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Trauma is common among those seeking Ob-Gyn care and may have pervasive impact on obstetrical and gynecological health, social functioning, and healthcare engagement. While guidelines exist on the detection and treatment of perinatal mood and anxiety disorders within Ob-Gyn care, the role of Ob-gyn clinicians in identifying and addressing patients' traumatic experiences and related symptoms is less clearly delineated. This manuscript provides an overview of trauma-related symptoms in the context of Ob-Gyn care and practical guidance of clinicians aiming to improve their detection and response to trauma in their clinical practice.Posttraumatic stress disorder (PTSD) describes a psychiatric illness which develops as a response to a traumatic event. Women who have experienced trauma are also at increased risk for borderline personality disorder and other psychiatric comorbidities. Postpartum PTSD has particular relevance to obstetrical care.Screening for trauma in Ob-Gyn care can provide an opportunity to address risk and offer targeted intervention. Several brief evidence-based screening tools are available. Individuals who screen positive require assessment of immediate safety and targeted referrals. Trauma informed care describes an approach to healthcare aimed to enhance physical and emotional safety for patients and clinicians.Given the prevalence and the potentially devastating and enduring impact of trauma and trauma-related symptoms, there is a critical need to address trauma within Ob-Gyn care. By recognizing the signs of trauma and initiating or referring to appropriate treatments, Ob-Gyn clinicians have a unique opportunity to better understand their patients and to improve their care.

Funding Information: This work was supported by EFRE (K-Regio project FAENOMENAL, Grant No. EFRE 2016-4) and the Austrian Science Fund FWF (Project No. P31149, I4130). This work was also supported by Fundação para a Ciência e a Tecnologia (FCT-MCTES), Radiation Biology and Biophysics Doctoral Training Programme (RaBBiT, PD/00193/2012); Applied Molecular Biosciences Unit - UCIBIO (UIDB/04378/2020) and CEFITEC Unit (UIDB/00068/2020); and scholarship Grant No. PD/BD/114447/2016 to J.A., F. Zappa acknowledges support from the Brazilian agency CNPq. K.v.H. kindly acknowledges the award of a LFUI guest professorship. The demand for nanoscale materials of ultra-high purity and narrow size distribution is addressed. Clusters of Au, C60, H2O, and serine are produced inside helium nanodroplets using a combination of ionization, mass filtering, collisions with atomic or molecular vapor, and electrostatic extraction, in a specific and novel sequence. The helium droplets are produced in an expansion of cold helium gas through a nozzle into vacuum. The droplets are ionized by electron bombardment and subjected to a mass filter. The ionic and mass-selected helium droplets are then guided through a vacuum chamber filled with atomic or molecular vapor where they collide and "pick up" the vapor. The dopants then agglomerate inside the helium droplets around charge centers to singly charged clusters. Evaporation of the helium droplets is induced by collisions in a helium-filled radio frequency (RF)-hexapole, which liberates the cluster ions from the host droplets. The clusters are analyzed with a time-of-flight mass spectrometer. It is demonstrated that using this sequence, the size distribution of the dopant cluster ions is distinctly narrower compared to ionization after pickup. Likewise, the ion cluster beam is more intense. The mass spectra show, as well, that ion clusters of the dopants can be produced with only few helium atoms attached, which will be important for messenger spectroscopy. All these findings are important for the scientific research of clusters and nanoscale materials in general. publishersversion published

