended primarily to the target stimulus and the person demonstrating the target actions, but did not preferentially attend to the stimulus. Thus, increasing attention to the puppet, per se, in this imitation task is unlikely to be the central factor in the development of retention and memory flexibility during the infancy period. This finding replicates the findings of Taylor and Herbert  and exteThe developing ability to focus in on individual components of the video, rather than viewing the scene more holistically , these features are not dissimilar to what infants would experience when watching infant-directed television programs. Thus, the low level of learning in the present study compared to prior imitation demonstration studies, potentially more closely reflects infant learning from television in everyday life. Importantly, the role of the background as a potential distracter when learning from video has implications for both the imitation literature and infant media.Overall, there was little evidence of recognition memory for the person, puppet, and background from the demonstration video, with only 9-month-old infants showing recognition of the person (also see Taylor & Herbert, In sum, the present study found that differences in attention are related to memory outcome during the first year of infancy. This finding lends support to the argument that changes in attention may influence how an event is encoded in a memory representation and what is available for subsequent recall (also see Jones & Herbert,


In November 2013, the Irish Regulator for emergency medical technicians (EMTs) introduced the first mandatory requirement for registrants to demonstrate evidence of continuous professional development (CPD)/continuous professional competence (CPC). This qualitative study assessed the experience of practitioners with CPC-related materials provided to them by the Regulator in addition to identifying perceived or encountered practical challenges and suggested improvements six months following introduction of the requirement.Five fora were utilised, comprising two distinct groupings: a group of student EMTs (n = 62) and four discrete groups of qualified EMTs  all of whom had commenced the newly-introduced CPC process. All 193 volunteers were members of the Civil Defence (an auxiliary/voluntary organisation) and represented a nationwide distribution of personnel. Responses were categorised as ‘perceived’ challenges to CPC, relating to student EMTs, and ‘experienced’ challenges to CPC, relating to qualified EMTs. Responses also included suggestions from both groups of EMTs on how to improve the current system and guidance material. Audio/visual recordings were made, transcribed and then analysed using NVivo (version 10). A coding framework was developed which identified unifying themes.All participants agreed that CPC for pre-hospital practitioners was a welcomed initiative believing that CPC activities would help ensure that EMTs maintain or enhance their skills and be better enabled to provide quality care to the patients they might encounter. Two specific areas were identified by both groups as being challenging: 1) the practicalities of completing CPC and 2) the governance and administration of the CPC process. Challenging practicalities included: ability of voluntary EMTs to gain access to operational placements with paramedics and advanced paramedics; the ability to experience the number of patient contacts required and the definition of what constitutes a ‘patient contact’. With regard to the governance and administration of CPC, it was suggested that in order to enhance the process, the Regulator should provide: an outline of the CPC audit process; examples of cases studies and reflective practice; templates for portfolios; and should establish a central hub for CPC information.These groups of Irish EMTs appeared keen to participate in continuous professional competence activities. In addition, these EMTs identified areas that, in their opinion, required clarification by the Regulator related to the practicalities of CPC and the governance and administration of CPC. More information, dissemination of sample requirements and further effective engagement with the Regulator could be used to refine the current CPC requirements for EMTs. In Ireland, there are three levels of registration for practitioners of pre-hospital care: emergency medical technician (EMT), paramedic and advanced paramedic. In November 2013, the Regulator for pre-hospital (ambulance) practitioners in Ireland, the Pre-Hospital Emergency Care Council (PHECC), introduced a framework of Continuous Professional Development (CPD)/Continuous Professional Competence (CPC) targeting EMTs for the first time in Ireland. In doing so the Regulator was acknowledging the fact that EMTs represent the largest cohort of pre-hospital practitioners in Ireland and that while their focus was initially placed on this grouping CPC requirements for the smaller but more advanced practitioners, paramedics and advanced paramedics, would be enacted in 2016. The Regulator adopted CPC as the preferred term used to describe ongoing education and development for pre-hospital practitioners. The guidance provided to practitioners, by the Regulator, regarding CPC requirements, resulted from surveys and fora conducted and published by our group , it just won’t happen”. To give further context, another EMT commented: “…we are getting plenty of duties, we are just not getting the patients, and so unless we start pushing people off horses or something, we are not going to get patients”. However, frontline ambulance placements alone were not seen to be the solution: “What if we go to events but don’t get any patient contacts?”, thus, highlighting the importance of not just accessing frontline ambulance experience but that such access must also be accompanied by the potential for more patient encounters.The participants’ difficulties related primarily to their ability to experience and access frontline ambulance services and patient engagement; to experience diversity of patient types and scenarios; and to overcome limitations relating to the points above due to their geographic location  (HCPC) have considerable resources related to Continuous Professional Development (CPD): information documents; templates; CPD video guides; audit process video; constructing your CPD profile video; glossary of terms; CPD evidence examples; CPD activity examples; audit dates; Standards of CPD; and a section on Frequently Asked Questions . HoweverOverall, there appears to be a consensus between both cohorts in our study that further clarification in the areas described above should be addressed by the Regulator  to allow an effective model of CPC to be maintained and standardised amongst participating cohorts.As these were large fora comprising five groups with a total of 193 EMTs, this may have prevented everyone from participating in the discussions. Also, as the questions presented were pre-selected, these specific topics may have restricted other topics from further discussion. While the group was drawn from many regions, it was representative of only one EMT organisation, the Civil Defence, and while key areas were identified for further clarification or requiring additional information from the Regulator, the views are only that of one organisation’s members.This is the first study to consult with pre-hospital practitioners in Ireland, after the introduction of a CPC model. It demonstrates the similarities between what student EMTs perceived as practical challenges to the introduction of CPC, as they had not actively encountered CPC at that time due to their student status, and the actual practical challenges encountered by the experienced EMT groups. The study identified no evident difference between the stated views of either cohort and, in fact, may emphasise the need for the Regulator to consider reviewing the current iteration of CPC requirements for EMTs. While the introduction of Continuous Professional Competence requirements for EMTs in Ireland is a positive step by the Regulator, and is welcomed by the EMTs in this study, there remains some work to be done to refine the process. EMTs are keen to meet the requirements but need the Regulator to provide more information, examples and further clarification. It would appear that EMTs are motivated and accept CPC but further guidance from the Regulator could maintain and support such an initiative. Further research with professional groups could guide the appropriate revisions of this CPC model to be suitable for all pre-hospital practitioners, including those not currently required to maintain CPC such as paramedics and advanced paramedics.


