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ABSTRACTIntroductionAsthma is a common disease with a global burden of 358 million patients. Despite improvements in pharmacological and non-pharmacological treatments, many patients still do not achieve complete asthma control. Therefore, innovative pharmacotherapy is important.Areas coveredFollowing a semi-structured search in Pubmed, an overview of advances in inhaled asthma therapy is provided, looking at innovations in digital inhalers, eco-friendly inhalers and novel inhaled biologic therapies, antibiotics and vaccines, as well as other potential novel asthma therapy targets.Expert opinionDigital inhalers, sending reminders and monitoring inhalation technique electronically, can support medication adherence and improve asthma control. To reduce the global warming potential of traditional aerosols used in pressurized metered-dose inhalers (HFA-134a, HFA-227ea), greener alternatives are under development (HFA-152a, HFO-1234ze) that are expected to be available by 2025. Current pharmacological advances in asthma therapy are mainly achieved by novel biologicals (anti-IgE, anti-IL5, anti-IL4/13, and anti-TSLP) targeting specific severe asthma phenotypes. While injection is the usual administration route for biologics and vaccines used in asthma, inhalation is an option being explored, although several (mainly formulation) challenges need to be overcome. Other potential novel future inhaled asthma therapies include anti-IL-33/ST2 biologicals and JAK inhibitors, all still requiring more clinical evidence.

Simulation of unsteady flow of SF6gas in a simplified high-voltage circuit breaker model describing the nozzle, contacts and their nearest surrounding is presented. SF6is considered as viscous, compressible, real gas described by Redlich-Kwong model. Heat transfer is taken into account due to the gas compressibility. The heat source, triggered by the electric arc between the contacts, was out of the scope of the current research, thus it was not included in the simulations presented. Turbulence, caused by the gas viscosity, is described using realizable k-εmodel. In the simulation model, one of the contact sides – electrodes, is considered as moving at prescribed velocity. The part of the space ‘swept’ by the moving electrode is considered as the gas with imposed artificially increased viscosity in order to imitate the rigid body behaviour. Thus, no moving parts of the computational mesh are used in the model. The conservation equations of mass, momentum and energy, given in integral form, are solved using a finite-volume method on unstructured computational grids.

Settlement of unintended deviation between scheduled and realized energy exchange among LFC (Load Frequency Control) areas used to be conducted through the energy compensation programs, where energy deviation from period of registration is compensated at a later stage period of compensation of unintended deviation. With the adoption of the Synchronous Area Framework Agreement (SAFA), the Regional Group for Continental Europe the methodology of accounting and financial settlement of unintended deviations FSKAR (Financial settlement k?f, ACE and ramping period) is defined. The FSKAR methodology defines necessary data for the calculation and determination of unintended deviation. The methodology defines the method of determining settlement prices. The paper describes the methodology of determining settlement prices, the method of data collection and validation, the method of calculation of deviations and other energy and financial quantities, and data exchange between entities.

The goal of this project was to create an up‐to‐date joint European clinical practice guideline for the diagnosis and treatment of faecal incontinence (FI), using the best available evidence. These guidelines are intended to help guide all medical professionals treating adult patients with FI (e.g., general practitioners, surgeons, gastroenterologists, other healthcare workers) and any patients who are interested in information regarding the diagnosis and management of FI. These guidelines have been created in cooperation with members from the United European Gastroenterology (UEG), European Society of Coloproctology (ESCP), European Society of Neurogastroenterology and Motility (ESNM) and the European Society for Primary Care Gastroenterology (ESPCG). These members made up the guideline development group (GDG). Additionally, a patient advisory board (PAB) was created to reflect and comment on the draft guidelines from a patient perspective. Relevant review questions were established by the GDG along with a set of outcomes most important for decision making. A systematic literature search was performed using these review questions and outcomes as a framework. For each predefined review question, the study or studies with the highest level of study design were included. If evidence of a higher‐level study design was available, no lower level of evidence was sought or included. Data from the studies were extracted by two reviewers for each predefined important outcome within each review question. Where possible, forest plots were created. After summarising the results for each review question, a systematic quality assessment using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach was performed. For each review question, we assessed the quality of evidence for every predetermined important outcome. After evidence review and quality assessment were completed, recommendations could be formulated. The wording used for each recommendation was dependent on the level of quality of evidence. Lower levels of evidence resulted in weaker recommendations and higher levels of evidence resulted in stronger recommendations. Recommendations were discussed within the GDG to reach consensus. These guidelines contain 45 recommendations on the classification, diagnosis and management of FI in adult patients. These multidisciplinary European guidelines provide an up‐to‐date comprehensive evidence‐based framework with recommendations on the diagnosis and management of adult patients who suffer from FI.

Introduction: Portfolio use to support self-regulated learning (SRL) during clinical workplace learning is widespread, but much is still unknown regarding its effectiveness. This review aimed to gain insight in the extent to which portfolio use supports SRL and under what circumstances. Methods: A realist review was conducted in two phases. First, stakeholder interviews and a scoping search were used to formulate a program theory that explains how portfolio use could support SRL. Second, an in-depth literature search was conducted. The included papers were coded to extract context–mechanism–outcome configurations (CMOs). These were synthesized to answer the research question. Results: Sixteen papers were included (four fulfilled all qualitative rigor criteria). Two primary portfolio mechanisms were established: documenting as a moment of contemplation (learners analyze experiences while writing portfolio reports) and documentation as a reminder of past events (previous portfolio reports aid recall). These mechanisms may explain the positive relationship between portfolio use and self-assessment, reflection, and feedback. However, other SRL outcomes were only supported to a limited extent: formulation of learning objectives and plans, and monitoring. The partial support of the program theory can be explained by interference of contextual factors (e.g., system of assessment) and portfolio-related mechanisms (e.g., mentoring). Discussion: Portfolio research is falling short both theoretically—in defining and conceptualizing SRL—and methodologically. Nevertheless, this review indicates that portfolio use has potential to support SRL. However, the working mechanisms of portfolio use are easily disrupted. These disruptions seem to relate to tensions between different portfolio purposes, which may undermine learners’ motivation.