RESUMEN. La relación existente entre el medioambiente y los antimicrobianos, es un tema todavía poco explorado en el Paraguay. Los antimicrobianos son agentes quimioterapéuticos que restringen o anulan el crecimiento de microorganismos. En la actualidad son de amplia utilización en medicamentos humanos y veterinarios, así como en: la agricultura, la acuicultura, la apicultura y la ganadería, sea con objetivos terapéuticos o promotores del crecimiento, que han impactado de manera positiva o de manera negativa. Entre los impactos negativos del uso de los antimicrobianos, se mencionan la aparición de bacterias resistentes a los efectos de estos fármacos, así como la diseminación de las mismas, mediante elementos del medioambiente como el agua. Esta revisión bibliográfica, a más de abordar estos aspectos de manera general, también contempla las posibles alternativas de mitigación de los efectos del vertido de antimicrobianos en el medioambiente, así como las políticas internacionales actuales. La recopilación de información actualizada extraída de diferentes plataformas de búsqueda ha permitido poner de manifiesto la situación actual de la problemática. ABSTRACT. The relationship between the environment and antibiotics, a subject that has not yet been fully explored in Paraguay. Antibiotics are chemotherapeutic agents that restrict or nullify the growth of microorganisms. Currently they are widely used in human and veterinary medicaments, in a beneficial way in agriculture, aquaculture, apiculture and livestock, be with therapeutic targets or growth promoters, which have impacted positively or negatively. Between the negative impacts of the use of antimicrobials, mention is made of the appearance of bacteria resistant to the effects of these drugs as well as their dissemination, through elements of the environment such as water. This review, besides addressing these aspects, also contemplates possible alternatives for mitigating the effects of the spill on the environment, as well as current international policies. The collection of updated information extracted from different search platforms has made it possible to highlight the current situation of the problem.

Introduction Postoperative ileus(POI) and anastomotic leakage(AL) are highly associated but the direction of this link is unknown. Indeed, it has traditionally been stated that AL leads to POI(secondary POI). The objective was to statistically determine the best model of link between POI and AL by comparing different Structural Equation Models(SEM). Methods This is a retrospective analysis of a prospective multicentric database from the Francophone Group for Enhanced Recovery after surgery(GRACE) including patients undergoing colorectal resection or Hartmann reversal between 2014 and 2017. The main outcome measure was the occurrence of postoperative ileus defined by the absence of Gastrointestinal (GI)-3 recovery in or after postoperative day 4 and the occurrence of AL. Results Among the 2227 patients included, 223 patients experienced POI (10 %) and 72 patients experienced anastomotic leakage (3.2 %). In all the models, POI was significantly increased in case of male gender, older age, opioids consumption, right colectomy, chronic obstructive bronchopneumopathy disease and performance of a stoma, and reduced by Enhanced Recovery Programs (ERP) compliance ≥ 70 % and intake of Non-Steroidal Anti-Inflammatory Drugs. Open surgery was not significantly associated with POI in all the models. In contrast, the male gender was the only factor increasing AL in the model drawn with ERP risk factors for AL. In all the models, POI was highly associated with AL and statistical analyses advocate for POI leading to AL. Conclusion The findings of the present large study suggest that the more statistically probable model is the one in which POI come first before AL.

Synopsis We have produced and mass-selected large, highly charged helium droplets containing up to 1010 He atoms and several tens of charges. They are stable with both multiple positive and negative charge carriers and are stabilized by losing small fragments of excess charge instead of disintegrating (highly asymmetric fission).

Perinatal depression is associated with serious risks for the mother, baby, and family. When considering treating perinatal depression with a drug indicated for the treatment of depression, the major concerns are whether the drug increases the risks of teratogenicity, pregnancy complications, poor neonatal adaptation, or neurodevelopmental disorders. Although different studies have produced different results, the majority have not shown increases in risk for selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, or the noradrenergic/dopaminergic drug bupropion. In this review we will discuss the reproductive safety data for these medications as well as monoamine oxidase inhibitors and benzodiazepines.