Recent experimental evidence suggests a finer genetic, structural and functional subdivision of the layers which form a cortical column. The classical layer II/III (LII/III) of rodent neocortex integrates ascending sensory information with contextual cortical information for behavioral read-out. We systematically investigated to which extent regular-spiking supragranular pyramidal neurons, located at different depths within the cortex, show different input–output connectivity patterns. Combining glutamate uncaging with whole-cell recordings and biocytin filling, we revealed a novel cellular organization of LII/III: (1) “Lower LII/III” pyramidal cells receive a very strong excitatory input from lemniscal LIV and much fewer inputs from paralemniscal LVa. They project to all layers of the home column, including a feedback projection to LIV, whereas transcolumnar projections are relatively sparse. (2) “Upper LII/III” pyramidal cells also receive their strongest input from LIV, but in addition, a very strong and dense excitatory input from LVa. They project extensively to LII/III as well as LVa and Vb of their home and neighboring columns. (3) “Middle LII/III” pyramidal cell shows an intermediate connectivity phenotype that stands in many ways in between the features described for lower versus upper LII/III. “Lower LII/III” intracolumnarly segregates and transcolumnarly integrates lemniscal information, whereas “upper LII/III” seems to integrate lemniscal with paralemniscal information. This suggests a fine-grained functional subdivision of the supragranular compartment containing multiple circuits without any obvious cytoarchitectonic, other structural or functional correlate of a laminar border in rodent barrel cortex. The supragranular compartment within the primary somatosensory (barrel) cortex of rodents is difficult to separate into a genuine layer (L) II or III, due to its homogeneous appearance in cytoarchitectonic stains  with a gradual transition of inputs targeting the upper LII/III, which are mainly arising from LIV but also prominently from LVa  were deeply anesthetized with isoflurane and decapitated. Brain slices of 300 μm thickness, containing the primary somatosensory cortex  artificial cerebrospinal fluid that was modified for cutting and storage purposes (cACSF). Compared to standard ACSF , in cACSF the concentrations of Ca2+ and Mg2+ were modified to reduce neuronal activity .Slices were pre-incubated for 1 h at 34 °C and later kept at room temperature in oxygenated . Data were recorded, stored and analyzed with PC-based software . Passive intrinsic electrophysiological properties were tested at resting membrane potential (Vrmp) by applying hyperpolarizing current injection (50 pA), whereas active properties were analyzed by applying depolarizing current injections ranging from 50 to 300 pA at Vrmp. We classified the supragranular pyramidal cells by means of their firing properties into regular-spiking neurons of the slow-adapting type 1 (SA1) and type 2 (SA2), as well as fast-adapting (FA) neurons  in an upright microscope . The barrel field was visualized at low magnification 2.5×) under bright-field conditions  was added to circulating ACSF , resulting in a 0.5 mM concentration. In control experiments with blocked synaptic transmission, low Ca2+/high Mg2+ ACSF containing (in mM) 0.2 CaCl2 and 4 MgSO4 was used. For local stimulation, UV light pulses from a Xenon arc lamp  were focused on 50 μm × 50 μm large areas. Illumination intensity was calibrated to a value that ensured action potential generation only upon perisomatic photostimulation  from the soma at Vrmp. In agreement with previous studies  of −60 mV in voltage-clamp controlled current-clamp mode (VCcCC) to reveal hyperpolarizing inhibitory synaptic inputs, in addition to depolarizing excitatory synaptic inputs  showed that direct responses occurred only (1) when stimulating fields that contained dendritic extensions of the recorded neuron and (2) at short latency varying between 0.5 ms (perisomatic stimulation) and 6 ms  Direct responses, induced by activation of glutamate receptors within the recorded cell’s membrane and (2) synaptic inputs induced by activation of presynaptic neurons within the respective flashed field. The properties and reliability of direct responses as well as synaptic inputs upon flash stimulation have been investigated and described in detail before for several other classes of excitatory cortical neurons . If direct responses were induced, their integral values were subtracted from the integral of the synaptic activity  superimposed onto the photomicrograph of the native slice using standard graphics software and (2) quantitatively analyzed with Neuroexplorer (MBF Bioscience Europe).After recording, slices were fixed in phosphate-buffered 4 % paraformaldehyde for 24 h at 4 °C. For visualization of the biocytin-filled neurons, slices were processed as described previously  and total density of excitatory as well as inhibitory inputs from the home column. As structural data, we furthermore considered the following somatodendritic properties: (1) total number of endings, (2) length of the apical dendrite, (3) total number of dendrites and (4) maximal trunk diameter of the apical dendrite. Sufficient quantitative axonal data were not available for the entire set of neuronal populations.p = 0.05 in the downward sliding window approach. Likewise, in the upward approach, we defined the upper boundary of lower LII/III by a drop below p = 0.05. To obtain a concrete number for the depth of these statistical borders, sigmoidal functions  and tested from which vertical position in LII/III neuron populations differed structurally and functionally significantly from a reference population at the upper and lower limits of LII/III, i.e., a population at the LI or LIV border. This multiparametric analysis  included sets of dendritic, axonal, intrinsic electrophysiological and synaptic input properties that showed significant correlation with the relative soma position within LII/III. The adapted sliding window analysis was performed with windows of 20 % span of the relative distance between LIV-II/III border and pia. This span within LII/III covered a similar proportion of the cortical column as the window span used for the classical sliding windows analysis of the entire cortical column. For each set of parameters, the sliding windows were moved in steps of 5 % from a base window at the LI border downwards to LIV; and, vice versa, from a base window at the LIV border upwards to LI. We defined the lower boundary of where the reference population in upper LII/III becomes statistically dissimilar from their counterparts below, i.e., where the MANOVA comparison dropped below For analysis of the properties of the three neuronal populations that were defined by the adapted window analysis , we performed a multiparametric discriminant analysis. The analysis was done independently for structural and functional properties. Statistical analysis of individual parameters was performed using a linear regression (Pearson correlation) and a multivariate analysis of variance (MANOVA) with layer-specific data as repeated measures and Bonferroni correction for post hoc pairwise comparisons . If not mentioned differently, data are presented as mean ± SEM.n was the number of contributing slices, σ the sample standard deviation, and T the cumulative Student’s t distribution. For display purposes, only those template grid points to which at least three slices contributed (n ≥ 3) and for which We also applied a novel procedure to illustrate the average functional connectivity of neuronal populations in upper, middle and lower LII/III, including a visualization of the confidence levels of evoked synaptic inputs. For this method, the individual inputs maps were projected into a template map by matching the slice-specific laminar and columnar cytoarchitecture with the template using vertical and horizontal scaling. This procedure involved, as a first step, translating, scaling and rotating photomicrographs of the native slice in a graphics program until an optimal match with a template’s center barrel position, overall barrel size, slice orientation and pial surface was obtained. For every template grid point, we then calculated the corresponding position in the original photomicrographs, and hence in the glutamate-induced activity maps, by mathematically inverting the used transformations. Since the reorientation and scaling procedure used only linear transformations and translation, this inversion was exact. Subsequently, we averaged the activity found in the corresponding glutamate-induced activity maps and assigned these averages Vrmp) more negative than −60 mV. In a first step, to describe general differences between neurons that are located closer to LI versus those closer to LIV, we horizontally segregated LII/III into three equally sized parts, i.e., upper LII/III, middle LII/III and lower LII/III. Given that in our acute slice preparations the distance between the border to LI and LIV was approximately 400 μm  belonged to one of the