Mapping nitrate leaching to upper groundwater in the sandy regions of The Netherlands, using conceptual knowledge

The European Community asks its Member States to provide a comprehensive and coherent overview of their groundwater chemical status. It is stated that simple conceptual models are necessary to allow assessments of the risks of failing to meet quality objectives. In The Netherlands two monitoring networks (one for agriculture and one for nature) are operational, providing results which can be used for an overview. Two regression models, based upon simple conceptual models, link measured nitrate concentrations to data from remote sensing images of land use, national forest inventory, national cattle inventory, fertiliser use statistics, atmospheric N deposition, soil maps and weather monitoring. The models are used to draw a nitrate leaching map and to estimate the size of the area exceeding the EU limit value in the early 1990s. The 95% confidence interval for the fraction nature and agricultural areas where the EU limit value for nitrate (50 mg/l) was exceeded amounted to 0.77–0.85 while the lower 97.5% confidence limit for the fraction agricultural area where the EU limit value was exceeded amounted to 0.94. Although the two conceptual models can be regarded as simple, the use of the models to give an overview was experienced as complex

ifo Konjunkturprognose 2017/2018: Deutsche Wirtschaft stark und stabil

Der Aufschwung, in dem sich die deutsche Wirtschaft seit nunmehr 2013 befindet, gewinnt an Stärke und Breite. Das ifo Institut rechnet mit einem Zuwachs des realen Bruttoinlandsprodukts von 1,8% im laufenden und 2,0% im kommenden Jahr. Wie schon in den vergangenen Jahren wird die konjunkturelle Entwicklung von der weiter lebhaften Konsumnachfrage der privaten Haushalte und der regen Bautätigkeit bestimmt. Einen zunehmenden Beitrag zum Aufschwung werden die Exporte leisten

Primary vs. Secondary Antibody Deficiency: Clinical Features and Infection Outcomes of Immunoglobulin Replacement

<div><p>Secondary antibody deficiency can occur as a result of haematological malignancies or certain medications, but not much is known about the clinical and immunological features of this group of patients as a whole. Here we describe a cohort of 167 patients with primary or secondary antibody deficiencies on immunoglobulin (Ig)-replacement treatment. The demographics, causes of immunodeficiency, diagnostic delay, clinical and laboratory features, and infection frequency were analysed retrospectively. Chemotherapy for B cell lymphoma and the use of Rituximab, corticosteroids or immunosuppressive medications were the most common causes of secondary antibody deficiency in this cohort. There was no difference in diagnostic delay or bronchiectasis between primary and secondary antibody deficiency patients, and both groups experienced disorders associated with immune dysregulation. Secondary antibody deficiency patients had similar baseline levels of serum IgG, but higher IgM and IgA, and a higher frequency of switched memory B cells than primary antibody deficiency patients. Serious and non-serious infections before and after Ig-replacement were also compared in both groups. Although secondary antibody deficiency patients had more serious infections before initiation of Ig-replacement, treatment resulted in a significant reduction of serious and non-serious infections in both primary and secondary antibody deficiency patients. Patients with secondary antibody deficiency experience similar delays in diagnosis as primary antibody deficiency patients and can also benefit from immunoglobulin-replacement treatment.</p></div

The placebo response rate in pharmacological trials in patients with irritable bowel syndrome: a systematic review and meta-analysis

BackgroundClinical trials in irritable bowel syndrome are associated with high placebo response rates. We aimed to identify the magnitude of the placebo response and the contributing factors to this occurrence.MethodsWe did a systematic review and meta-analysis with a search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials between April 1, 1959, and April 30, 2020. We included all randomised controlled trials that compared an active pharmacotherapeutic agent with placebo and had a dichotomous outcome of response to therapy (in terms of global improvement or improvement in abdominal pain) in adults (aged ≥18 years) with irritable bowel syndrome. Exclusion criteria were trials reporting on treatment satisfaction as a dichotomous outcome of response to therapy or clinician-reported outcomes and a treatment duration of less than 4 weeks. Our main outcome was identification of the magnitude of the pooled placebo response rate for the following endpoints: global improvement, abdominal pain, and US Food and Drug Administration (FDA) endpoints. We extracted information from published reports and pooled proportions through meta-analysis with random effects. The study was registered with PROSPERO, CRD42020170908.FindingsOf the 6863 publications identified, 70 articles describing 73 randomised controlled trials were included in our analysis. The pooled placebo response rate was 27·3% (95% CI 24·3–30·9) using the global improvement endpoint, 34·4% (31·2–37·8) using the abdominal pain endpoint, and 17·9% (15·2–21·0) using the composite FDA endpoint responder definition, all with substantial heterogeneity between the trials. Studies published before 2006, and those done in Europe, with a parallel design, a run-in period of 2 weeks or less, a dose schedule of three times a day or more, or a smaller sample size of the control group were significantly associated with an increased pooled placebo response rate.InterpretationMore than a quarter of patients with irritable bowel syndrome had a placebo response in terms of global improvement, with multiple associated moderators. We recommend future trials apply a run-in period of at least 2 weeks and dose once or twice a day to minimise the placebo response rate