Introduction: For several decades, educational experts have promoted reflection as essential to professional development. In the medical setting, collaborative reflection has gained significant importance across the curriculum. Collaborative reflection has a unique edge over individual reflection, but many medical teachers find facilitating group reflection sessions challenging and there is little documentation about the didactics of teaching in such collaborative reflection settings. To address this knowledge gap, we aim to capture the professional knowledge base for facilitating collaborative reflection by analyzing the formal and perceived goals and strategies of this practice. Methods: The professional knowledge base consists of formal curricular materials as well as individual teacher expertise. Using Template Analysis, we analyzed the goals and strategies of collaborative reflection reported in institutional training documents and video-stimulated interviews with individual teachers across all Dutch general practitioner training institutes. Results: The analysis resulted in a highly diverse overview of educational goals for residents during the sessions, teacher goals that contribute to those educational goals, and a myriad of situation-specific teacher strategies to accomplish both types of goals. Teachers reported that the main educational goal was for residents to learn and develop and that the teachers’ main goal was to facilitate learning and development by ensuring everyone’s participation in reflection. Key teacher strategies to that end were to manage participation, to ensure a safe learning environment, and to create conditions for learning. Discussion: The variety of strategies and goals that constitute the professional knowledge base for facilitating collaborative reflection in postgraduate medical education shows how diverse and situation-dependent such facilitation can be. Our analysis identifies a repertoire of tools that both novice and experienced teachers can use to develop their professional skill in facilitating collaborative reflection.

Functional dyspepsia (FD) is one of the most common conditions in clinical practice. In spite of its prevalence, FD is associated with major uncertainties in terms of its definition, underlying pathophysiology, diagnosis, treatment, and prognosis. A Delphi consensus was initiated with 41 experts from 22 European countries who conducted a literature summary and voting process on 87 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 36 statements. The panel agreed with the definition in terms of its cardinal symptoms (early satiation, postprandial fullness, epigastric pain, and epigastric burning), its subdivision into epigastric pain syndrome and postprandial distress syndrome, and the presence of accessory symptoms (upper abdominal bloating, nausea, belching), and overlapping conditions. Also, well accepted are the female predominance of FD, its impact on quality of life and health costs, and acute gastrointestinal infections, and anxiety as risk factors. In terms of pathophysiological mechanisms, the consensus supports a role for impaired gastric accommodation, delayed gastric emptying, hypersensitivity to gastric distention, Helicobacter pyloriinfection, and altered central processing of signals from the gastroduodenal region. There is consensus that endoscopy is mandatory for establishing a firm diagnosis of FD, but that in primary care, patients without alarm symptoms or risk factors can be managed without endoscopy. There is consensus that H. pyloristatus should be determined in every patient with dyspeptic symptoms and H. pyloripositive patients should receive eradication therapy. Also, proton pump inhibitor therapy is considered an effective therapy for FD, but no other treatment approach reached a consensus. The long‐term prognosis and life expectancy are favorable. A multinational group of European experts summarized the current state of consensus on the definition, diagnosis and management of FD. Current knowledge Functional dyspepsia is one of the most common conditions encountered in clinical practice.There is a lack of guidance for clinicians in guiding diagnosis and treatment of this prevalent condition.No treatments are currently approved for the treatment of functional dyspepsia in Europe. Functional dyspepsia is one of the most common conditions encountered in clinical practice. There is a lack of guidance for clinicians in guiding diagnosis and treatment of this prevalent condition. No treatments are currently approved for the treatment of functional dyspepsia in Europe. What is new here A Delphi panel consisting of 41 experts from 22 European countries established the level of consensus on 87 statements regarding functional dyspepsia.The statements reaching consensus serve to guide clinicians in recognizing, diagnosing and treating FD in clinical practice.Endoscopy is mandatory for establishing a firm diagnosis of functional dyspepsia D, but in primary care patients without alarm symptoms or risk factors can be managed without endoscopy.Helicobacter pyloristatus should be determined in every patient with dyspeptic symptoms and H. Pyloripositive patients should receive eradication therapy.Proton pump inhibitor‐therapy is considered an effective therapy for FD, but no other treatment approach reached consensus support. A Delphi panel consisting of 41 experts from 22 European countries established the level of consensus on 87 statements regarding functional dyspepsia. The statements reaching consensus serve to guide clinicians in recognizing, diagnosing and treating FD in clinical practice. Endoscopy is mandatory for establishing a firm diagnosis of functional dyspepsia D, but in primary care patients without alarm symptoms or risk factors can be managed without endoscopy. Helicobacter pyloristatus should be determined in every patient with dyspeptic symptoms and H. Pyloripositive patients should receive eradication therapy. Proton pump inhibitor‐therapy is considered an effective therapy for FD, but no other treatment approach reached consensus support.