three different subclasses of regular-spiking neurons: slow-adapting types 1 (SA1) and 2 (SA2), and fast-adapting (FA)  at Vh = −60 mV using multisite focal photolysis of caged glutamate in combination with whole-cell recordings of single (n = 24) or simultaneous recordings of two neurons (n = 10). In the latter case, we recorded and mapped two pyramidal neurons at similar cortical depth within LII/III (n = 5) or at different cortical depth  originated most prominently from the supragranular compartment itself, but also from LIV Fig. b1, c. ExA striking difference between neurons in lower LII/III as compared to those in upper LII/III, was that the latter, in 11 out of 14 cases, received prominent excitatory input from LVa, the main cortical target layer of the paralemniscal pathway. We weighted the functional impact of the excitatory inputs originating from a given layer by multiplying the layer-specific density and the average strength of excitatory inputs. We found that lower LII/III possessed mainly neurons in which the impact of local inputs exceeded that of LVa  basal dendrites that emerged from an ovoid to pyramidal shaped soma and an apical dendrite that always reached LI Fig. . Two main = 24), LVa (n = 27) and LVb (n = 15) in addition to the pyramidal neurons of LII/III (n = 44). The relative position of all somata was determined in relation to the LIV-Va border  as well as for the strength of excitatory inputs originating from LIV of the neighboring column . The linear change of neuronal properties with respect to depth implies that these individual properties are indeed heterogeneous in LII/III. Therefore, depending on where in LII/III pyramidal neurons and their respective networks are positioned, they may serve different functions in intracortical sensory signal processing. To quantitatively assess the input/output connectivity of LII/III neuronal networks, we tested up to which position within LII/III, neuron populations of the upper and the lower LII/III can still be considered as statistically similar. For this purpose, we performed an adapted sliding window analysis on the different sets of somatodendritic, axonal, intrinsic electrophysiological and functional input parameters . We tested for differences both in the LI → LIV and LIV → LI direction  reflect the similarity between the neural population in the base windows and the one in the sliding window. Base window and starting point for the sliding window were at the border to LI  or at the border to LIV , respectively. We did not find extended plateaus of similar p values in any set of tested parameters, except where the test window overlapped extensively with the base window at the upper and lower supragranular borders  with respect to soma position. These properties were found among intrinsic electrophysiological properties, functional input connectivity as well as structural input and output connectivity  from the base population at depths between 27.0 and 35.4 % depending on analysis window size and respective set of parameters , yielded 32.7 % (LI → LIV) and 64.4 % (LIV → LI), respectively. Taking into account the variation across individual sets of parameters and fit uncertainties . Accordingly, the canonical scores plots showed the three groups as only weakly overlapping populations  nor in the strength of excitatory inputs . For excitatory inputs originating from supragranular fields of the neighboring column, we found a distinct reduction of almost 50 % in density (p < 0.0001), although no significant reduction in input strength was found. The density and strength of excitatory inputs did not change significantly for supragranular fields of the septum as compared to that of the home column  and weaker than those of the home barrel . However, the strength of inputs from the neighboring barrels was significantly higher for pyramidal neurons in lower LII/III  than for those in upper LII/III . Excitatory inputs from the septa between the barrels were very heterogeneously distributed: for a number of pyramidal cells, these excitatory inputs were lacking entirely . In the remaining neurons such inputs had densities ranging from 26 to 50 %. Whereas neurons in lower LII/III received inputs from the septum that were of similar strength as those from the barrel of the home column  with moderate amplitudes from 0.5 to 2 mV Fig. a, 8c. WhVh = −60 mV  s mV Fig. b, 8d. Fr mV Fig. b. These n = 20; middle LII/III n = 19, upper LII/III n = 20; p = 0.001, Wilk’s lambda, 78 % correct classification; axonal properties: lower LII/III n = 7; middle LII/III n = 6, upper LII/III n = 9; p = 0.001, 100 % correct classification). The most important discriminating properties were the morphological parameters that also showed a significant correlation with the depth of the soma. We found significant correlations with the soma position for the vertical soma diameter (p = 0.005), vertical and horizontal dendritic span (p < 0.001 each), number of primary dendrites (p = 0.02) and the maximal diameter of the basal dendrites (p = 0.01). In terms of axonal properties, we found significant correlations for bouton numbers in LI (p = 0.003), LIV (p < 0.001) and LVb (p = 0.007) of the home column (HC) and LI of the septal column . In agreement with the discriminant analysis, canonical scores plots displayed a partial overlap between the three groups for the dendritic properties . Interestingly, the average total length of the dendrites was comparable for all groups of pyramidal cells. Evidently, a smaller vertical dendritic span was compensated by a broader horizontal span and vice versa. We found that correlations existed across all supragranular compartment values of the vertical and horizontal span of the apical dendrites . Thus, the appearance of atypical pyramidal cells in the upper LII/III likely reflects dendritic reorganization due to the proximity to the pial surface, since we found no differences in input maps of oblique versus straight pyramidal cells.The main distinguishing somatodendritic properties between neurons in lower, middle and upper LII/III were differences in the maximal vertical dendritic span, which was significantly longer in lower LII/III neurons (394.9 ± 76.3 μm) than for those of the upper LII/III . Furthermore, for neurons of lower LII/III, large numbers of boutons were found in LIV of the home column, which is in surprising contrast to neurons in upper LII/III (lower LII/IIII 392 ± 43; upper LII/III 95 ± 20; p < 0.001, Fig. The axonal output connectivity showed several prominent differences between lower, middle and upper LII/III. A summary of the axonal properties is given in Tables We present evidence that multiple circuits are embedded in the classical layer II/III of rat barrel cortex. We find structurally and functionally distinct pyramidal neurons, which display a depth-dependent gradual change of connection properties Fig. . In ratsA major outcome of rodent in vivo calcium imaging studies within LII/III has been the finding that the topological characteristics of sensory stimuli are preserved at the columnar population level, whereas considerable variability can be found at the individual cell level. In the visual cortex this was shown for stimulus orientation (Ohki et al. These in vivo studies have concluded that multiple circuits have to be laid out within LII/III, circuits which might depend on the different target regions of the projection neurons (Chen et al. Our results indicate strong and effective information transmission from LIV and LVa, which both represent important cortical entry points for parallel streams of sensory information, to LII/III. Previous studies showed that pyramidal neurons of the supragranular compartment integrate sensory information obtained via the lemniscal pathway from neurons in LIV barrels (Dantzker and Callaway To which extent do networks within the supragranular compartment interact? Previous studies have found a substantial number of connections between local excitatory and inhibitory neurons (Avermann et al. Previous studies have distinguished “typical” pyramidal neurons in LIII and “atypical” ones in LII (Peters and Kara Interestingly, the axonal arborizations showed many significant differences. First, all upper LII/III pyramidal cells issued extensive transcolumnar axonal projections, whereas only a fraction of the lower LII/III pyramidal cells did. Although the sparseness of transcolumnar projections in lower LII/III pyramidal cells could be a slice artifact (Stepanyants et al. What causes the appearance of a continuum-like organization of neuronal properties within the supragranular compartment? On the one hand, one could speculate about a novel network organizing principle whose computational power is not yet understood but could allow a more flexible functional integration of lemniscal and paralemniscal pathways. On the other hand, a set of very “thin” layers, difficult to sample specifically, may cause the impression of a continuous change of neuronal properties. Recent data on the distribution of molecular markers show differential sometimes gradually spread-out patterns (Lein et al.