Resume Introduction La securisation du circuit du medicament en etablissement de sante est un enjeu majeur de sante publique. Le circuit du medicament est un processus complexe, potentiellement source d’erreurs et de dommages pour le patient. SHAM est le premier assureur responsabilite civile en France et dispose d’une source pertinente d’informations sur la sinistralite liee aux soins. Methodes L’objectif principal de l’etude a ete d’analyser la nature et la cause des erreurs medicamenteuses qui ont eu un reglement judiciaire. Nous avons etudie retrospectivement les sinistres dus a une erreur medicamenteuse et declares a la SHAM sur une periode de 6 ans (2005 a 2010). Resultats L’etude a porte sur 31 dossiers d’activite programmee (21 dossiers) ou urgente (10). Les consequences des sinistres etaient majoritairement graves (12 deces, 14 complications graves, 5 complications simples). La nature de l’erreur medicamenteuse etait liee a un probleme de surveillance (11 cas), a une erreur d’administration (5 cas), a un surdosage (6 cas), a une allergie (4 cas), a une contre-indication (3 cas) ou une omission (2 cas). La voie injectable etait impliquee dans 19 cas sur 31 (61 %). Les causes retenues par l’expert judiciaire etaient une erreur liee a l’environnement et/ou a l’organisation du service (11), a la pratique medicale (11) ou infirmiere (13). Un seul sinistre etait lie a la pharmacie a usage interieur. Conclusion La sinistralite liee au circuit du medicament est peu frequente, mais potentiellement grave. Ces donnees permettront d’aider a renforcer la gestion des risques.

Chitin degradation is a key step in the cycling of nutrients in marine ecosystems and chitinolytic bacteria are the primary agents of this process. Chitinases, produced by bacteria, have potential applications in agriculture, medicine and in a wide range of biotechnological processes. We utilized a simple, rapid and cost-effective method of colloidal chitin preparation and a culture medium, in which colloidal chitin is the sole carbon source for the purpose of counting and isolating chitinolytic bacteria from seawater and plankton. This culture medium could be useful to isolate bacteria with the ability to produce extracellular chitinases for biotechnological applications.

The main objective of MEAL is to develop a pedagogical tool aimed to help teachers and nutritionists (students and professionals) to acquire, train, promote and deliver to children basic nutritional education and healthy eating behaviours competencies. MEAL is focused on eating behaviours and not only in nutritional literacy, and will use new technologies like Information and Communication Technologies (ICTs) and serious games (SG) platforms to consolidate the nutritional competences and habits., {"references":["cf Diet, Nutrition and the Prevention of Chronic Diseases, Report of a\nJoint WHO/FAO ExpertConsultation, 2003\n(http://www.who.int/dietphysicalactivity/publications/trs916/download/e\nn/index.html).","R. Hyde, \"Europe Battles with obesity\", The Lancet, vol. 371 (9631), pp.\n2160–2161, 2009.","I. Krug, C. Villarejo, S. Jimenez-Murcia, C. Perpiña, N. Vilarrasa, R.\nGranero, et al., \"Eating-related environmental factors in underweight\neating disorders and obesity: are there common vulnerabilities during\nchildhood and early adolescence?\", Eur Eat Disord Rev., vol. 21(3), pp.\n202-208, 2012.","A. Preti, G. Girolamo, G. Vilagut, J. Alonso, R. Graaf, R. Bruffaerts, et\nal., \"The epidemiology of eating disorders in six european countries:\nresults of the ESEMeD-WMH Project\", J. Phychiatr. Res, vol. 43, No.\n14, pp. 1125-1132, 2009.","A. Robertson, C. Tirado, T. Lobstein, M. Jermini, C. Knai, J. Hensen, et\nal., Food and Health in Europe: a new basis for action, WHO Regional\nPublications, European Series, No. 96, 2004.","E. Weichselbaum, J. Buttriss, \"Nutrition, health and schoolchildren\",\nBritish Nutrition Foundation - Nutrition Bulletin,vol. 36(3), pp. 295-355,\n2011.","EC, White paper on A strategy for Europe on Nutrition, Overweight and\nObesity related health issues, 2007.","WHO, European Food and Nutrition Action Plan 2015-2020, Regional\nCommittee for Europe, 2014","I. Contento, \"Nutrition education: linking research, theory, and\npractice\",Asia Pac J ClinNutr;vol17(1), pp. 176-179, 2008.\n[10] Effects of diet on behaviour and cognition in children.Br J Nutr.,vol. 92\nSuppl 2. pp. 227-232, 2004\n[11] G. Mitchell, J. Brunstrom,\"Everyday dietary behaviour and the\nrelationship between attention and meal size\", Appetite, vol. 45(3), pp.\n344-355, 2005.\n[12] T. Baranowski, R. Buday, D. Thompson, J. Baranowski, \"Playing for\nreal: video games and stories for health-related behavior change\",Am J\nPrev Med., vol. 34(1), pp. 74-82, 2008.\n[13] B. Sawyer, D. Rejeski, Serious Games: Improving Public Policy\nThrough Game-based Learning and Simulation, Woodrow Wilson\nInternational Center for Scholars, 2002.\n[14] M. Yi, Y. Hwang, 'Predicting the Use of Web-based Information\nSystems: Self-efficacy, Enjoyment, Learning Goal Orientation, and the Technology Acceptance Model', International Journal Human-\nComputer Studies, vol. 59(4), pp. 431-449, 2003.\n[15] E. Rogers, Diffusion of Innovations, The Free Press, 1962.\n[16] J. Brooke, SUS: a \"quick and dirty\" usability scale. In P. W. Jordan, B.\nThomas, B. A. Weerdmeester, & A. L. McClelland. Usability Evaluation\nin Industry. London: Taylor and Francis, 1986."]}

