Disparity between General Symptom Relief and Remission Criteria in the Positive and Negative Syndrome Scale (PANSS): A Post-treatment Bifactor Item Response Theory Model.

Objective: Total scale scores derived by summing ratings from the 30-item PANSS are commonly used in clinical trial research to measure overall symptom severity, and percentage reductions in the total scores are sometimes used to document the efficacy of treatment. Acknowledging that some patients may have substantial changes in PANSS total scores but still be sufficiently symptomatic to warrant diagnosis, ratings on a subset of 8 items, referred to here as the "Remission set," are sometimes used to determine if patients' symptoms no longer satisfy diagnostic criteria. An unanswered question remains: is the goal of treatment better conceptualized as reduction in overall symptom severity, or reduction in symptoms below the threshold for diagnosis? We evaluated the psychometric properties of PANSS total scores, to assess whether having low symptom severity post-treatment is equivalent to attaining Remission. Design: We applied a bifactor item response theory (IRT) model to post-treatment PANSS ratings of 3,647 subjects diagnosed with schizophrenia assessed at the termination of 11 clinical trials. The bifactor model specified one general dimension to reflect overall symptom severity, and five domain-specific dimensions. We assessed how PANSS item discrimination and information parameters varied across the range of overall symptom severity (θ), with a special focus on low levels of symptoms (i.e., θ<-1), which we refer to as "Relief" from symptoms. A score of θ=-1 corresponds to an expected PANSS item score of 1.83, a rating between "Absent" and "Minimal" for a PANSS symptom. Results: The application of the bifactor IRT model revealed: (1) 88% of total score variation was attributable to variation in general symptom severity, and only 8% reflected secondary domain factors. This implies that a general factor may provide a good indicator of symptom severity, and that interpretation is not overly complicated by multidimensionality; (2) Post-treatment, 534 individuals (about 15% of the whole sample) scored in the "Relief" range of general symptom severity, but more than twice that number (n = 1351) satisfied Remission criteria (37%). 2 in 3 Remitted patients had scores that were not in a low symptom range (corresponding to Absent or Minimal item scores); (3) PANSS items vary greatly in their ability to measure the general symptom severity dimension; while many items are highly discriminating and relatively "pure" indicators of general symptom severity (delusions, conceptual disorganization), others are better indicators of specific dimensions (blunted affect, depression). The utility of a given PANSS item for assessing a patient depended on the illness level of the patient. Conclusion: Satisfying conventional Remission criteria was not strongly associated with low levels of symptoms. The items providing the most information for patients in the symptom Relief range were Delusions, Preoccupation, Suspiciousness Persecution, Unusual Thought Content, Conceptual Disorganization, Stereotyped Thinking, Active Social Avoidance, and Lack of Judgment and Insight. Lower scores on these items (item scores ≤2) were strongly associated with having a low latent trait θ or experiencing overall symptom relief. The inter-rater agreement between Remission and Relief subjects suggested that these criteria identified different subsets of patients. Alternative subsets of items may offer better indicators of general symptom severity and provide better discrimination (and lower standard errors) for scaling individuals and judging symptom relief, where the "best" subset of items ultimately depends on the illness range and treatment phase being evaluated

Psychometric precision in phenotype definition is a useful step in molecular genetic investigation of psychiatric disorders

Affective disorders are highly heritable, but few genetic risk variants have been consistently replicated in molecular genetic association studies. The common method of defining psychiatric phenotypes in molecular genetic research is either a summation of symptom scores or binary threshold score representing the risk of diagnosis. Psychometric latent variable methods can improve the precision of psychiatric phenotypes, especially when the data structure is not straightforward. Using data from the British 1946 birth cohort, we compared summary scores with psychometric modeling based on the General Health Questionnaire (GHQ-28) scale for affective symptoms in an association analysis of 27 candidate genes (249 single-nucleotide polymorphisms (SNPs)). The psychometric method utilized a bi-factor model that partitioned the phenotype variances into five orthogonal latent variable factors, in accordance with the multidimensional data structure of the GHQ-28 involving somatic, social, anxiety and depression domains. Results showed that, compared with the summation approach, the affective symptoms defined by the bi-factor psychometric model had a higher number of associated SNPs of larger effect sizes. These results suggest that psychometrically defined mental health phenotypes can reflect the dimensions of complex phenotypes better than summation scores, and therefore offer a useful approach in genetic association investigations

Spread of the invasive shell-boring annelid Polydora websteri (Polychaeta, Spionidae) into naturalised oyster reefs in the European Wadden Sea