Global hand hygiene (HH) campaign has been promoted since 2004 to protect the patient safety. On World HH day (May 5), 2014, a video campaign was launched in National Taiwan University Hospital (NTUH), Taiwan. We aimed to evaluate the effect of different social media on promoting the HH program.One 3 minutes-long video of HH campaign in 8 language was posted on the YouTube. The Chinese version had been promoted through three platforms, including the official hospital website, hospital group e-mail, and the Facebook site of one famous internet celebrity, who was also 6th grade medical student of the school the hospital affiliated to. The video traffic of the Chinese version during May 5, to Dec, 31, 2014 was analyzed via Google Analytics. The HH compliance was observed and compared in Nov. of 2013 and Nov. 2014, separately.During the observed period, 5,252 times the video was viewed, mainly on the Chinese version . The cost of the video was 6,250 USD and the cost per clink was 1.2 USD. For the hospital level, the official website of NTUH had 24,000 subscribers and 151 linked to the video. The connection rate was 0.6% . As to the hospital-group e-mail, 9,967 peoples received the e-mail and 91 receiver opened the link . There were no further feedback from the e-mail system or website. For the personal level, there were 13,080 impressions from the internet celebrity’s Facebook site and 807 had linked into the video. The connection rate as 6.2%  was significantly higher than the hospital website and group e-mail . 525 persons  had pressed “Like” for the HH campaign and 21  persons further shared the video. The hospital-wide HH compliance was 83.7% (473/565) in 2013 and 86.7 % (589/679) in 2014 (P=0.13).We succeeded the HH compliance via a video campaign in 2014. For the Net Generation, social media as Facebook had provided significantly high connection rate. It revealed that the information transmission may not be depended on the hierarchy within the hospital. The information leader in novel social media, like Facebook, could be a strong support for future HH promoting program.None declared.


In recent years, much research has been conducted in order to understand the effects of action video games on mind and behavior. For example, it has been tried to investigate potential links between playing action video games and aggressive behavior  are harmful or not, a heated debate is very likely to start. Especially demographic groups which are not familiar with video games are four to six times more likely to hold a negative opinion regarding that matter  could show that there is no negative impact on the hippocampus, certain games could be used or new ones could be designed based on neuroscientific data to enhance route learning skills.Another set of skills, which declines over time, concerns visual perception. For example, it is known that the useful field of view, which “is defined as the visual area in which information can be acquired within one eye fixation,” declines with age . Making use of the remarkable neuroplasticity during development, eye patching is seen as the standard of treating amblyopia in children. On the contrary, this means that i et al.  showed ti et al. .In everyday life, the ability to switch tasks and perform tasks simultaneously is becoming more and more important, especially because of the impact of information technology. Kray and Lindenberger  found byRecent studies show that gaming can be associated with enhancements in regards to task switching abilities. For instance, there seems to be a causal relationship between playing action video games and reduction of switch costs (Green et al., Taken these findings together, the desire to utilize the useful potential of virtual environments emerges (see Figure The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Changing trends demonstrate that women, in a number of economically-developed countries, are drinking at higher levels than ever before. Exploring key targets for intervention, this study examined the extent to which underlying beliefs in relation to alcohol consumption predicted intentions to drink in three different ways .N = 1069), aged 18–87 years, completed a questionnaire measuring their beliefs and intentions regarding alcohol consumption. Then, two weeks later, 845 of the original sample, completed a follow-up questionnaire reporting their engagement in the drinking behaviors. A mixed design ANOVA was conducted to examine potential differences between women of different age groups  and their intentions to engage in the three different drinking behaviors. Based upon The Theory of Planned Behavior, critical beliefs analyses were carried out to identify key determinants underlying intentions to engage in the three different drinking behaviors.Utilizing a prospective design survey, women  contains supplementary material, which is available to authorized users. Alcohol misuse continues to pose widespread public health problems , 2. ChanThe trend of women’s increased alcohol consumption is now evidenced across all ages, yet most research has focused on younger women , 10, 11 Australian data shows an anomaly in the proportion of women drinking at risky or high risk levels between the ages of 18 years and 55 years where an apparent dip in the proportion of women drinking at risky or high risk levels between the ages of 25 to 34 years (assumed to be associated with women being of prime child-bearing age) is observed   is  is 18]) Research has shown that these critical beliefs underlying attitude, subjective norm and PBC may help inform the content of interventions to reduce harmful behaviors , 23. CurDrawing on the TPB as a useful framework for informing the development of interventions, the current study had two principle objectives. The first objective was to elicit women’s beliefs regarding alcohol consumption in general. Second, the study aimed to examine the strength of the relationships between these critical beliefs and intentions to drink in three different ways .N = 1049) was via social networking sites , email lists and websites. Hard copy questionnaires (N = 20) were provided to women who requested them.Participant recruitment was initiated by a media release (e.g. nationwide radio and newspaper interviews) and through subsequent snowballing. Additionally, there was recruitment of first year students at a large Australian university. Flyers requested participation of all women living in Australia regardless of whether they drank alcohol or not. Dissemination of online questionnaires N = 049 was vN = 1069) residing in Australia and aged between 18 and 87 years  completed the questionnaire. Of these 1069 women, 845 (79 %) also completed the follow up questionnaire assessing their self-reported engagement in low risk, frequent and binge drinking. To examine potential differences across age groups in the underlying beliefs regarding drinking, the responses were grouped according to the following ages: 18 to 24 years (30.6 %); 25 to 34 years (25.8 %); 35 to 44 years (20.5 %); 45 to 54 years 13.8 %); and 55 years and above (9.3 %). This age group categorization is consistent with the fluctuating drinking trends [Women  explored beliefs underpinning drinking in general . The curQuestions assessing intentions to drink, and the associated underlying critical beliefs, were based on the standard TPB self-report format –29. All Participants were provided with a standard drinks guide and definitions of the three target drinking behaviors as follows: Low Risk—drinking no more than one or two drinks occasionally; Frequent Drinking—drinking 6 or more days in the one week; Binge drinking—drinking 5 or more standard alcoholic drinks on any one occasion.For each of the three behaviors, five items measured intention .Five items measured normative beliefs, with normative referents including one’s partner, family, friends and professional/work colleagues. The fifth item stated, “Having concerned family members or friends would stop me from drinking.”Asking participants, “How likely is it that the following would occur as a result of you drinking alcohol?” 16 items (8 benefits and 8 costs) measured behavioral beliefs. .Providing the context, “How likely is it that the following would STOP you from drinking alcohol?” participants were asked 12 items to assess barriers to drinking (e.g. “The following factors would stop me from drinking …Being pregnant or breastfeeding.”). With the precursor “How likely is it that the following would INCREASE the possibility of you drinking alcohol?” 