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Background An efficient diagnostic pathway and early stage diagnosis for cancer patients is widely pursued. This study aims to chart the duration of the diagnostic pathway for patients with symptomatic oesophageal and gastric cancer, to identify factors associated with long duration and to assess the association of duration with tumour stage at diagnosis.Methods This was a retrospective cohort study, using electronic health records of six routine primary care databases covering about 640,000 patients, partly linked to the Netherlands Cancer Registry. Symptomatic patients with oesophageal and gastric cancer (2010–2015) that presented in primary care were included. Duration of four diagnostic intervals was determined: patient interval; first symptoms to primary care consultation, primary care interval; consultation to referral, secondary care interval; referral to diagnosis, and the diagnostic interval; consultation to diagnosis. Characteristics associated with ‘long duration’ (≥P75 duration) were assessed using log-binomial regression. Median durations were stratified for tumour stages.Results Among 312 symptomatic patients with upper gastrointestinal cancer, median durations were: patient interval: 29 days (interquartile interval 15–73), primary care interval: 12 days (interquartile interval 1–43), secondary care interval: 13 days (interquartile interval 6–29) and diagnostic interval: 31 days (11–74). Patient interval duration was comparable for patients with and without alarm symptoms. Absence of cancer-specific alarm symptoms was associated with ‘long duration’ of primary care interval and secondary care interval: relative risk 5.0 (95% confidence interval 2.7–9.1) and 2.1 (95% confidence interval 1.3–3.7), respectively. Median diagnostic interval duration for local stage disease was 51 days (interquartile interval 13–135) versus 27 days (interquartile interval 11–71) for advanced stage (p= 0.07).Conclusion In the diagnostic pathway of upper gastrointestinal cancers, the longest interval is the patient interval. Reducing time to diagnosis may be achieved by improving patients’ awareness of alarm symptoms and by diagnostic strategies which better identify cancer patients despite low suspicion.

An efficient diagnostic pathway and early stage diagnosis for cancer patients is widely pursued. This study aims to chart the duration of the diagnostic pathway for patients with symptomatic oesophageal and gastric cancer, to identify factors associated with long duration and to assess the association of duration with tumour stage at diagnosis. This was a retrospective cohort study, using electronic health records of six routine primary care databases covering about 640,000 patients, partly linked to the Netherlands Cancer Registry. Symptomatic patients with oesophageal and gastric cancer (2010–2015) that presented in primary care were included. Duration of four diagnostic intervals was determined: patient interval; first symptoms to primary care consultation, primary care interval; consultation to referral, secondary care interval; referral to diagnosis, and the diagnostic interval; consultation to diagnosis. Characteristics associated with ‘long duration’ (=P75 duration) were assessed using log-binomial regression. Median durations were stratified for tumour stages. Among 312 symptomatic patients with upper gastrointestinal cancer, median durations were: patient interval: 29 days (interquartile interval 15–73), primary care interval: 12 days (interquartile interval 1–43), secondary care interval: 13 days (interquartile interval 6–29) and diagnostic interval: 31 days (11–74). Patient interval duration was comparable for patients with and without alarm symptoms. Absence of cancer-specific alarm symptoms was associated with ‘long duration’ of primary care interval and secondary care interval: relative risk 5.0 (95% confidence interval 2.7–9.1) and 2.1 (95% confidence interval 1.3–3.7), respectively. Median diagnostic interval duration for local stage disease was 51 days (interquartile interval 13–135) versus 27 days (interquartile interval 11–71) for advanced stage (p?=?0.07). In the diagnostic pathway of upper gastrointestinal cancers, the longest interval is the patient interval. Reducing time to diagnosis may be achieved by improving patients’ awareness of alarm symptoms and by diagnostic strategies which better identify cancer patients despite low suspicion.

The majority of past studies assessed the impact of oil price on stock returns using aggregate stock price index from different countries and assuming the effects to be symmetric. In this paper, we investigate asymmetric causality not only from oil price to stock returns but also from stock returns to oil price. To reduce aggregation bias, we use data from nine different sectors of the U.S. economy. We found that an increase in oil price causes returns of three sectors, while a decrease in oil price causes returns of four sectors, all in the short run. On the other hand, we found that an increase in returns in three sectors causes oil price to rise, while a decrease in returns in six sectors causes oil price to decline. We do not discover significant long-run causal relationship in either direction.

Children are often viewed as poor eyewitnesses. Fact-finders, lawyers, and researchers assume that children are exceptionally prone to accept external suggestive (leading) questions and to create false memories. Is this assumption justified? This review will show it is not. First, studies on spontaneous false memories—elicited without any suggestive pressure—reveal that children are less likely than adults to produce them. Second, under certain circumstances, children are even less prone to accept external suggestions than adults. This counterintuitive finding happens when false suggestions contain information that is associatively related but in actuality not experienced by children or adults. Using empirically based interview protocols can maximize the retrieval of accurate memories in children and adults. Furthermore, expert witnesses should use alternative scenarios to better evaluate whether statements by children or adults are based on truth or fiction.

We recently made the case that associative activation is a viable mechanism underlying false memory formation and hence also false memory formation in psychopathology. In a recent issue of Clinical Psychological Science, Tryon argued that our description of associative activation did not meet the criteria of causation and explanatory value in order to qualify as a mechanism. In this commentary, we explain why we disagree with Tryon. Many studies focused on associative activation and false memory creation. We believe that these studies provide good arguments for associative activation as a likely causal antecedent in the production of false memories.