It appears that many individuals with body dysmorphic disorder (BDD) receive nonpsychiatric medical treatment and surgery; however, this topic has had little systematic investigation. This study assessed the nonpsychiatric treatment sought and received by 289 individuals (250 adults and 39 children/adolescents) with DSM-IV BDD. Such treatment was sought by 76.4% and received by 66.0% of adults. Dermatologic treatment was most often received (by 45.2% of adults), followed by surgery (by 23.2%). These treatments rarely improved BDD symptoms. Results were similar in children/adolescents. These findings indicate that a majority of patients with BDD receive nonpsychiatric treatment but tend to respond poorly.

Summary What is known and objective Endocrine therapy is an effective treatment for post-menopausal women with ‘oestrogen receptor-positive’ invasive breast cancers. There are two main types of endocrine therapies: selective oestrogen receptor modulators (tamoxifen) and aromatase inhibitors (anastrozole, letrozole and exemestane). The aim of this study was to compare the patterns of use of endocrine therapies for breast cancer in women between nine developed countries. Methods A longitudinal, cross-national drug utilization study was conducted. The endocrine therapies included were tamoxifen and the aromatase inhibitors: anastrozole, letrozole and exemestane. Annual drug utilization data were collected from Australia, Denmark, England, Finland, France, Iceland, the Netherlands, Norway and Sweden over the period 2001–2012. Utilization was measured in DDD/1000 inhabitants/day and was also adjusted for breast cancer incidence and female population statistics. Results and discussion Total use of endocrine therapies either increased or remained steady in all countries. Total endocrine therapy usage was consistently highest in England and France. Norway showed the lowest usage of endocrine therapies overall, using only 1·80 DDD/1000 inhabitants/day in 2012. Downward trends in tamoxifen use and upward trends in aromatase inhibitors were seen across all countries over the study period. By 2012, aromatase inhibitors represented over half of total endocrine therapy use in all countries, and as high as 74% and 80% in France and Denmark, respectively. What is new and conclusion Our analysis found a shift in use of endocrine therapy from tamoxifen to aromatase inhibitors. This trend is consistent with major clinical guidelines endorsing preferential use of aromatase inhibitors in post-menopausal women. Stabilization or small increase in tamoxifen use in the recent years may reflect the recognition of tamoxifen as still an appropriate first-line treatment. The similarity in utilization patterns may be due to the relatively comparable healthcare systems in the countries, namely universal health insurance and pharmaceutical coverage. Differences in utilization observed could be due to differences in breast cancer incidence, prescribing behaviours, interpretation of new trial evidence, and timing of drug marketing approval and reimbursement between countries.