13 items assessed facilitators of drinking (e.g. “The following would increase the chances of me drinking…If it was my birthday.”).Two weeks after Phase 1 was conducted participants were asked to report their drinking behavior over the interim period from the Phase 1 survey. Participants were asked to report the quantity of alcohol they had consumed, “In the last 2 weeks if you drank alcohol, how many standard alcoholic drinks did you have on a typical drinking occasion?” which assessed the amount that they drank and was compared with intentions to low risk drink. Frequency of drinking was assessed by asking participants “In the last 2 weeks, on how many days did you have a drink containing alcohol?” Finally, consistent with the main survey’s assessment of binge drinking, participants were asked to select “Never, Once, Twice, 3 times, 4 times or 5 or more times in response to the question, “In the last 2 weeks how often did you have 5 or more standards drinks on any one occasion?” This allowed an examination of the extent to which the women were engaging in binge drinking. Please see the attached file displaying the Additional file A three step critical beliefs analysis was undertaken as guided by von Haeften, Fishbein, Kasprzyk and Montano . Firstlyn = 324); 25 to 34 years (n = 278); 35 to 44 years (n = 217); 45 to 54 years (n = 150); and 55 years and above (n = 100). Multivariate results revealed a significant interaction between age and intention to drink, Wilks’ E = .80, F = 30.57, p < .001, partial ŋ2 = .10.A 5 x 3 mixed design ANOVA was conducted to examine the differences between the age groups’ engagement in the three different drinking behaviors of low risk, frequent drinking and binge drinking. Age was operationalised by dividing participants into the age groups: 18 to 24 years .Perceived benefits and facilitators of consuming alcohol were identified as significant predictors of intentions for women aged between 35 and 54. In particular, these beliefs included perceiving an advantage of drinking as being it helping one to relax  and a perceived facilitator of drinking being it reduces stress (control belief), and were also significantly predictive of women’s reported drinking behavior. These findings may be reflective of a time of life where family and work commitments are high and a need to for work, life and family balance is needed , 38. AltOlder women, aged 45 years and above, were more likely to report an intention to drink frequently compared with younger women, a finding that is consistent with other research , 31. ExaBeing pregnant or breastfeeding was reported by women aged between 25 and 44 as a significant control belief associated with reduced reported intentions to frequent drink, but this belief was not a significant predictor of actual drinking frequency. These findings are consistent with data showing that women are having children at an older age, compared with previous generations , 38, andWith the exception of the 35 to 44 years age cohort, all of the age groups reported a perceived advantage of alcohol as it offering a means to relax  and to be used as a stress management tool (control beliefs—facilitator), both of these beliefs were also significant predictors of frequent drinking behavior. Such consistent findings across age cohorts indicate a need to address stressors specific to women and promote alternative healthy stress management techniques. Although Australian drinking guidelines do not explicitly warn against drinking on a daily basis they indicate long term health risks associated with high frequency of drinking . FurtherIn line with drinking patterns in many developed nations , 31, 44,For the women aged 18 to 24 who were most likely to binge drink, a number of control beliefs were found to be significant predictors, specifically beliefs which would facilitate their intentions to drink more than four drinks on any one occasion. These facilitators related to: birthday celebrations, if their alcohol tolerance was better, accessibility to wineries and wine clubs; and if they did not have children. Possibly, this latter facilitator is tapping into younger mothers who are no longer able to binge drink because of their responsibility as a mother, but further investigation is needed to clarify this result as this suggestion is only speculative. With increasing age, an interesting finding was the finding that the behavioral belief of “help me to have fun” was a significant predictor of intentions to binge drink in the 25 to 34 year olds but, not for 18 to 24 year olds. Previous research has identified elements of fun and excitement as motivating factors for young women (aged 18 to 30 years)  and younFor women aged 35 to 44, a significant control belief which would prevent binge drinking which emerged related to health issues. In line with women’s drinking patterns , this fiThe main consistency in regards to the significant predictors of binge drinking across all age groups was that of the control belief of short term side effects (e.g. hangovers) which was associated with significantly lower intentions to binge drink. Avoiding short term side effects was also significantly associated with self-reported engagement in binge drinking behaviors for women aged 18 to 44 years old. It would seem prudent then to target interventions to build upon women’s perceptions about these beliefs, especially for the younger women who tend to binge drink at higher rates. An anomaly in the results emerged for the women aged 18 to 24 years and 35 to 44 years with regard to accessibility of “wineries or wine clubs”. It was expected that the control belief “If I was close to wineries or wine clubs” would be a factor that facilitated intentions to binge drink, not the negative relationship that was actually found. One reason for this may be that context is the important factor wherein wineries are not perceived as venues in which to binge drink. Drinking context has been found to be an influential factor on drinking behaviors , 48.Across behaviors and age groups it became evident that two beliefs consistently underpinned probable targets of intervention. Firstly, although beliefs varied across age groups and drinking behaviors, beliefs surrounding alcohol as a tonic to a stressful week and a way to unwind and relax, were consistent across age groups and across behaviors. Implications from this current study call upon a focus on women’s decision-making regarding alcohol and stress-relief. The findings highlight the role that alcohol and drinking has taken on in the lives of contemporary women as a means of relieving stress. Furthermore, the findings suggest that there may be value in both challenging the notion that alcohol is an important and regular means by which to reduce stress and instead highlight healthy alternatives to stress relief including, for instance, going for a walk or taking a bath. Secondly, the perceived short term effects of binge drinking was found to be a barrier to engaging in this behavior across all age groups. Alongside this finding, however, the finding that the behavioral belief of “cause ill-health in the long term” was not a significant predictor in any of the regression models is, arguably, most noteworthy. It is noteworthy given that it suggests that many women are not perceiving and/or are have limited awareness of the long term health risks associated with alcohol consumption, highlighting the need to raise awareness in regard to this issue .For the older women intending to drink more than five days in a week, behavioral and control beliefs regarding relaxation and stress relief, respectively, and perceived peer expectations (normative beliefs) may be of value in informing intervention content. The belief that friends approve or expect a woman to drink frequently needs further investigation. Previous examinations have found misperceptions regarding normative beliefs around alcohol consumption, whereby individuals may well overestimate the perceived peer expectations to drink . ConsequAlthough the current study did not investigate drinking locations, other studies have raised concerns about older women’s alcohol related risk because of the way in which they drink . If oldest), with excessive alcohol consumption [In conjunction with other TPB research outlining the importance of beliefs in devising and informing targeted interventions , 24, thisumption –51. SuchAs discussed above, emphasizing the short term health risks and side effects of drinking more than four drinks on any one occasion could help to consolidate such a barrier to binge drinking for women of all ages. In line with this suggestion, young women reported that if their tolerance for alcohol meant that they would suffer less adverse reactions to binge drinking, it would facilitate more binge drinking. This belief needs to