Barrett Esophagus: Improving Surveillance Strategies

The aim of surveillance in patients with a Barrett esophagus (BE) is to detect progression of dysplasia at an early and therefore likely curable stage. The interval of endoscopic surveillance in patients with BE is currently based on the histopathological stage (i.e. grade of dysplasia). This approach is however known to have several pitfalls. First, only patients with intestinal metaplasia (IM) in the columnar-lined segment of the esophagus (CLE) have so far been regarded to have a premalignant condition and are enrolled in an endoscopic surveillance program, in contrast to patients with only cardiac-type mucosa (CM) in their biopsies. However, as IM and CM can be both present in the CLE and are endoscopically indiscernible, sampling error can occur, and exclusion of patients with only CM from endoscopic follow-up might therefore be incorrect. In addition, it has been suggested that IM in CLE may develop over time, and a follow-up endoscopy in the course of time may than detect IM. Secondly, in line with the risk of neoplastic progression, the presence or absence of dysplasia in IM determines the frequency of endoscopic surveillance, but the interpretation of dysplasia is subject to considerable interobserver variability, leading to both superfl uous follow-up endoscopies in some patients and insuffi cient control of others. Therefore, it is relevant to perform risk stratifi cation to defi ne which subgroup of patients with CLE with or without IM should undergo endoscopic follow-up, and at which frequency. The aim of the work described in this thesis was to assess the currently used criteria for performing endoscopic surveillance in patients with CLE, and to evaluate which clinical characteristics and biomarkers could contribute to risk stratifi cation in patients with CLE, in order to refi ne surveillance strategies in these patients

Tungsten trioxide (WO3) as an actuator electrode material for ISFET-based coulometric sensor-actuator systems

Acid or base concentrations can be determined by performing an acid-base titration with OH− or H+ ions, coulometrically generated by the electrolysis of water at a noble metal actuator electrode. This can be done very rapidly if the actuator electrode is in close proximity to an ISFET which is used as the indicator electrode to detect the equivalence point in the titration curve. In order to restrict the effect of interfering redox reactions at the actuator electrode during coulometric generation, electroactive actuator materials have been studied which can exchange H+ ions at a lower electrode potential than the potential of anodic water electrolysis. In this paper, electrochemically grown tungsten trioxide (WO3) is proposed as an actuator electrode material. At a WO3 electrode, H+ ions can be generated by a redox reaction at approximately 0.1 V versus SCE in a mildly alkaline solution (0.5–7 mM KOH) (anodic water electrolysis at a Pt electrode occurs at 1.5 V versus SCE). The observed thermodynamic and kinetic behaviour of the redox reaction is in good agreement with the theoretical predictions. Disadvantages of WO3 are its slow dissolution in aqueous solutions and the restriction that a titration at a WO3 electrode can only be performed in alkaline solutions

The Phenomenon of Suicide Bombing: A Review of Psychological and Nonpsychological Factors

This article reviews the literature on the phenomenon of suicide bombing. It addresses the question of just how much a psychological understanding of the individuals involved can aid in prevention. The article looks at historical, epidemiological, and cultural perspectives and compares the nonpsychological and psychological approaches to suicide bombing. On the basis of the material available it seems that social processes such as group-dynamic indoctrination and political factors are decisive in analyzing this problem. Cultural, nationalistic, and religious factors are important. The conclusion is that in suicidal bombing, suicide is instrumental in the context of war, not in the context of psychopathology. Suicide bombing is instrumental in realizing fatalities, and it is only one of many weapons. The act of killing in warfare is more important to understanding suicidal terrorism than the act of suicide. This explains why psychological profiling of suicidal terrorists has to date not been successful. Keywords: suicide, terror, bombing, indoctrination, psychological and nonpsychological approache

Bedreigingen, persterijen en suicidaliteit in detentie

achtergrond Onderzoek van Blaauw en Kerkhof onderscheidde 16 indicatoren voor verhoogd suïciderisico in een gedetineerdenpopulatie. Deze indicatoren suggereren dat het hoge suïcidecijfer in penitentiaire inrichtingen het gevolg is van blootstelling van kwetsbare personen aan een stressvolle situatie. Hierdoor is een verband te verwachten tussen pesterijen, bedreigingen en suïcidaliteit. Deze verwachting wordt door onderzoeken indirect ondersteund. doel Nagaan of pesterijen en bedreigingen samenhangen met verhoogd suïciderisico en of de door Blaauw en Kerkhof onderscheiden persoonsgebonden risicofactoren samenhangen met het ervaren van pesterijen of bedreigingen. methode Meldingen van bedreigingen en pesterijen werden nagegaan in dossiers van 95 gedetineerden die suïcide hadden gepleegd, en interviews werden afgenomen van 221 gedetineerden met laag suïciderisico en 53 gedetineerden met hoog suïciderisico. resultaten In 34% van de dossiers stond weergegeven dat de suïcidepleger zich gepest en/of bedreigd had gevoeld. Pesterijen en bedreigingen kwamen vaker voor onder suïcidale gedetineerden dan onder niet-suïcidale gedetineerden. Verbanden werden gevonden tussen pesterijen en bedreigingen enerzijds en indicatoren voor kwetsbaarheid anderzijds. conclusie Pesterijen en bedreigingen hebben een relatie met suïcidaliteit onder gedetineerden

Brief Report: Examining the Link Between Autistic Traits and Compulsive Internet Use in a Non-Clinical Sample

Individuals with autism spectrum disorders or autistic traits may profit from Internet and computer-mediated interactions, but there is concern about their Internet use becoming compulsive. This study investigated the link between autistic traits and Internet use in a 2-wave longitudinal study with a non-clinical community sample (n = 390). As compared to people with less autistic traits, people with more autistic traits did not report a higher frequency of Internet use, but they were more prone to compulsive Internet use. For women, more autistic traits predicted an increase in compulsive Internet use over time. These results suggest that, despite its appeal for people with autistic traits, the Internet carries the risk of compulsive use