We analyze the downlink of a massive multiuser multiple input, multiple output (MIMO) system where antenna units at the base station are connected in a daisy chain without a central processing unit and only possess local channel knowledge. For this setup, we develop and analyze a linear precoding algorithm for suppressing interuser interference. It is demonstrated that the algorithm is close to zero-forcing precoding in terms of performance for a large number of antennas. Moreover, we show that with careful scheduling of processing across antennas, requirements for interconnection throughput are reduced compared with the fully centralized solution. Favorable tradeoff between performance and interconnection throughput makes the daisy chain a viable candidate topology for real-life implementations of base stations in MIMO systems where the number of antennas is very large.

In clinical and court settings, it is imperative to know whether posttraumatic stress disorder (PTSD) and depression may make people susceptible to false memories. We conducted a review of the literature on false memory effects in participants with PTSD, a history of trauma, or depression. When emotional associative material was presented to these groups, their levels of false memory were raised relative to those in relevant comparison groups. This difference did not consistently emerge when neutral or nonassociative material was presented. Our conclusion is supported by a quantitative comparison of effect sizes between studies using emotional associative or neutral, nonassociative material. Our review suggests that individuals with PTSD, a history of trauma, or depression are at risk for producing false memories when they are exposed to information that is related to their knowledge base.

Dans les lettres dites « du voyant », Rimbaud se donne comme tâche de « trouver une langue » engageant une réflexion sur ce qu'est la langue de création qui s'accompagne dans sa poésie d'une interrogation sur la qualité du matériau poétique qu'est le langage et sur sa forme: celle de la prose. Trouver une langue pour faire de la poésie c'est trouver la forme d'une parole polyphonique et presque polyglotte. Le « je est un autre » de Rimbaud résonne avec la formule de Derrida « Je n'ai qu'une langue mais ce n'est pas la mienne » pour la transformer en: « Je n'est qu'une langue, mais ce n'est pas moi. » La poésie rimbaldienne se définit comme un projet où le je est à la fois multiple et potentiel pour devenir ce « lieu mixte » dont parle Kristin Ross et mettre au point ce que nous appellerons une éthique de la traduction.

Resident loved ones of patients with COPD can play an important role in helping these patients engage in physical activity. We aimed to compare activity levels and exercise motivation between patients with COPD and their resident loved ones; to compare the same outcome measures in patients after stratification for the physical activity level of the loved ones; and to predict the likelihood of being physically active in patients with a physically active resident loved one.

L’infiltration des eaux pluviales urbaines dans les nappes est une technique alternative au système traditionnel d’assainissement largement utilisée dans l’Est lyonnais. Les eaux infiltrées conduisent à l’accumulation dans les premiers centimètres du sol de matière organique, de polluants organiques et minéraux et de micro-organismes. Ce papier présente les différents travaux menés pour mieux comprendre le rôle du compartiment microbien de cette surface sur le devenir des métaux piégés à la surface et le risque de leur migration dans la nappe souterraine. Une approche sur métal et bactérie modèles a permis de mettre en évidence une forte capacité d’adsorption des cations métalliques par la bactérie, adsorption qui peut conduire au transfert de ce métal via le transport biocolloïdal. Des études sur milieu réels multicontaminés montre que les bactéries présentes en grands nombres dans ces milieux pollués sont adaptées à ce stress chimique et sont potentiellement très actives.

Context and Objective:Moderate-to-vigorous physical activity (MVPA) and physical fitness (PF) are positively associated with glucose tolerance. Such associations may be partly conditioned by microvascular function, which is a common correlate to MVPA, PF, and glucose tolerance. To test this hypothesis, the present study sought to investigate independent associations of MVPA and PF with glucose tolerance and to what extent these associations are mediated by microvascular function.Design, Setting, Participants, and Outcome Measures:Data from The Maastricht Study were used (n = 512 for MVPA and n = 488 for PF analyses; mean age, 59 [SD = 9] y, 52 % men). Glucose tolerance was assessed by 2-hour postload plasma glucose levels (2hPG). The total number of weekly hours of MVPA was estimated with the Community Healthy Activities Model Program for Seniors questionnaire. Walking speed during the 6-minute walk test was used to evaluate PF. Microvascular function was determined by postocclusive capillary recruitment and flowmotion with capillaroscopy and laser Doppler flowmetry in skin microcirculation.Results:In univariate analyses, MVPA, PF, and microvascular function variables were associated with 2hPG. MVPA (n = 512, β = −0.056, P= .019) and PF (n = 488, β = −0.368, P= .006) remained associated with 2hPG after adjustment for established cardio-metabolic risk factors and history of cardiovascular disease; addition of microvascular function variables as potential mediators did not materially change the associations of MVPA (β = −0.054, P= .024) and PF (β = −0.364, P= .006) with 2hPG. No mediation effects of microvascular function variables were detected.Conclusions:MVPA and PF were independently associated with 2hPG, irrespective of established risk factors and generalized microvascular function. The possibility that specific microvascular functions, eg, insulin-mediated vasodilation, influence the association of MVPA and PF with 2hPG needs further investigation.