be challenged, but also outlines the presence of a desire to binge drink. It also raises the point that if women had a high tolerance level then potentially their consumption would increase. This was a theme that arose in the beliefs elicitation study . Hence, This current study has a number of strengths including: the examination of women’s drinking across a broad age range and across different drinking behaviors; having a large sample of women; and using a well-established theoretical framework to identify critical beliefs underlying intentions to engage in drinking behaviors. Furthermore, this study examined differences in beliefs across age and behavior that can inform targeted interventions. One limitation is the cross-sectional nature of the study and hence results must be interpreted as such. Furthermore, whilst possible intervention foci have been identified, further research is needed to assess the efficacy of interventions targeting beliefs to reduce alcohol-related risks.Although, the TPB is a reliable measure of the cognitive influences of intention it is acknowledged that utilising this theory in the current research does not take into account influences such as: potential physiological dependence ; or exteOverall, however, the current study has increased understanding of women’s decision-making around intentions to drink, specifically pertaining to three drinking behaviors. It has provided a picture of the underlying beliefs and patterns that significantly influence women of varying ages intentions to low risk drink, frequent drink and binge drink. Such an understanding can help target preventative measures for those women at risk of alcohol-related harms or interventions for those who are currently partaking in risky drinking practices.Given the existing knowledge that women’s drinking is emerging as a major issue across all age groups, this study has sought to identify how a woman’s intentions to drink and the underlying beliefs predictive of those intentions may change over their lifespan. The current study examined the underlying beliefs which predict women’s intentions to consume alcohol and engagement in drinking behavior. The current study provided evidence that the beliefs underlying intentions varied according to age group and drinking behavior. The presence of differing beliefs that underlie women’s motivations to drink according to age group and drinking behavior demonstrated the importance of tailoring interventions and public health messages to address specific age groups and drinking behaviors, thus targeting those most at risk and the most salient motivations underpinning their behavior. Additionally, identification of patterns across drinking behaviors and age has increased understanding of interventions that can provide a broader application. Drinking as a stress management tool was highlighted, as was women’s increased awareness of the short term effects of risky drinking behaviors, but seemingly limited awareness of the long term effects.Overall, this study has addressed a number of gaps in the literature with regard to women’s drinking using a novel approach of integrating a well-known theoretical model to underpin a large sample size of empirical data . The key beliefs identified through a substantial cohort of women of various ages has been identified as important foci for future targeted interventions such as public health messages to address specific age groups and drinking behaviors, rather than a one size fits all approach.TPB, The Theory of Planned Behavior


To examine whether the frequency and amount of alcohol consumed in binge drinking sessions, total annual volume of alcohol consumed, problem drinking and abstaining from alcohol are associated with depressive symptoms in Eastern Europe.Cross-sectional data from a total of 24,381 participants from general population samples of the Czech Republic , Russia  and Poland  aged 45–69 years in 2002–2005. Depressive symptoms were defined as ≥16 points on the Centre for Epidemiological Studies – Depression (CES-D) scale. Several alcohol related measures were derived using responses from the graduated frequency questionnaire. Binge drinking was defined at several sex-specific thresholds (ranging from 60+ to 140+ g of ethanol) and two frequencies (at least monthly or weekly). Total annual alcohol intake in grams was also extracted. Problem drinking was defined as ≥2 positive answers on the CAGE questionnaire.Problem drinking was consistently associated with approximately a 2-fold increase in odds of depressive symptoms across all countries and in both sexes. Abstaining from alcohol was typically associated with increased odds of depressive symptoms. Analyses separating lifelong abstainers and former drinkers in the Russian cohort revealed that this increased odds was driven by former drinkers. Amongst men, heavy frequent binge drinking was associated with increased odds of depressive symptoms in the Czech Republic and Poland. In women, heavy infrequent binge drinking was associated with increased odds of depressive symptoms in Russia and Poland. Only in Polish men was higher annual volume of alcohol intake associated with increased odds of depressive symptoms.Abstaining from alcohol and problem drinking were associated with increased odds of depressive symptoms in these Eastern European populations. Annual volume of alcohol intake as well as frequency and amount of alcohol consumed in a binge drinking session were less consistently associated with depressive symptoms. Depression Both the prevalence of depression and frequency of consuming these different doses of alcohol as risk factors for depression. It is probable that the biological effect of alcohol on the brain/body depends on cumulative dose, therefore examining the effect of different doses of consumption as well as the frequency of drinking makes intuitive sense. Others have, however, argued that it is problem drinking which is harmful to psychological health Differentiating between different patterns of heavy drinking has been particularly encouraged in the context of Eastern Europe where a high prevalence of episodic heavy drinking exists Given the paucity of research on these important public health issues, the purpose of this study was to determine the extent to which binge drinking at different intensities (i.e. doses) and frequencies (e.g. on a monthly or weekly basis), annual drinking volume, problem drinking and abstention from alcohol are related to depressive symptoms in Eastern Europe.The University College London Hospital Research Ethics Committee Alpha approved the HAPIEE study. Ethical approval was also obtained from local research ethics committees at each HAPIEE site: National Institute of Public Health Ethics Committee , Jagellonian University Medical College Bioethics Committee , and Institute of Internal and Preventive Medicine Ethics Committee . Participants provided written, informed consent.Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study Cross-sectional data from the baseline wave (2003–2005) of the X amount of alcohol with separate doses, equivalent to: ≥10 g, ≥40 g, ≥60 g, ≥100 g, ≥140 g and ≥180 g of pure ethanol . There were nine frequency responses, spanning from never to daily.Data on drinking patterns come from the graduated frequency questionnaire Given gender differences in alcohol consumption and metabolism X g per occasion. The estimates from these models can be found in Information S1.The purpose of deriving this variable was to compare each dose/frequency category (as well as abstention) with a non-binge drinking reference group always consuming between 1 and <59 g of alcohol per occasion; not simply, for example, looking at those who drank ≥100 grams in a single sitting on a monthly basis compared to those who did not consume this amount . However, for the sake of completeness, we also estimated models examining the relationship between frequency of consuming 60+, 100+ and 140+g and depressive symptoms separately. For each dose of alcohol, frequency responses were as follows: (1) never, (2) 1–11 times per year, (3) 1–3 times per month, (4) weekly, and (5) past year abstainers. At doses of 100+ and 140+ g per occasion the category of never was divided into those always consuming between 1–59 g of alcohol per single drinking occasion (referent) and those who drank above 60 g but always less than From the graduated frequency we also derived a measure of total volume of alcohol consumed in the previous year. We categorised consumption levels above 240 g (a threshold reflecting less than one drink per month) into sex-specific tertiles of consumption derived from the entire sample. These were 260–1740 g, 1750–6020 g and >6400 g for men, and 260–420 g, 430–1200 g and >1210 g for women. The final variable used in analyses consisted of the following categories: (1) abstainers, (2) ≤240 g per annum, (3) first tertile of consumption, (4) second tertile of consumption (reference category), and (5) third tertile of consumption.Cut down on your drinking?”, 2) “Have people ever Annoyed you by criticising your drinking?”, 3) “Have you ever felt bad or Guilty about your drinking?”, and 4) “Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (as an “Eye opener”)?”