It appears that many individuals with body dysmorphic disorder (BDD) receive nonpsychiatric medical treatment and surgery; however, this topic has had little systematic investigation. This study assessed the nonpsychiatric treatment sought and received by 289 individuals (250 adults and 39 children/adolescents) with DSM-IV BDD. Such treatment was sought by 76.4% and received by 66.0% of adults. Dermatologic treatment was most often received (by 45.2% of adults), followed by surgery (by 23.2%). These treatments rarely improved BDD symptoms. Results were similar in children/adolescents. These findings indicate that a majority of patients with BDD receive nonpsychiatric treatment but tend to respond poorly.

A decrease in the cytokinesis-block proliferation index (CBPI) or replication index (RI) is routinely used to determine cytotoxicity of a test compound and therefore the choice of its appropriate test concentration for the in vitro micronucleus (MN) test conducted in the presence of cytochalasin B. As a number of laboratories prefer to conduct the in vitro MN test in the absence of cytochalasin B, it is important that selected test concentrations, based on cytotoxicity, should be similar to what they would have been if cytochalasin B had been used, and should be relevant of a true cytotoxicity. By using models to analyse the dynamics of the cell cultures with and without cytochalasin B we have compared different methods for evaluation of cytotoxicity, and demonstrate that relative decrease in population doubling or relative increase in cell counts are the most appropriate measures of cytotoxicity to compare with reduction in CBPI or RI.

Bacteriophages are the most abundant and genetically diverse viruses on Earth, with complex ecology in both quantitative and qualitative terms. Somatic coliphages (SC) have been reported to be good indicators of fecal pollution in seawater. This study focused on determining the concentration of SC and their diversity by electron microscopy of seawater, plankton, and bivalve samples collected at three coastal regions in São Paulo, Brazil. The SC counts varied from 3 PFU/100 ml in seawater (73 samples tested), from 2 PFU/g in plankton (46 samples tested), and from 1 PFU/g in bivalves (11 samples tested). In seawater samples, a relationship between the thermotolerant coliforms and Escherichia coli and SC was observed at the three regions ( P = 0.0001) according to the anthropogenic activities present at each region. However, SC were found in plankton samples from three regions: Baixada Santista (17/20), Canal de São Sebastião (6/14), and Ubatuba (3/12). In seawater samples collected from Baixada Santista, four morphotypes were observed: A1 (4.5%), B1 (50%), C1 (36.4%), and D1 (9.1%). One coliphage, Siphoviridae type T1, had the longest tail: between 939 and 995 nm. In plankton samples, Siphoviridae (65.8%), Podoviridae (15.8%), Microviridae (15.8%), and Myoviridae (2.6%) were found. In bivalves, only the morphotype B1 was observed. These SC were associated with enteric hosts: enterobacteria, E. coli , Proteus , Salmonella , and Yersinia . Baixada Santista is an area containing a high level of fecal pollution compared to those in the Canal de São Sebastião and Ubatuba. This is the first report of coliphage diversity in seawater, plankton, and bivalve samples collected from São Paulo coastal regions. A better characterization of SC diversity in coastal environments will help with the management and evaluation of the microbiological risks for recreation, seafood cultivation, and consumption.

A decrease in the cytokinesis-block proliferation index (CBPI) or replication index (RI) is routinely used to determine cytotoxicity of a test compound and therefore the choice of its appropriate test concentration for the in vitro micronucleus (MN) test conducted in the presence of cytochalasin B. As a number of laboratories prefer to conduct the in vitro MN test in the absence of cytochalasin B, it is important that selected test concentrations, based on cytotoxicity, should be similar to what they would have been if cytochalasin B had been used, and should be relevant of a true cytotoxicity. By using models to analyse the dynamics of the cell cultures with and without cytochalasin B we have compared different methods for evaluation of cytotoxicity, and demonstrate that relative decrease in population doubling or relative increase in cell counts are the most appropriate measures of cytotoxicity to compare with reduction in CBPI or RI.