This study examines the ability of nanozeolite-geopolyme ras adsorbent material for motor vehicle emissions. There were three samples that have been synthesized by varying metakaolin and rice husk ash masses. Nanozeolite-geopolymer samples were synthesized through geopolymerization method at 70°C by mixing metakaolin with rice husk ash and activated with NaOH solution. Samples were recurring at 200°C to improve the crystalline level. Based on the XRD characterization of the three samples, two of them contain zeolite X, namely ZG_A (100% metakaolin, ASP 0%) and ZG_B (metakaolin: ASP, 2: 1). However, zeolite X phase most conceived by ZG_A. Therefore, the ZG_A sample was then used as adsorbent to absorb motor vehicle exhaust. The tests were performed four times with time variation of 10, 20, 30, and 40 minutes. The XRD results showed that the material was successfully absorbed lead oxide, manganese oxide and phosphorus which are hazardous compounds when inhale by human being.

This paper investigates to what extent international migration can be explained by climatic variations. A gravity model of migration augmented with average temperature and precipitation in the country of origin is estimated using a panel data set of 142 sending countries for the period 1995 to 2006. We find two primary results. First, temperature is positively correlated with migration. Second, stronger changes in precipitation are also associated with aligned, but small changes in migration. Both effects are robust to various model modifications. Furthermore, we present initial explorations into the channels relating climate changes with migration via agriculture and internal conflict. F22, Q54

Growth cone guidance is driven by attractive and repulsive signaling cues. Until recently, repulsive signaling by semaphorins was thought to be mediated through Plexin receptors, whereas Slits-induced repulsion was solely mediated through Robo receptors. In a recent report published in Nature Neuroscience, Celine Delloye-Bourgeois and colleagues (2015) combined phenotypic analyses of transgenic mouse lines and in vitrobiochemical experiments to identify PlexinA1 as a novel receptor for Slits. Strikingly, they uncovered for the very first time that the Slit2C-terminal fragment possesses some unique biological activity as binding partner for PlexinA1. Even more excitingly, the signaling cascade triggered by SlitC binding to PlexinA1 mediates growth cone collapse of commissural axons both in vivoand ex vivoand nicely complements Robo-Slit signaling in the developing spinal cord midline to prevent midline recrossing.

Penile cancer is rare among male malignancies. Various biomarkers have been used to predict the prognosis of cancer, one of which is the neutrophil to lymphocyte ratio (NLR). Therefore, we conducted this systematic review and meta-analysis to evaluate the prognostic value of NLR in penile cancer.

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With this paper the authors aim not only to investigate the lifestyle specifics of the Western Balkan market, but also to define common lifestyle segments for the entire region. The question addressed in this research is whether current political issues and economic differences have led to dissimilar ways of living, or whether cultural similarities have prevailed and lifestyles can be defined accordingly.

This study examines changes in beliefs, satisfaction and intention that occur among experienced users of information system (IS). In order to examine these changes, a research has been conducted about measuring of perception, satisfaction and continuance intention of integral accounting budget software (IABS) users on two occasions, during 2009 and 2013, respectively. The extended expectation-confirmation model of IS continuance (EECM-IS), the original ECM-IS having been extended for a construct of perceived ease of use, has been used in this research. The statistical comparison shows that only the path coefficient from perceived ease of use to satisfaction in the structural model during the second survey is significantly stronger than the corresponding path coefficients in the structural model in the first survey. Also, results show that all other path coefficients are not statistically different. A subsequent analysis of changes that have taken place among users in relation to the use of other programs, such as MS Word, MS Excel and internet, shows that there is a statistically important difference in usage of these programs in the course of the first and second research studies conducted.

Skin microvascular flow motion (SMF) – blood flow fluctuation attributed to the rhythmic contraction and dilation of arterioles – is thought to be an important component of the microcirculation, by ensuring optimal delivery of nutrients and oxygen to tissue and regulating local hydraulic resistance. There is some evidence that SMF is altered in obesity, type 2 diabetes mellitus, and hypertension. Nevertheless, most studies of SMF have been conducted in highly selected patient groups, and evidence how SMF relates to other cardiovascular risk factors is scarce. Therefore, the aim of the present study was to examine in a population-based setting which cardiovascular risk factors are associated with SMF.

Lifestyle preferences are inculcated in childhood and once established, persist into adulthood. The Project PROMoting Health LIteracy in School (i-PROMISe) aims to promote a healthy lifestyle among students for the universal prevention of non-communicable diseases (NCDs) like diabetes.

The Expectation-Confirmation Model of Information Systems Continuance (ECM-IS) explains antecedents that influence IS users’ behavior and affect their decision whether to continue or discontinue information system (IS) using. ECM-IS emphasizes differences between initial acceptance and IS continuance. For companies that deal with the design and software development, IS continuance is retaining of existing customers of product and services. This study extends the ECM-IS by accounting for unobserved heterogeneity. The Finite Mixture Partial Least Squares (FIMIX-PLS) methodology is applied for identification of distinctive customer segments. Segmentation of IS users was made on the basis of cognitive beliefs and affect influencing one’s intention to continue using IS and two different segments of users were derived. The first segment comprises 65.6%, and the other one 34.4% users. The ECM-IS explained 51.9% of IS continuance intention and 20.7% of satisfaction for the first segment, while for the second segment the ECM-IS explained 98.1% of IS continuance intention and 91.3% of satisfaction.

The present study offers exploratory insights about the importance of health-consciousness for an adequate frequency of visits to a family doctor or specialist. The main purpose was to empirically investigate the relationship between the conceptsbearing in mind the cultural background of Bosnia and Herzegovina. A total of 114 cases were used to assess the overall fit of the proposed model and to test the hypotheses using covariance-based structural equation modeling. The results support the proposed conceptual model. Therefore, the study contributes to the existing literature by offering exploratory insights that could be especially valuable for policy makers and the pharmaceutical industry.The implications and limitations of the results are discussed, and recommendations for future research are made.