. Positive responses to two or more of the questions are commonly used as an indicator of problem drinking Problem drinking was assessed using the CAGE questionnaire In the Russian cohort those who reported having not consumed alcohol in the past 12 months were asked whether they had previously consumed alcohol. These questions were used to stratify the abstainer group into former drinkers and life-long abstainers.Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies Depression (CES-D) scale The following covariates were used in analyses: age, marital status  Information S2).Logistic regression was used to estimate odds ratios (ORs) and associated 95% confidence intervals (CIs) for depressive symptoms by binge drinking dose/frequency, annual volume of alcohol intake as well as problem drinking. Separate models were fitted for each drinking measure as including all drinking components in the same model would likely represent over-adjustment To compare the consistency of associations across countries, we tested for interactions between drinking variables and cohort; we found p-values <0.01 in all interaction tests. Models were further stratified by gender (frequency/dose variables differed by sex). Within all centres, we present two models: model 1 was adjusted for age only, and model 2 was adjusted for all covariates.All models were fitted using Stata 13.1 Among women, abstaining rates were high in Poland doubling the rate of both Russia and the Czech Republic. Problem drinking was highest for women from the Czech Republic followed by those from Russia and Poland. A greater proportion of those from the Czech Republic and Russia engaged in binge drinking on a monthly or weekly basis, although the behaviour was not common in any country . Women from the Czech Republic had a higher annual intake of alcohol than women from Russia and Poland. Depressive symptoms were more common amongst women; almost a quarter of women from the Czech Republic and, 34 and 33% of women from Russia and Poland were identified as having depressive symptoms.For men , in the For women , those wProblem drinking was consistently associated with increased odds of depressive symptoms across all countries in both men  and womeWhen stratifying the abstainer group into former drinkers and life-long abstainers  in the RIn this large population based study in Eastern Europe, we found that problem drinking was consistently associated with an increased prevalence of depressive symptoms in all populations and both sexes. With binge drinking, the results were slightly less consistent. In men, frequent heavy binge drinking (140+ g in a sitting at least once a week) was associated with increased odds of depressive symptoms in the Czech Republic and Poland. Interestingly, Russian men who drank 100–139 g of alcohol in a single sitting on a monthly basis had lower odds of depressive symptoms than those always drinking less than 60 g in a single sitting. Among women, there was a tendency for those who engaged in heavy binge drinking (100+g in a single sitting) to have higher odds of depressive symptoms but the odds ratios were not statistically significant in the case of at least weekly binge drinking.Abstaining from alcohol was also associated with increased odds of depressive symptoms in comparison to moderate drinking except in Russia; however, compared to the second tertile of annual alcohol consumption, abstainers had consistently higher odds of depressive symptoms. Analyses attempting to disentangle lifelong non-drinkers from former drinkers typically revealed significantly increased odds of depressive symptoms in former drinkers.These findings corroborate previous studies in Central and Eastern Europe which have found binge drinking to be associated with increased rates of depressive symptoms An unexpected finding was that Russian men who consumed 100–139 g in a single sitting at least monthly had lower odds of depressive symptoms than those who always consumed less than 60 g in a drinking occasion. A possible explanation for this finding is that those who drank heavily did so with friends and therefore social participation served as a protective factor against depression, whilst also increasing the opportunity to drink at hazardous levels To our knowledge only one other study has examined abstaining from alcohol as a risk factor for poor mental health in Eastern Europe, focussing on Russian men In our data, problem drinkers had consistently increased odds of depressive symptoms. This finding is in line with previous findings on the topic of depression and alcohol consumption in Eastern Europe Specific strengths of this analysis include the large sample size of each country – providing relatively good statistical power (with certain exceptions outlined below). Furthermore, standardised internationally validated tools were used to collect information on individual drinking episodes and depressive symptoms. Data from the graduated frequency questionnaire were then used to create a variable which took into account both dose and frequency of binge drinking and derive total annual alcohol intake.There are, however, also several shortcomings. First, these analyses are based on cross-sectional data. It is plausible that the relationship would differ over time and examining the association over multiple occasions may provide additional aetiological insights into the possibly bi-directional relationship between alcohol consumption and depressive symptoms Another limitation is that in some of our statistical models, abstainers had to be grouped into a single aggregate category of past year non-drinkers, although the reasons for present/recent non-drinking are likely to be heterogeneous. Many other investigators have pointed out the weaknesses of using an aggregate group of abstainers A third limitation is that the frequency of consuming <60 g in a single sitting was not taken into account. The reference group used in these analyses may therefore contain a number of occasional or, conversely, frequent drinkers which may bias the relationship observed Fourth, there may also be concerns about the small number of female binge drinkers identified in the study, especially categories relating to heavy and frequent binge drinking. The odds ratios for female drinkers have wide confidence intervals and should be interpreted with appropriate caution.A fifth limitation relates to both alcohol and depressive symptom measures being based on self-reported data. Self-report measures of alcohol consumption have been consistently demonstrated to provide inaccurate estimates of consumption Sixth, participants were aged between 45 and 69 years of age. It is plausible that the same relationship might not be present in younger or older populations. Studies examining the relationship between alcohol use disorders and major depression earlier in the life-course also find a consistent relationship between problematic drinking and depression Finally, the rates of abstention in Poland were higher than in other populations in HAPIEE and than what we would expect from population level surveys Our findings indicate that dose of alcohol consumed in a binge drinking session and the frequency of doing so may contribute to the burden of depression in Eastern Europe but problem drinking was the alcohol variable consistently associated with increased odds of depressive symptoms in all countries, indicating that it is likely to be a useful predictor of depression in Eastern Europe. It is possible that the increased odds of depressive symptoms observed amongst non-drinkers is driven by former drinkers. Future work will however need to investigate whether this relationship holds when predicting depressive symptoms prospectively using a longitudinal design.Information S1Estimates from models relating the frequency of drinking >60, 100 and 140 g in the past year to depressive symptoms.(PDF)Click here for additional data file.Information S2Estimates from models whereby binge drinking dose/frequency, annual drinking volume and problem drinking are simultaneously included in the same model.(PDF)Click here for additional data file.