With globally growing aquaculture activities, the co-introduction of parasites alongside large-scale movements of commercial species poses an increasing risk for marine ecosystems. Here, we present the first record of the shell-boring polychaete Polydora websteri Hartman in Loosanoff and Engle, 1943 in invasive Pacific oysters Crassostrea (Magallana) gigas (Thunberg, 1793) in the European Atlantic Ocean. In October 2014, mud blisters in the shells of wild Pacific oysters and specimens of a spionid polychaete were observed in close proximity to a commercial oyster farm at the island of Sylt (Germany) in the European Wadden Sea. Subsequent investigations indicated that these blisters only occurred near the farm and that no other mollusc species were affected. Morphological and molecular analysis identified the polychaete as Polydora websteri, a species that nowadays widely occurs around the globe, but likely is native to the Asian Pacific. Later sampling activities detected P. websteri also at other locations around Sylt as well as in the Dutch part of the Wadden Sea at the island of Texel. The number of polychaetes in the oysters was, however, relatively low and mostly below 10 individuals per oyster. Together, this evidence suggests that P. websteri is currently extending its range. As the introduction of P. websteri may have severe ecological and economic implications, this study aims to alert others to look for P. websteri at Western European coasts within farmed or wild Pacific oysters to further document its spread

Mangal communities of the "Salgado Paraense": Ecological heterogeneity along the Bragança peninsula assessed through soil and leaf analyses

Mangroves in the Bragança peninsula occur in a variety of environmental settings differing in tidal influence and fresh water run-off. The construction of a paved road running through the middle of the peninsula modified the transversal flow of water. Five sites were sampled along this road: I. Coastal site near the village of Ajuruteua, II. Tidal creeks flowing into the lower Caeté river, III. Central lagoons, IV. Avicennia basin forest, and V. Upper Caeté estuary near the village of Acarajó. All but site III, harbored the three common mangroves species Rhizophora mangle, Laguncularia racemosa and Avicennia germinans. Monospecific communities of shrub-like Avicennia germinans stands characterized site III. Soils were highly organic therefore bulk density was inversely correlated to the concentrations of C and N. Sites I and V had the lowest salinity values. The highest salinity was measured ii the Avicennia dominated sites III and IV. Nitrogen showed similar values in all sites, but S was clearly more abundant in sites II and V. Leaf dimensions varied significantly between sites. Considering leaf area expansion as indicator ofstress and δ 13C values as indicator of water use efficiency, site V was more favorable for Rhizophora and Laguncularia while site IV was so for Avicennia. Leaf shape measured as the length/width ratio was more variable in Avicennia and least variable in Rhizophora. Leaf nutrients were not correlated with soil nutrient content. Sodium and Mg were more concentrated in Avicennia leaves while Fe was more concentrated in Laguncularia and Mn in Rhizophora leaves. Avicennia showed the highest N and the lowest Ca concentrations as expected for being a glycinbetaine accumulator and an oxalate-former. δ 15N values indicate that N source for mangroves is essentially the mineralization of organic matter

Deroceras panormitanum and congeners from Malta and Sicily, with a redescription of the widespread pest slug as Deroceras invadens n. sp.

The name Deroceras panormitanum is generally applied to a terrestrial slug that has spread worldwide and can be a pest; earlier this tramp species had been called Deroceras caruanae. Neither name is appropriate. The taxonomic descriptions apply to a species from Sicily and Malta. This true D. panormitanum and the tramp species are distinct in morphology and mating behaviour. For instance, the penial caecum of D. panormitanum is more pointed, everting faster at copulation. The size of the penial lobe varies considerably in preserved specimens but is always prominent at copulation. D. panormitanum is distinct from the Maltese endemic Deroceras golcheri, but a phylogeny based on mtDNA COI sequences implies that they are more closely related than is the tramp species. D. golcheri has a still closer counterpart on Sicily, but we leave the taxonomy of this species X unresolved. In interspecific crosses, D. panormitanum may transfer sperm to the partner's sarcobelum whereas the partner fails to evert its penis (D. golcheri) or to transfer sperm (the tramp species). Names previously applied to the tramp species originally referred to D. panormitanum or are otherwise invalid, so it is here formally redescribed as D. invadens. Deroceras giustianum Wiktor, 1998 is synonymised with D. panormitanum

Evaluating psychometric properties of the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) in a clinical sample of children seeking treatment for obesity: a case for the unidimensional model.