Stigmatisering binnen de ggz:Onderzoek onder cliënten en hulpverleners

Achtergrond: Mensen met ernstige psychische aandoeningen ervaren naast belemmeringen in het sociaal en maatschappelijk functioneren ook de negatieve gevolgen van vooroordelen en stigmatisering. Ook binnen de ggz, inclusief verslavingszorg, komt stigmatisering voor. Doel: Beschrijven van het vóórkomen en de uitingsvormen van stigmatisering door hulpverleners, vanuit het perspectief van cliënten en hulpverleners. Methode: Digitale enquêtes onder leden van het panel Psychisch Gezien (n = 628) en onder hulpverleners (n = 471). Resultaten: Meer dan de helft (54%) van de panelleden had in de afgelopen twee jaar te maken gehad met stigmatisering door ggz-hulpverleners. Zij ervoeren dit vooral door een afstandelijke houding (22%) en door het taalgebruik van hulpverleners (20%). Twee vijfde (40%) van de hulpverleners gaf aan dat stigmatisering regelmatig of vaak voorkwam bij het eigen team. Zowel cliënten als hulpverleners benadrukten het belang van normalisering van psychische problemen, terughoudend gebruik van psychiatrische labels en herstelgericht werken om stigma te verminderen. Conclusie: Stigmatisering door ggz-hulpverleners komt op veel manieren tot uiting, waardoor het een complex en niet-eenduidig probleem is. Hoewel er geen ‘one-size-fits-all’-oplossing is, is normalisering van psychische problemen een belangrijk aanknopingspunt

Functional MRI of Auditory Responses in the Zebra Finch Forebrain Reveals a Hierarchical Organisation Based on Signal Strength but Not Selectivity

BACKGROUND: Male songbirds learn their songs from an adult tutor when they are young. A network of brain nuclei known as the 'song system' is the likely neural substrate for sensorimotor learning and production of song, but the neural networks involved in processing the auditory feedback signals necessary for song learning and maintenance remain unknown. Determining which regions show preferential responsiveness to the bird's own song (BOS) is of great importance because neurons sensitive to self-generated vocalisations could mediate this auditory feedback process. Neurons in the song nuclei and in a secondary auditory area, the caudal medial mesopallium (CMM), show selective responses to the BOS. The aim of the present study is to investigate the emergence of BOS selectivity within the network of primary auditory sub-regions in the avian pallium. METHODS AND FINDINGS: Using blood oxygen level-dependent (BOLD) fMRI, we investigated neural responsiveness to natural and manipulated self-generated vocalisations and compared the selectivity for BOS and conspecific song in different sub-regions of the thalamo-recipient area Field L. Zebra finch males were exposed to conspecific song, BOS and to synthetic variations on BOS that differed in spectro-temporal and/or modulation phase structure. We found significant differences in the strength of BOLD responses between regions L2a, L2b and CMM, but no inter-stimuli differences within regions. In particular, we have shown that the overall signal strength to song and synthetic variations thereof was different within two sub-regions of Field L2: zone L2a was significantly more activated compared to the adjacent sub-region L2b. CONCLUSIONS: Based on our results we suggest that unlike nuclei in the song system, sub-regions in the primary auditory pallium do not show selectivity for the BOS, but appear to show different levels of activity with exposure to any sound according to their place in the auditory processing stream

Neural Processing of Short-Term Recurrence in Songbird Vocal Communication

BACKGROUND: Many situations involving animal communication are dominated by recurring, stereotyped signals. How do receivers optimally distinguish between frequently recurring signals and novel ones? Cortical auditory systems are known to be pre-attentively sensitive to short-term delivery statistics of artificial stimuli, but it is unknown if this phenomenon extends to the level of behaviorally relevant delivery patterns, such as those used during communication. METHODOLOGY/PRINCIPAL FINDINGS: We recorded and analyzed complete auditory scenes of spontaneously communicating zebra finch (Taeniopygia guttata) pairs over a week-long period, and show that they can produce tens of thousands of short-range contact calls per day. Individual calls recur at time scales (median interval 1.5 s) matching those at which mammalian sensory systems are sensitive to recent stimulus history. Next, we presented to anesthetized birds sequences of frequently recurring calls interspersed with rare ones, and recorded, in parallel, action and local field potential responses in the medio-caudal auditory forebrain at 32 unique sites. Variation in call recurrence rate over natural ranges leads to widespread and significant modulation in strength of neural responses. Such modulation is highly call-specific in secondary auditory areas, but not in the main thalamo-recipient, primary auditory area. CONCLUSIONS/SIGNIFICANCE: Our results support the hypothesis that pre-attentive neural sensitivity to short-term stimulus recurrence is involved in the analysis of auditory scenes at the level of delivery patterns of meaningful sounds. This may enable birds to efficiently and automatically distinguish frequently recurring vocalizations from other events in their auditory scene

Distinct in vitro binding properties of the anti-CD20 small modular immunopharmaceutical 2LM20-4 result in profound and sustained in vivo potency in cynomolgus monkeys

Objectives. To characterize the in vitro binding and effector function properties of CD20-directed small modular immunopharmaceutical (SMIP) 2LM20-4, and to compare its in vivo B-cell depletion activity with the mutated 2LM20-4 P331S [no in vitro complement-dependent cytotoxicity (CDC)] and rituximab in cynomolgus monkeys

Cross-national variations in reported discrimination among people treated for major depression worldwide: The ASPEN/INDIGO international study

Background: No study has so far explored differences in discrimination reported by people with major depressive disorder (MDD) across countries and cultures. Aims: To (a) compare reported discrimination across different countries, and (b) explore the relative weight of individual and contextual factors in explaining levels of reported discrimination in people with MDD. Method: Cross-sectional multisite international survey (34 countries worldwide) of 1082 people with MDD. Experienced and anticipated discrimination were assessed by the Discrimination and Stigma Scale (DISC). Countries were classified according to their rating on the Human Development Index (HDI). Multilevel negative binomial and Poisson models were used. Results: People living in 'very high HDI' countries reported higher discrimination than those in 'medium/low HDI' countries. Variation in reported discrimination across countries was only partially explained by individual-level variables. The contribution of country-level variables was significant for anticipated discrimination only. Conclusions: Contextual factors play an important role in anticipated discrimination. Country-specific interventions should be implemented to prevent discrimination towards people with MDD