In this study, a grain-scale modelling technique has been developed to generate the capillary pressure–saturation curves for swelling granular materials. This model employs only basic granular properties such as particles size distribution, porosity, and the amount of absorbed water for swelling materials. Using this model, both drainage and imbibition curves are directly obtained by pore-scale simulations of fluid invasion. This allows us to produce capillary pressure–saturation curves for a large number of different packings of granular materials with varying porosity and/or amount of absorbed water. The algorithm is based on combining the Discrete Element Method for generating different particle packings with a pore-unit assembly approach. The pore space is extracted using a regular triangulation, with the centres of four neighbouring particles forming a tetrahedron. The pore space within each tetrahedron is referred to as a pore unit. Thus, the pore space of a particle packing is represented by an assembly of pore units for which we construct drainage and imbibition capillary pressure–saturation curves. A case study on Hostun sand is conducted to test the model against experimental data from literature and to investigate the required minimum number of particles to have a Representative Elementary Volume. Then, the capillary pressure–saturation curves are constructed for Absorbent Gelling Material particles, for different combinations of porosity values and amounts of absorbed water. Each combination yields a different configuration of pore units, and thus distinctly different capillary pressure–saturation curves. All these curves are shown to collapse into one curve for drainage and one curve for imbibition when we normalize capillary pressure and saturation values. We have developed a formula for the Van Genuchten parameter  The swelling and the deformation of granular porous media under variably saturated conditions are a common phenomenon in geotechnical problems, product engineering, and biological tissues. Examples are swelling clays  is a good alternative. DEM efficiently describes the movement of solid grains inside particle packings during deformation. DEM was introduced by Cundall and Strack . Since tMuch research has been conducted on the inclusion of hydromechanical coupling in DEM. Chareyre et al.  have impThe aim of this research is to study the effects of porosity change and swelling on the capillary pressure–saturation curve, using a pore-scale model. For this purpose, a model has been set up where we have combined a pore-unit assembly method with DEM, to account for hydromechanical coupling. Using this model, we can construct capillary pressure–saturation curves for drainage and imbibition, under a variety of conditions, as described below.The study material is Absorbent Gelling Material (AGM) particles, which are used in liquid-absorbent hygienic products. AGM particles are capable of absorbing water up to 200 times their initial weight and brine up to 30 times their initial weight , Poisson ratio R) and density.In this research, the open-source software Yade-DEM is used to generate different particle packings. Yade-DEM is based on the Discrete Element Method (DEM) Šmilauer et al. . DEM simi in contact with a neighbouring particle j. Particles i and j are pushed towards each other due to their surrounding particles. This causes a relative movement of particle i towards particle j and consequently the flattening of both particles at the contact. The tendency of a particle to maintain its original spherical shape causes an elastic force at the contact  that have a shared pore throat with an inscribed circle radius i is saturated with air and pore unit j is saturated with water, then an air–water interface is located at pore throat ij. The air–water interface will have a complex shape, resembling both a spherical cap and a liquid bridge. Here, it is assumed that the air–water interface has the shape of a spherical cap, following Gladkikh and Bryant , as defined by Buchholz and Graham . Next, e et al. . The finTo obtain the capillary pressure–saturation curve, the boundary conditions in the pore-unit model were chosen to mimic a column experiment. The top boundary of the modelling domain in Yade-DEM was assumed to be a nonwetting phase reservoir (e.g. air) at a pressure In the pore-unit model, the simulation procedure was as follows: (1) a capillary pressure was specified. (2) For drainage, the pore throats of all water-saturated pore units were checked to determine whether they could be invaded by air. For imbibition, the pore throats of all air-saturated pore units were checked whether water could invade. (3) Drainage of a water-saturated pore unit by air (or vice versa during imbibition) was allowed only when both phases were connected to their corresponding reservoirs. (4) Capillary pressure was increased during drainage and decreased during imbibition. (5) An algorithm was implemented to keep track of disconnected blobs of air and water, to ensure that no displacement of disconnected blobs could occur. These disconnected blobs would form the residual air or water saturation at the end of either imbibition or drainage, respectively.n are fitting parameters, representing the inverse of the entry pressure and the pore size distribution, respectively, and S is the saturation, All simulated capillary pressure–saturation points were fitted with the Van Genuchten function , which implies that the effects of small-scale heterogeneities are averaged out. The calculations were done for packings with different numbers of particles, varying from 1000 to 5000. Results showed that different primary drainage curves were obtained for different numbers of particles see Fig. . But, thAnother aspect related to the concept of REV is the variation in simulated curves for different realizations of the same packing. To illustrate this variation, different packings with the same number of particles were generated for different random distributions in the particle location. This was done for two cases: 1000 and 4000 particles. For each case, six capillary pressure–saturation curves were constructed. Figure Based on these results, we decided that the REV size should be around 4000 particles. All simulations hereafter were carried out for an assembly of 4000 particles.n are shown in Table n for drainage First, we simulated capillary pressure–saturation curves for Hostun sand and compared them to experimental data by Lins and Schanz , as showmentclass2pt{minimThe residual water saturation in our simulations was 0.14, which was close to the measured value of 0.11. Due to the angular shape of sand grains, corner flow of water at low saturation allows for additional drainage, and therefore, a lower saturation at higher capillary pressure can be reached. Moreover, the maximum water saturation after imbibition was 0.90, which is lower than the experimental value, namely 0.98. This may be related to the fact that particles are modelled as spheres in DEM, whereas sand is typically less round and more angular. The maximum water saturation is lower in packings of spherical grains. For example, the maximum water saturation in experiments with glass-bead packings has been found to be 0.92 , or 0.7Capillary pressure–saturation curves for main drainage and primary imbibition were simulated for a typical range of absorption ratios: from 5 to 40 g/g  and the porosity n was assumed to be constant. In their model, the load that was applied (P) to confine the sample was assumed to be constant. Therefore, the porosity was only considered to change with changing absorption ratio. Thus, it was assumed that both Q. Both dependencies were experimentally determined and used as input for the macro-scale simulations. However, for a varying confining load, porosity can change independently of Q. Thus, Q on Q constant while varying Q while releasing net stress in order to keep Diersch et al.  have devQ, as shown in Fig. First, capillary pressure–saturation curves were obtained for different absorption ratios, at a variety of constant porosity values. Results are shown in Fig. Next, capillary pressure saturation curves were obtained for packings with different porosities, at a number of constant absorption ratios. Results show that both h and Lu  studied The results in Fig. mentclasspt{minimathat Eq.  assumed mentclasspt{miniman has a weak dependency on the porosity value and has no dependency on the absorption ratio . This model is based on combining the DEM and the pore-unit assembly method. It is capable of producing capillary pressure–saturation curves for different particle packings, based on simple physical parameters: particle size distribution, porosity, and, in case of swelling granular materials, the amount of absorbed water. In order to test the model, the capillary pressure–saturation curves were constructed for Hostun sand. They were found to be in relatively good agreement with experimental data from the literature. Then, a large number of capillary pressure-saturation curves for primary imbibition and drainage were constructed for different porosities and different amounts of absorbed water. The simulated data were used to develop a relationship for the Van Genuchten parameter