The Classification of Obsessive–Compulsive and Related Disorders in the ICD-11

Background To present the rationale for the new Obsessive–Compulsive and Related Disorders (OCRD) grouping in the Mental and Behavioural Disorders chapter of the Eleventh Revision of the World Health Organization’s International Classification of Diseases and Related Health Problems (ICD-11), including the conceptualization and essential features of disorders in this grouping. Methods Review of the recommendations of the ICD-11 Working Group on the Classification for OCRD. These sought to maximize clinical utility, global applicability, and scientific validity. Results The rationale for the grouping is based on common clinical features of included disorders including repetitive unwanted thoughts and associated behaviours, and is supported by emerging evidence from imaging, neurochemical, and genetic studies. The proposed grouping includes obsessive–compulsive disorder, body dysmorphic disorder, hypochondriasis, olfactory reference disorder, and hoarding disorder. Body-focused repetitive behaviour disorders, including trichotillomania and excoriation disorder are also included. Tourette disorder, a neurological disorder in ICD-11, and personality disorder with anankastic features, a personality disorder in ICD-11, are recommended for cross-referencing. Limitations Alternative nosological conceptualizations have been described in the literature and have some merit and empirical basis. Further work is needed to determine whether the proposed ICD-11 OCRD grouping and diagnostic guidelines are mostly likely to achieve the goals of maximizing clinical utility and global applicability. Conclusion It is anticipated that creation of an OCRD grouping will contribute to accurate identification and appropriate treatment of affected patients as well as research efforts aimed at improving our understanding of the prevalence, assessment, and management of its constituent disorders

Effect of substitutional As impurity on electrical and optical properties of β-Si3N4 structure

β-Si3N4 is used as the gate dielectric for surface passivation in GaN-based, high-electron mobility transistors(HEMTs). In this study, the electrical and optical characteristics of the hexagonal β-Si3N4 crystal structure were calculated using density functional theory (DFT) and local-density approximation (LDA). Calculations of the electronic band structure and the density of states (DOS) were made for the pure β-Si3N4 crystal structure and the β-Si3N4 crystal doped with an arsenic (As) impurity atom. In addition, the optical properties such as the static dielectric constant, refractive index, extinction coefficient, absorption coefficient and reflection coefficient were examined depending on the photon energy. As a result of these calculations, it was observed that the As impurity atom drastically changed the electrical and optical properties of the pure β-Si3N4 crystalline structure, and improvements are suggested for potential further studies. © 2016 Elsevier Ltd. All rights reserved

Pituitary hypoplasia and growth hormone deficiency in a woman with glycogen storage disease type Ia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Growth retardation is one of the cardinal manifestations of glycogen storage disease type Ia. It is unclear which component of the growth hormone and/or insulin-like growth factor axis is primarily disrupted, and management of growth impairment in these patients remains controversial. Here we report the first case in the literature where glycogen storage disease type Ia is associated with pituitary hypoplasia and growth hormone deficiency.</p> <p>Case presentation</p> <p>A 20-year-old woman with glycogen storage disease type Ia was admitted to our endocrinology department because of growth retardation. Basal and overnight growth hormone sampling at 2-hour intervals demonstrated low levels; however, provocative testing revealed a relatively normal growth hormone response. A hypoplastic anterior pituitary with preserved growth hormone response to provocative testing suggested the possibility of growth hormone neurosecretory dysfunction and/or primary pituitary involvement.</p> <p>Conclusion</p> <p>Pituitary hypoplasia may result from growth hormone-releasing hormone deficiency, a condition generally known as growth hormone neurosecretory dysfunction. It is an abnormality with a spontaneous and pulsatile secretion pattern, characterized by short stature, growth retardation and normal serum growth hormone response to provocative testing. However, in the case described in this report, a normal although relatively low growth hormone response during insulin tolerance testing and pituitary hypoplasia suggested that primary pituitary involvement or growth hormone neurosecretory dysfunction may occur in glycogen storage disease type Ia. This is a potential cause of growth failure associated with a lower somatotroph mass, and may explain the variable responsiveness to growth hormone replacement therapy in people with glycogen storage disease.</p

Electronic structure of β-Si3N4 crystals with substitutional icosagen group impurities

The β-Si3N4 crystals are widely used in industrial and electronics areas. Therefore, β-Si3N4 has drawn the attention of researchers for many years. In this study, effects of icosagen group impurity atoms in the IIIA group on the electronic properties of the β-Si3N4 crystal were analyzed by using the density functional theory. As a result of these analyses, it was determined that the electronic properties of the crystal change significantly. Basic electronic characteristics for pure β-Si3N4 crystal and icosagen group impurity β-Si3N4 crystals, such as band structures, densities of states, binding energies, and formation energies were investigated. We identified that the band gap of the β-Si3N4 crystal was affected significantly by the impurity, and this change was varying linearly in line with the formation energy for the impurity cases. As a result of calculations, the Al-impurity was found to be the lowest-energy impurity state

Targeting sustainable competitiveness in Croatia by implementation of “20 Keys” methodology