Introduction:Anxiety disorders represent one of the most prevalent forms of psychopathology among children and adolescents. As these problems tend to persist and have a negative impact on young people's development, there is a need for evidence-based interventions. Cognitive-behavioral therapy (CBT) is at present the treatment of first choice, but pharmacotherapy and in particular antidepressant medication may be a viable alternative or adjunct to CBT.Areas covered:This paper provides a detailed overview of controlled treatment outcome studies on the efficacy of tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs) and serotonin–noradrenaline reuptake inhibitors (SNRIs) in children and adolescents with anxiety disorders. Further, a discussion is provided on how clinically anxious youths should be preferably treated, with special focus on the position of pharmacotherapy in the treatment process.Expert opinion:The short-term efficacy of antidepressants in anxious youths is good, and this is particularly true for SSRIs. Therefore, this type of medication should be viewed as a viable treatment option, in particular for youths with obsessive-compulsive disorder (OCD) or other severe and pervasive anxiety disorders. More research is needed on the long-term effects, the consequences of prolonged use of this type of medication for children's developing brains and the efficacy of an intervention in which CBT and SSRIs are combined.

Threat/control-override symptoms refer to delusional persecutory thoughts and feelings of losing control over mind and body. The Threat/Control-Override Questionnaire (TCOQ) was developed to assess such symptoms, and the purpose of the present study was to examine the psychometric properties of this measure in nonclinical students (n= 759) and acute and stabilized psychotic patients (n= 111 and 33, respectively). Factor analysis of TCOQ data in students and acute psychotic patients yielded a two-factor solution, with components referring to "threat" and "control-override" symptoms. Internal consistency and test-retest reliability were satisfactory and concurrent and discriminant validity were shown by a meaningful pattern of correlations with other self-report and interview measures. Group comparisons showed that patients displayed significantly higher scores on the TCOQ than did the nonclinical students. Altogether, it can be concluded that the TCOQ is a reliable and valid index for assessing feelings of persecution and losing control.

This cross-sectional multicenter study was carried out to examine whether the experience of threat/control-override symptoms and emotional reactions to positive symptoms (e.g., anger, anxiety) are related to aggressive behavior. Patients diagnosed with schizophrenia, delusional disorder, psychotic disorder not otherwise specified, or a schizoaffective disorder (N= 124) were interviewed and filled out self-report questionnaires. Results indicated that, in particular, threat/control-override symptoms were significantly related to aggressive behavior in psychotic patients. Further analysis revealed that the threat symptoms especially, but not the control-override symptoms, carried this effect. Anger disposition also accounted for a significant and unique proportion of the variance in the aggressive behavior of psychotic patients, whereas state anger and anxiety in reaction to positive symptoms did not. These results seem to suggest that feeling threatened by positive psychotic symptoms and anger disposition play a role in the origins of aggressive behavior of psychotic patients.

Reward, such as monetary gain, and punishment, such as monetary loss, are capable of modifying the electrophysiological signals of the brain. Further, it is known that there are individual differences in the sensitivity for reward and punishment. This study set out to test the relationship between self-reported sensitivity to reward and sensitivity to punishment and electrophysiological brain responses to monetary gains and losses. Subjects filled out the modified Behavioral Inhibition System/Behavioral Activation System scales for measuring responsiveness to reward (RR) and responsiveness to punishment (RP), and performed a gambling task. The results showed that there was a significant positive correlation between scores on the RR scale and P3 amplitudes on the Fz electrode location to win, loss, and break even outcomes. There was no significant correlation, however, between scores on the RP scale and the P3 amplitudes to all outcomes. For the feedback-related negativity, no significant correlations with both the RR and RP scales were present. Thus individuals scoring high on RR seem to be generally more sensitive to outcomes (either positive or negative) during a task where they might receive a reward.

Diagnostic imaging of traumatic pseudoaneurysm of the thoracic aortaBackground.The purpose of the study was the presentation of findings and diagnostic imaging in patients with traumatic pseudoaneurysms of the thoracic aorta, as a rare consequence of road traffic accidents.Patients and methods.In 22 years we have found 8 traumatic pseudoaneurysms of the thoracic aorta, out of which 7 (87.5%) in male and 1 (12.5%) in female patients. At the time of accidents the youngest patient was 21 and the oldest was 55 (mean age 33.8 years), and at the moment of diagnosing a pseudoaneurysm they were 26 and 55 years old, respectively (mean age 38.7 years). In all patients chest radiography was performed as well as CT scan, in 6 (75%) patients intra-venous digital subtraction angiography was performed (i.v.DSA) and in 1 (12.5%) MRI. CT was performed with the application of 120 ml, and i.v.DSA with 60 ml of contrast medium, respectively.Results.In 8 (100%) patients, who suffered a road traffic accident, and whose chest radiograph showed the enlargement of the aortic knob and widening of the mediastinum, CT, i.v.DSA and MRI revealed a traumatic pseudoaneurysm of the thoracic aorta. Periods of time between the accidents and the initial diagnosis of the pseudoaneurysm varied from 7 days to 18 years (median 2.0 years). The diameter of the pseudoaneurysm was from 4.5 to 9.2 cm (median 5.5 cm). In 7 (87.5%) isthmus was involved, and in 1 (12.5%) descending thoracic aorta, respectively. The chest radiograph revealed marginal calcifications in 4 (50%), and on the CT in 5 (62.5%) patients. Intraluminal thrombosis was found by CT in 2(25%) traumatized patients.Conclusions.Traumatic pseudoaneurysm should be taken into consideration in blunt chest trauma, where a chest radiograph shows suspicious regions. A multislice CT is a diagnostic method of choice.