BackgroundThe Emotional Eating Scale - Adapted for Children and Adolescents (EES-C) assesses children's urge to eat in response to experiences of negative affect. Prior psychometric studies have demonstrated the high reliability, concurrent validity, and test-retest reliability of theoretically defined subconstructs among non-clinical samples of children and adolescents who were primarily healthy weight; however, no psychometric studies exist investigating the EES-C among clinical samples of children with overweight/obesity (OW/OB). Furthermore, studies conducted in different contexts have suggested a discordant number of subconstructs of emotions related to eating. The purpose of this study was to evaluate the validity of the EES-C in a clinical sample of children seeking weight-loss treatment.MethodUsing a hierarchical bi-factor approach, we evaluated the validity of the EES-C to measure a single general construct, a set of two separate correlated subconstructs, or a hierarchical arrangement of two constructs, and determined reliability in a clinical sample of treatment-seeking children with OW/OB aged 8-12 years (N = 147, mean age = 10.4 years.; mean BMI z = 2.0; female = 66%; Hispanic = 32%, White and other = 68%).ResultsComparison of factor-extraction methods suggested a single primary construct underlying EES-C in this clinical sample. The bi-factor indices provided clear evidence that most of the reliable variance in the total score (90.8 for bi-factor model with three grouping factors and 95.2 for bi-factor model with five grouping factors) was attributed to the general construct. After adjusting for relationships with the primary construct, remaining correlations among sets of items did not suggest additional reliable constructs.ConclusionResults suggest that the primary interpretive emphasis of the EES-C among treatment-seeking children with overweight or obesity should be placed on a single general construct, not on the 3- or 5- subconstructs as was previously suggested

Flagging greens: hydrobiid snails as substrata for the development of green algal mats (Enteromorpha spp.) on tidal flats of North Atlantic coasts

During the past 3 decades, dense mats of green algae (especially Enteromorpha spp.) have been recorded regularly from tidal flats worldwide. The development of green algal mats on tidal flats may be initiated by overwintering and regrowth of adult plants or by the formation and release of small propagules, i.e. vegetative fragments, zoospores and zygotes. On soft sediments, macroinvertebrates may constitute prime substrata for germination of algal spores. Hydrobud (mud-) snails are widespread along North Atlantic soft sediment shores and were identified previously as important substrata for Enteromorpha spp. germlings in 1 of our study areas. To test the generality of this phenomenon, we investigated the presence of Enteromorpha spp. gerrnlings attached to hydrobud snails from November 1995 to December 1996 on 6 tidal flats of North Atlantic coasts (Tralebergslule, Sweden; Konigshafen Bay, Germany; Mondego Estuary, Portugal; Ria Formosa, Portugal; Cole Harbour, Nova Scotia, Canada; Lowes Cove, Maine, USA). With 1 exception, hydrobiid snails were present in all areas studied, and intensive growth of Enteromorpha spp. occurred during summer. Throughout winter 1995/96, hardly any Enteromorpha spp. gerrnlings were found on snail shells, but over the following months germlings developed on up to 60% of the hydrobiid snails present. In 2 areas (Konigshafen, Germany; Lowes Cove, USA), germhng abundance on hydrobuds began to rise before the peak of green algal mat development. In Tralebergskile, Sweden, high mat abundance occurred simultaneous to and after increased germling abundance on Hydrobia ulvae. Densities of snails were very low, however, and hydrobuds appeared to be unimportant as substratum. No clear temporal pattern between high germling abundance on snails followed by mat development was found in the other 3 study areas (Ria Formosa, Portugal; Mondego Estuary, Portugal; Cole Harbour, Canada). In Lowes Cove, USA, gerrnlings and juveniles of Enteromorpha spp. first grew at the site with high Hydrobia abundance and were subsequently drifted to another site where they developed into full mats. We conclude that initiation of green algal mats by germination on Hydrobia spp. may be a general phenomenon, but that other modes of development also occur frequently. Pelagic dnft of overwintering thalli to new sites, followed by prolific growth, might be of similar or greater importance

In vivo performance of chitosan/soy-based membranes as wound dressing devices for acute skin wounds

Wound management represents a major clinical challenge on what concerns healing enhancement and pain control. The selection of an appropriate dressing plays an important role in both recovery and esthetic ap- pearance of the regenerated tissue. Despite the wide range of available dressings, the progress in the wound care market relies on the increasing interest in using natural-based biomedical products. Herein, a rat wound- dressing model of partial-thickness skin wounds was used to study newly developed chitosan/soy (cht/soy)- based membranes as wound-dressing materials. Healing and repair of nondressed, cht/soy membrane-dressed, and Epigard -dressed wounds were followed macroscopically and histologically for 1 and 2 weeks. cht/soy membranes performed better than the controls, promoting a faster wound repair. Re-epithelialization, ob- served 1 week after wounding, was followed by cornification of the outermost epidermal layer at the second week of dressing, indicating repair of the wounded tissue. The use of this rodent model, although in impaired healing conditions, may enclose some drawbacks regarding the inevitable wound contraction. Moreover, being the main purpose the evaluation of cht/soy-based membranes’ performance in the absence of growth factors, the choice of a clinically relevant positive control was limited to a polymeric mesh, without any growth factor influencing skin healing/repair, Epigard. These new cht/soy membranes possess the desired features regarding healing/repair stimulation, ease of handling, and final esthetic appearance-thus, valuable prop- erties for wound dressings.The author Tircia C. Santos acknowledges the Portuguese Foundation for Science and Technology (FCT) for her PhD grant (SFRH/BD/40861/2007). This work was developed under the scope of the European Network of Excellence EXPERTISSUES (NMP3-CT-2004-5000283)