The cause of the association between breast cancer (BC) and thyroid autoimmunity is still unknown. Na+/I- symporter (NIS) is highly expressed in BC cells, and previous studies demonstrated that iodine content in BC is lower than in remote normal breast tissue, suggesting a disorder of iodide uptake in BC. In this study, we evaluated the presence of putative serum autoantibodies able to block the function of NIS in BC patients with thyroid autoimmunity. IgGs were obtained from: a) 11 patients with BC and high antithyroglobulin (TgAb) and antithyroperoxidase (TPOAb) autoantibodies serum concentration; b) 34 patients with Hashimoto's thyroiditis (HT) (1 was euthyroid, 4 had subclinical hypothyroidism and 29 were overtly hypothyroid); c) 15 control subjects. The biological activity of NIS was studied using a chinese hamster ovary (CHO) cell line stably expressing NIS (NIS-CHO). The course of iodide accumulation in NIS-CHO was studied after addition of Na125 I in culture medium. The accumulation of iodide linearly increased between 2 and 10 min, reaching a plateau at 45 min. The preincubation of NIS-CHO with IgGs purified from sera of BC with the highest levels of TPOAb and TgAb caused an inhibition of iodine uptake of no more than 5%. Similar results were obtained using IgGs purified from patients with HT and control subjects. Our data showed no interference of autoantibodies on iodine uptake in patients with BC and thyroid autoimmunity and the very low percentage of inhibition of iodine uptake cannot explain the lower content of iodine in BC tissue.

Introduction La rachianesthesie (RA) en chirurgie ambulatoire [1] est une technique bien connue. La 2-chloroprocaine (Clorotekal*) 10 mg/mL a recemment obtenu l’AMM dans cette indication et un avis favorable de la commission de transparence le 17/04/2013 [2] . C’est un AL de type aminoester de la procaine isobare, sans conservateur, de courte duree d’action, qui semble interessant pour les interventions de moins de 1 heure. Nous proposons d’evaluer par une etude prospective observationnelle en chirurgie ambulatoire cet AL en injection intrathecale, en particulier le temps necessaire a la recuperation post RA (autonomie du patient) et rechercher d’eventuels effets secondaires. Materiel et methodes Etude monocentrique observationnelle prospective sur une periode de 3,5 mois (decembre 2013 a mi-mars 2014) : – inclusion des patients : Chirurgie orthopedique du membre inferieur, uro-digestive et gynecologique basse ; – dose de chloroprocaine 1 % utilisee en RA est de 50 mg ; – une miction systematique des patients avant la RA est exigee ; – les donnees recueillies : le delai d’installation, la duree d’action, le niveau superieur du bloc sensitif et le score de Bromage pour le bloc moteur, le delai d’aptitude a la marche (avec ou sans aide), le delai avant la 1ere miction spontanee apres la levee de la RA. La dose totale d’ephedrine injectee pour compenser le bloc sympathique est colligee. La recherche de complications de type retention aigue d’urine (RAU) (mesure par bladder scan), syndrome neurologique transitoire (SNT), et cephalees post ponction (CPP) ont ete systematiquement recherches par un appel telephonique a J7. Resultats Cinquante-quatre patients ont ete inclus (18 femmes, 36 hommes) repartis en 50 interventions de chirurgie orthopedique et 4 de chirurgie uro-digestive et gynecologique. Aucun echec de ponction rachidienne n’a ete retrouve. Le delai d’apparition du bloc moteur avec un score de Bromage a 4 etait de 6,4 ± 1,5 min. (moyenne ± DS). Le niveau sensitif superieur etait dans 13 % en T12, 64,8 % en T10 et 22,2 % en T8. Le delai de levee du bloc moteur avec un Bromage a 0 de 77,7 ± 10,7 min. Le delai pour une marche autonome sans aide de 122,4 ± 19,2 min. La dose totale d’Ephedrine de 12 ± 4 mg en compensation du bloc sympathique de la RA. Le volume urinaire avant la 1 ere miction spontanee mesure au Bladder Scan de 180 ± 72 mL. 98 % des patients ont urine spontanement. Une seule RAU a ete observee mais aucune complication de type CPP ou SNT. La satisfaction des patients etait evaluee a 98 % et celle des IDE du service d’ambulatoire a 100 %. Discussion et conclusion La chloroprocaine 1 % a la dose de 50 mg en RA se montre d’une excellente faisabilite en chirurgie ambulatoire sous ombilicale de courte duree (50–60 min). Elle presente une bonne alternative a la lidocaine en RA ambulatoire du fait de sa moindre neurotoxicite. Sa courte duree d’action impose une collaboration etroite entre l’anesthesiste et le chirurgien au bloc ambulatoire et egalement une anticipation de l’analgesie post operatoire (analgesie multimodale et infiltration du site operatoire).