Throughout the current wave of regulatory reforms, several theoretical models have been proposed that call for the emergence of instruments of self-regulation under some form of state supervision as part of the demand to improve product development performances aligned with awareness of environmental needs, to help with meeting regulation and to reduce the risk of production nonconformance. “20 Keys” is one example of a mass application of a methodology for raising sustainable development and holistic approach to competitiveness in new EU member the Republic of Croatia, and therefore, the aim of this study is to observe the results of the methodology application in Croatian companies. 20 Keys is a methodology that brings an integrated set of tools aimed at increasing overall productive efficiency and quality level with simultaneous reduction of costs. As it was shown in this paper, implementation success is coincident with senior management’s active role in setting the main goals for implementation, assuring that suitable methods and tools are used, allocating resources appropriately and enabling communication within the company

Relapsing insulin-induced lipoatrophy, cured by prolonged low-dose oral prednisone: a case report

<p>Abstract</p> <p>Introduction</p> <p>Circumscript, progressing lipoatrophy at the insulin injection sites is an unexplained, however rare condition in diabetes mellitus.</p> <p>Case presentation</p> <p>We report a case of severe localised lipoatrophy developing during insulin pump-treatment (continuous subcutaneous insulin infusion) with the insulin analogue lispro (Humalog^®) in a woman with type-1 diabetes mellitus. After 11 months of progressing lipoatrophy at two spots on the abdomen, low-dose prednisone (5-10 mg) p.o. was given at breakfast for 8 months, whereby the atrophic lesions centripetally re-filled with subcutaneous fat tissue (confirmed by MRI) despite ongoing use of insulin lispro. However, 4 weeks after cessation of prednisone, lipoatrophy relapsed, but resolved after another 2 months of low-dose prednisone. No further relapse was noted during 12 months of follow-up on insulin-pump therapy with Humalog^®.</p> <p>Conclusion</p> <p>Consistent with an assumed inflammatory nature of the condition, low-dose oral prednisone appeared to have cured the lipoatrophic reaction in our patient. Our observation suggests a temporary intolerance of the subcutaneous fat tissue to insulin lispro (Humalog^®), triggered by an unknown endogenous mechanism.</p

Quetiapine augmentation of SRIs in treatment refractory obsessive-compulsive disorder: a double-blind, randomised, placebo-controlled study [ISRCTN83050762]

BACKGROUND: Although serotonin reuptake inhibitors are effective in the treatment of OCD, many patients fail to respond to these agents. Growing evidence from open-label and placebo-controlled trials suggests a role for augmentation of SRIs with atypical antipsychotics in OCD. Quetiapine is generally well tolerated and previous open-label data has produced mixed results in OCD and additional controlled data is needed. METHODS: We undertook a double-blind, randomised, parallel-group, flexible-dose, placebo-controlled study of quetiapine augmentation in subjects who had responded inadequately to open-label treatment with an SRI for 12 weeks. Following informed consent and screening, forty-two subjects were randomised to either placebo or quetiapine for six weeks. RESULTS: There was significant improvement from baseline to endpoint on the Yale-Brown Obsessive-Compulsive Scale in both the quetiapine and placebo groups (quetiapine, n = 20, p < 0.0001; placebo, n = 21, p = 0.001) with 40% (n = 8) of quetiapine and 47.6% (n = 10) of placebo treated subjects being classified as responders. Quetiapine did not demonstrate a significant benefit over placebo at the end of the six-week treatment period (p = .636). Similarly quetiapine failed to separate from placebo in the subgroup of subjects (n = 10) with co-morbid tics. Quetiapine was generally well tolerated. CONCLUSIONS: In this study, quetiapine augmentation was no more effective than placebo augmentation of SRIs. A number of limitations in study design make comparisons with previous studies in this area difficult and probably contributed to our negative findings. Future work in this important clinical area should address these limitations

Making oneself predictable: reduced temporal variability facilitates joint action coordination

Performing joint actions often requires precise temporal coordination of individual actions. The present study investigated how people coordinate their actions at discrete points in time when continuous or rhythmic information about others’ actions is not available. In particular, we tested the hypothesis that making oneself predictable is used as a coordination strategy. Pairs of participants were instructed to coordinate key presses in a two-choice reaction time task, either responding in synchrony (Experiments 1 and 2) or in close temporal succession (Experiment 3). Across all experiments, we found that coactors reduced the variability of their actions in the joint context compared with the same task performed individually. Correlation analyses indicated that the less variable the actions were, the better was interpersonal coordination. The relation between reduced variability and improved coordination performance was not observed when pairs of participants performed independent tasks next to each other without intending to coordinate. These findings support the claim that reducing variability is used as a coordination strategy to achieve predictability. Identifying coordination strategies contributes to the understanding of the mechanisms involved in real-time coordination

The Role of Attention in a Joint-Action Effect

The most common explanation for joint-action effects has been the action co-representation account in which observation of another's action is represented within one's own action system. However, recent evidence has shown that the most prominent of these joint-action effects (i.e., the Social Simon effect), can occur when no co-actor is present. In the current work we examined whether another joint-action phenomenon (a movement congruency effect) can be induced when a participant performs their part of the task with a different effector to that of their co-actor and when a co-actor's action is replaced by an attention-capturing luminance signal. Contrary to what is predicted by the action co-representation account, results show that the basic movement congruency effect occurred in both situations. These findings challenge the action co-representation account of this particular effect and suggest instead that it is driven by bottom-up mechanisms