Two studies were conducted to investigate the psychometric properties of a Dutch translation of the Dimensions of Anger Reactions, a brief test to measure anger disposition. In the first study, the factor structure, internal consistency, and validity of the scale were examined in a sample of 97 students. Factor analysis essentially yielded one factor, although further inspection found some evidence for a two-factor structure referring to “anger response” and “impairment.” The internal consistency was acceptable, and convergent and divergent validities were supported by a theoretically meaningful pattern of correlations with other self-report measures, such as the Aggression Questionnaire, Barrat's Impulsivity Scale–11, and the Symptom Checklist–90. In a second study, the test-retest reliability of the scale was examined in a separate sample of 37 students. A correlation coeffcient of .84 was found, supporting the reliability of the scale. Altogether, it can be concluded that the Dutch Dimensions of Anger Reactions seems to be reliable and valid for assessing anger disposition.

Samenvatting: De gegeneraliseerde angststoornis is een ‘piekerstoornis’, waarbij mensen zich over van alles en nog wat zorgen maken. De stoornis komt vaak voor. Naar schatting krijgt ruim 5% van de mensen er in de loop van hun leven last van. Helaas wordt de diagnose nog vaak ‘gemist’. De klachten worden regelmatig als lichamelijk probleem behandeld. Dit komt doordat veel mensen die aan deze stoornis lijden naar de huisarts gaan vanwege nervositeit, vermoeidheid of slaapproblemen. Hier gaan we in op wat een gegeneraliseerde angststoornis is, hoe deze ontstaat en hoe deze te verhelpen is.

Background: Although it has frequently been suggested that alcohol influences emotions such as anxiety and fear through the modulation of affective information processing, few studies addressed this topic using objective measures.

Abstract.The Behavioral Inhibition Scale (BIS) is a brief questionnaire for measuring Kagan's (1994) temperamental characteristic of children and adolescents to be unusually shy and to react with fear and withdrawal in situations that are novel and/or unfamiliar. The present study examined the psychometric properties of the BIS in two separate samples of undergraduate students (Ns = 124 and 73). The students of Sample 1 completed the BIS as well as questionnaires for measuring personality traits, anxiety, and other psychopathological symptoms, whereas students of Sample 2 completed the scale as well as a widely used anxiety inventory on two separate occasions, some 4 weeks apart. The results showed that the BIS was reliable in terms of internal consistency and test-retest stability. Further, the scale was predominantly correlated with general levels of anxiety symptoms and not with other psychopathological symptoms. Finally, the BIS was related to other personality factors in a theoretically meaningful way, and essentially seems to reflect a combination of high neuroticism/behavioral inhibition and low extraversion/behavioral approach.

Polyurea microcapsules were obtained via interfacial polymerization at the interface of methanol-in-cyclohexane, formamide-in-cyclohexane, and N,N-dimethylformamide-in-cyclohexane emulsions. Coumarin-1 was used as a model encapsulant; both dye leaching and encapsulation efficiency were examined. For the methanol-in-cyclohexane system, design of experiments was used to assess the influence of five different variables on capsule size. A model was obtained that accurately predicts the size of capsules resulting from a given formulation.

This article describes the creation of a nontoxic, biodegradable coating using calcium alginate and FD&C approved dyes. The coating is robust but is rapidly removed upon treatment with disodium ethylenediamine tetraacetate (EDTA). Dye leaching from calcium alginate films was studied, and it was determined that the efficiency of dye retention is proportional to the degree of cross-linking. Degradation rates were studied on calcium alginate beads serving as a model for a coating. We determined that degradation rates depend on the gel's cross-linking and on the amount of EDTA used. Bead size also influenced the degradation rates; smaller beads degraded faster than larger beads. We show that the coating can be used as an easily removable and environmentally friendly logotype on an artificial turf surface. Applications of these coatings can be extended to food, cosmetic, medicinal, and textile uses and to wherever nontoxic, easily removable colored coating is desired.

AbstractThe present article describes two experimental studies investigating whether individual differences in intolerance of uncertainty (IU) predict worry in response to uncertain situations. In both studies, undergraduate students completed the Intolerance of Uncertainty Scale (IUS; Freeston, Rheaume, Letarte, Dugas, & Ladouceur, 1994) and then completed an intelligence task, which was thought to elicit feelings of uncertainty. After completing the task, state worry was measured. Results of both studies showed that there were positive correlations between IUS scores and task-related state worry. Furthermore, Study 2 showed that individual differences in IU only were predictive of worry in a situation that elicits low to medium levels of uncertainty, and not in a situation high in uncertainty. Thus, only under certain conditions IU-related personality characteristics seem to be predictive of worrisome thoughts.

AbstractThe specific phobias in children, such as night-time fears and animal phobias, should not be underestimated since they cause personal distress to the child and also much interference with daily activities. Intervention plans should be informed by multimethod assessment, using tools that are empirically sound and developmentally sensitive. This article selectively reviews a number of assessment tools including structured diagnostic interview schedules, standardised instruments such as anxiety or fear self-report questionnaires, and behavioural tasks. An overview is given of the main intervention approaches, from a behavioural perspective, including traditional behavioural intervention procedures such as systematic desensitisation and its variants, cognitive?behavioural therapy, and behavioural family therapy. The authors also present recent developments in psychodynamic treatment for phobic and anxious children. Finally, we present conclusions on the empirical standing of the various treatment approaches and also examine the important issue of treatment outcome prediction.

