Empirical foundations for the diagnosis of somatization:implications for DSM-5

Background. The aim of this study was to develop empirically validated criteria for the diagnoses of clinically relevant somatization. Method. This study was performed in a population-representative cohort consisting of 461 males (47.8%) and 503 females (52.2%), with an average age of 55.8 years (S.D. = 11.1). Somatization, anxiety and depression were derived from the Composite International Diagnostic Interview. Mplus was used to perform confirmative factor analyses on the current DSM-IV symptom groups; on alternative symptom clusters previously suggested; and to perform latent class analysis in order to define an empirically derived cut-off for somatization. Results. The existence of symptom groups as described in DSM-IV was not supported by our data, whereas a differentiation between cardiopulmonary, musculoskeletal, gastrointestinal and general somatic symptoms did fit our data. Latent class analysis revealed two classes characterized by few (n = 859) and many (n = 105) symptoms. The class of subjects could be approached by a simple cut-off of four functional symptoms (sensitivity 79%, specificity 98%, positive predictive value 82%, negative predictive value 97%) regardless of the number of organ systems involved. Conclusions. This study in a large population-representative cohort suggests that a simple symptom count can be used as a dimensional diagnosis of somatization. In those instances in which a categorical diagnosis is preferred, a simple cut-off of four out of 43 functional symptoms best fitted our data. We did not find any added value for incorporating the number of symptom clusters into the diagnostic criteria

Prediction of biopore- and matrix-dominated flow from X-ray CT-derived macropore network characteristics

Peer reviewedPublisher PD

Topoisomerase I inhibitors: the relevance of prolonged exposure for present clinical development.

Topoisomerase I inhibitors constitute a new class of anti-cancer agents. Recently, topotecan and irinotecan were registered for clinical use in ovarian cancer and colorectal cancer respectively. Cytotoxicity of topoisomerase I inhibitors is S-phase specific, and in vitro and in vivo studies have suggested that, for efficacy, prolonged exposure might be more important than short-term exposure to high concentration. Clinical development of those topoisomerase I inhibitors that have reached this stage is also focused on schedules aiming to achieve prolonged exposure. In this review, we summarize all published preclinical studies on this topic for topoisomerase I inhibitors in clinical development, namely 20-S-camptothecin, 9-nitro-camptothecin, 9-amino-camptothecin, topotecan, irinotecan and GI147211. In addition, preliminary data on clinical studies concerning this topic are also reviewed. The data suggest that prolonged exposure may indeed be relevant for anti-tumour activity. However, the optimal schedule is yet to be determined. Finally, clinical data are yet too immature to draw definitive conclusions

In situ produced branched glycerol dialkyl glycerol tetraethers in suspended particulate matter from the Yenisei River, Eastern Siberia

Soil-derived branched glycerol dialkyl glycerol tetraethers (brGDGTs) in marine river fan sediments have a potential use for determining changes in the mean annual temperature (MAT) and pH of the river watershed soils. Prior to their incorporation in marine sediments, the compounds are transported to the marine system by rivers. However, emerging evidence suggests that the brGDGTs in freshwater systems can be derived from both soil run-off and in situ production. The production of brGDGTs in the river system can complicate the interpretation of the brGDGT signal delivered to the marine system. Therefore, we studied the distribution of brGDGT lipids in suspended particulate matter (SPM) of the Yenisei River. Chromatographic improvements allowed quantification of the recently described hexamethylated brGDGT isomer, characterized by having two methyl groups at the 6/6 ' instead of the 5/5 ' positions, in an environmental dataset for the first time. This novel compound was the most abundant brGDGT in SPM from the Yenisei. Its fractional abundance correlated well with that of the 6-methyl isomer of the hexamethylated brGDGT that contains one cyclopentane moiety. The Yenisei River watershed is characterized by large differences in MAT (>11 degrees C) as it spans a large latitudinal range (46-73 degrees N), which would be expected to be reflected in brGDGT distributions of its soils. However, the brGDGT distributions in its SPM show little variation. Furthermore, the reconstructed pH values are high compared to the watershed soil pH. We, therefore, hypothesize that the brGDGTs in the Yenisei River SPM are predominantly produced in situ and not primarily derived from erosion of soil. This accounts for the absence of a change in the temperature signal, as the river water temperature is more stable. Using a lake calibration, the reconstructed temperature values agree with the mean summer temperatures (MST) recorded. The brGDGTs delivered to the sea by the Yenisei River during this season are thus not soil-derived, possibly complicating the use of brGDGTs in marine sediments for palaeoclimate reconstructions

De invloed van informatie over risico's, voordelen en bestaande attitudes op post-attitudes ten opzichte van voedselproductiemethodes

Het effect van eenzijdige versus tweezijdige informatievoorziening en bestaande attitudes op post-attitudes is onderzocht. Met name is gekeken naar de mogelijke asymmetrische invloed van positieve en negatieve informatie op post-attitudes. Daarnaast is gekeken hoe bestaande attitudes dit effect beïnvloeden. Eenzijdige informatie beïnvloedde attitudeformatie in de richting van de informatie. In tegenstelling tot de verwachting had negatieve informatie in een tweezijdige boodschap geen dominant effect op attitudeformatie. Het effect van tweezijdige informatie was afhankelijk van bestaande attitudes wanneer de informatie verschillende domeinen betrof (gezondheid en milieu), maar had geen effect wanneer de informatie eenzelfde domein betrof