In past decades the prevalence of asthma in children has increased substantially but this trend seems not to have persisted into the twenty-first century. What might have caused the increased prevalence is not well understood. With the expectation that the prevalence may be decreased by reducing exposure to environmental factors, several birth cohort studies are being (or have been) carried out all over the world. Although many studies are still ongoing, decisions on data gathered by these studies will be of great importance for clinical practice. An overview of designs of available studies will be essential in constructing a metaanalysis. We describe the similarities and differences between designs and variable sets of birth cohort studies focusing on the relationship between allergen exposure (solely or in combination with other environmental exposures) and development of childhood asthma. We also evaluate which studies are particularly qualified for inclusion in a meta-analysis relating asthma prevention to environmental exposures. Ongoing birth cohort studies on allergen exposure (solely or in combination with other environmental exposures) in relation to asthma development in children were identified and all available information on study designs was collected and compared. From the 19 studies selected, 13 are prospective cohort studies and 6 are randomized clinical trials (RCTs). All 6 RCTs included children during prenatal life whereas all but 5 prospective cohort studies started after birth. The exposures that almost all studies focus on are house dust mite (HDM) allergens, pet allergens, food allergens, and environmental tobacco smoke (ETS). We concluded that RCTs are the best candidates for inclusion in a meta-analysis (an individual subject data analysis) in the future. Four RCTs we evaluated as being particularly suitable for inclusion in a meta-analysis on the basis of similarities in their study designs: the Isle of Wight Study, the Canadian Allergy and Asthma Project (CAAP), the CAPS Study, and the PREVASC Project. Of these four all recommend multifaceted interventions, and differences in their designs are expected to be overcome by stratification and restriction to homogeneous clusters. (Pediatr Asthma Allergy Immunol 2005; 18[4]:201–215.)

Samenvatting: De psychometrische eigenschappen van de Screen for Child Anxiety Related Emotional Disorders (scared) zijn onderzocht binnen een grote steekproef uit de algemene adolescentenpopulatie. In 2001 hebben 1.340 adolescenten van twaalf verschillende middelbare scholen in de provincie Utrecht de scared ingevuld. De scared is een zelfbeoordelingsvragenlijst waarmee beoogd wordt vijf symptoomdimensies van angst bij adolescenten te meten. Confirmatieve factoranalyses (voor de factorstructuur) en variantieanalyses (voor de scoreverschillen) werden uitgevoerd voor zowel de gehele steekproef als voor jongens en meisjes, jongere adolescenten (10-13 jr.) en oudere adolescenten (14-18 jr.) en autochtone adolescenten en Nederlandse adolescenten van allochtone afkomst. Uit de analyses bleek dat de vijffactorstructuur van de scared niet alleen van toepassing is voor de algemene adolescentenpopulatie maar ook van toepassing is voor verschillende leeftijds-, geslachts- en etnische groepen. Tevens werd gevonden dat de symptoomdimensiescores van de scared voor diverse adolescentengroepen onderling verschillen. De onderzoeksresultaten ondersteunen de bewering dat de scared een vijffactorstructuur bezit en bevestigen de bruikbaarheid van de scared voor het meten van angstsymptomen bij adolescenten.

L’infiltration des eaux pluviales urbaines dans les nappes est une technique alternative au système traditionnel d’assainissement largement utilisée dans l’Est lyonnais. Les eaux infiltrées conduisent à l’accumulation dans les premiers centimètres du sol de matière organique, de polluants organiques et minéraux et de micro-organismes. Ce papier présente les différents travaux menés pour mieux comprendre le rôle du compartiment microbien de cette surface sur le devenir des métaux piégés à la surface et le risque de leur migration dans la nappe souterraine. Une approche sur métal et bactérie modèles a permis de mettre en évidence une forte capacité d’adsorption des cations métalliques par la bactérie, adsorption qui peut conduire au transfert de ce métal via le transport biocolloïdal. Des études sur milieu réels multicontaminés montre que les bactéries présentes en grands nombres dans ces milieux pollués sont adaptées à ce stress chimique et sont potentiellement très actives.

We used biopsy specimens of primary nodal diffuse large B-cell lymphoma (DLBCL) to investigate whether the inhibition of caspase 8 and/or 9 apoptosis signaling pathways predicts clinical outcome. Expression levels of cellular FLICE inhibitory protein (c-Flip) and numbers of active caspase 3-positive lymphoma cells were used to determine the status of the caspase 8-mediated pathway. Expression levels of Bcl-2 and X-linked inhibitor of apoptosis (XIAP) were used to determine the status of the caspase 9-mediated pathway. Expression of c-Flip, XIAP, Bcl-2, and caspase 3 activity all provided prognostic information. According to these immunohistochemical parameters, inhibition of either or both caspase signaling pathways was detected in all patients. Three groups of patients were identified, one with a caspase 8 inhibition profile, one with caspase 8 and 9 inhibition profiles, and one with a caspase 9 inhibition profile. Caspase 9 inhibition was strongly associated with poor response to chemotherapy and usually with fatal outcome, whereas caspase 8 inhibition was associated with excellent clinical outcome. Thus, our data strongly suggest that inhibition of the caspase 9-mediated pathway, but not the caspase 8-mediated pathway, is a major cause for therapy resistance in patients with nodal DLBCL.