Cognitive-behavior therapy for children and adolescents with anxiety disorders:A meta-analysis of secondary outcomes

Anxiety-focused cognitive-behavioral therapy (CBT) effectively reduces anxiety in children and adolescents. An important remaining question is to what extent anxiety-focused CBT also affects broader outcome domains. Additionally, it remains unclear whether parental involvement in treatment may have impact on domains other than anxiety. A meta-analysis (nstudies = 42, nparticipants = 3239) of the effects of CBT and the moderating role of parental involvement was conducted on the following major secondary outcomes: depressive symptoms, externalizing behaviors, general functioning, and social competence. Randomized controlled trials were included when having a waitlist or active control condition, a youth sample (aged<19) with a primary anxiety disorder diagnosis receiving anxiety-focused CBT and reported secondary outcomes. Controlled effect sizes (Cohen's d) were calculated employing random effect models. CBT had a large effect on general functioning (-1.25[-1.59;0.90], nstudies = 17), a small to moderate effect on depressive symptoms (-0.31[-0.41;-0.22], nstudies = 31) and a small effect on externalizing behaviors (-0.23[-0.38;-0.09], nstudies = 12) from pre-to post-treatment. Effects remained or even further improved at follow-up. Social competence only improved at follow-up (nstudies = 6). Concluding, anxiety-focused CBT has a positive effect on broader outcome domains than just anxiety. Higher parental involvement seemed to have beneficial effects at follow-up, with improvements in general functioning and comorbid symptoms

Access and benefit-sharing policies for climate-resilient seed systems.

The synthesis report is part of a series of papers on Integrated Seed Sector Development (ISSD) in Africa’s thematic working group on Matching national realities with global commitments. The thematic working group addressed the main question on how African governments implement their global commitments while fostering a viable pluralistic sector. The main hypothesis was that making these commitments more coherent with the practices and realities of farmers and creating an enabling environment for strengthening multiple seed systems will increase farmers’ access to quality seed. Three main topics were discussed under this theme: access and benefit sharing for climate resilient seed systems; national and regional seed laws that support the development of a robust, integrated seed sector that supports smallholder farmers' needs; and creating room for informal and intermediary seed systems in a UPOV '91 informed Plant Variety Protection system. This study provides an overview of climate related changes in past, present and future and the challenges to access to and exchange of genetic resources for climate change adaptation through different access and benefit sharing regimes in 4 countries – Zambia, Zimbabwe, Rwanda and Uganda. Findings from the studies indicate that most African countries face challenges in accessing required PGR for climate change adaptation because they do not have online accession-level documentation; they have not fully implemented international commitments related to ABS and national and regional seed laws hamper the flow of seeds and genetic resources. As a way forward the paper proposes capacity development for mutually supportive implementation of the ITPGRFA, Nagoya protocol and seed laws in ways which reflect the reality and diversity of different seed systems

Access and benefit sharing policies for climate resilient seed systems: matching global commitments with national realities.

This synthesis paper provides a summary of main findings on climate resilient seed systems and access and benefit sharing of case studies from Uganda, Rwanda, Zambia and Zimbabwe. This study analyses what is actually happening at the national and subnational levels in terms of climate change, its impacts on particular crops, what experiences countries have had to date in terms of accessing, using and sharing benefits derived from genetic resources for climate change adaptation, and what kinds of ABS policy initiatives or reforms could help those countries to make better use of genetic diversity for climate change adaptation in the future. This study is designed to analyze how these different ‘threads’ come together at national and subnational level in the four countries. Findings from these studies indicate that countries are already facing climate change which is affecting farmers and shaping their needs in terms of suitably adapted seed. As a result, the countries are embracing (inter and intra specific) crop diversification as a means to adapt to climate changes. This depends upon accessibility, availability and use of inter and intra specific crop genetic diversity from local, national and international sources. The proportion of PGRFA in the countries’ national genebanks that is potentially adaptable to that country’s changing climate is decreasing over time (as climates change more). National level research and the development of new varieties is also not sufficient to meet these demands. Countries are therefore becoming more interdependent. There are also significant constraints on ability to access, use and share benefits associated with materials in other countries as a result of the lack of on-line accession level documentation (and linked implementation of ITPGRFA and Nagoya Protocol) and lack of proper polices, legislation and guidelines on ABS. The study therefore recommends that international partnerships and programmes are important mechanisms for the exchanges of genetic resources into and out of the four countries for agricultural research and development especially at regional level and that the ITPGRFA and Nagoya Protocol are not self-executing agreements but need to be proactively implemented. In addition, considerable investment in capacity building is necessary for stakeholders – including farmers – to be able to exchange genetic resources in a way that makes seed systems more resilient