Objective Body dysmorphic disorder (BDD), a preoccupation with a nonexistent or slight defect in appearance, usually begins during adolescence. Because there have been no studies of the clinical features of BDD in children and adolescents, the authors assessed these features in the largest series to date. Method Thirty-three children and adolescents with DSM-IV BDD were assessed for demographic characteristics, phenomenology, associated psychopathology, and treatment history and response. Results Bodily preoccupations most often focused on the skin (61%) and hair (55%). All subjects had associated compulsive behaviors, most often camouflaging (e.g., with clothing) in 94%, comparing with others (87%), and mirror checking (85%). Ninety-four percent reported impairment in social functioning and 85% in academic or job functioning due to BDD. Thirty-nine percent had had psychiatric hospitalizations, and 21% had made a suicide attempt. Ten (53%) of 19 subjects treated with a serotonin reuptake inhibitor had much or very much improvement in BDD symptoms; in contrast, 0 of 8 trials with other psychotropic medications, 0 of 1 trial of cognitive-behavioral therapy, and 1 of 20 psychotherapy trials resulted in improvement. Twelve (36%) subjects received surgical, dermatological, or dental treatment, with a poor outcome in all cases. Conclusions BDD can cause significant morbidity in children and adolescents. These preliminary data suggest that serotonin reuptake inhibitors may be an effective treatment in this age group. J. Am. Acad. Child Adolesc, Psychiatry, 1999, 38(4):453–459.

Various aspects of genotoxicity testing of biotechnology-derived products are discussed based on information gathered from a questionnaire which was sent to about 30 predominantly European companies. Feedback was received from 13 companies on 78 compounds, mostly recombinant proteins but also on a number of nonrecombinant proteins, which had been assessed for genotoxicity in a total of 177 tests. Four of the 78 compounds appeared to elicit reproducible genotoxic effects. For one of these compounds, the activity could be related to a nonpeptidic linker molecule. No scientifically convincing rationale for the other three compounds could be established, although, at least for two compounds, their activity may be connected with the enzymatic/hormonal activity. In addition to the survey, published reports on genotoxicity testing of biotechnology products were reviewed. The data are discussed relative to whether genotoxicity testing is a valuable exercise when assessing potentially toxic liabilities of biotechnology-derived compounds. It is concluded that genotoxicity testing is generally inappropriate and unnecessary, a position which is in accordance with the available guidelines addressing this area. For the 'average' protein, electrophilic reactions are difficult to envision. Indirect reactions via DNA metabolism and growth regulation seem possible for only very specific proteins such as nucleases, growth factors, cytokines. No information on testing of different types of biotechnology-derived products (e.g., ribozymes, antisense-oligonucleotides, DNA vaccines) has been received in the questionnaires. Discussion of their potential to cause genotoxic changes was based on literature reports. Even for those products for which concerns of genotoxic/tumourigenic potential cannot be completely ruled out, e.g., because of their interaction with DNA metabolism or proliferation control, the performance of standard genotoxicity assays generally appears to be of little value. All information, including also information on the occurrence of genotoxic impurities, has been utilized to formulate a decision tree approach for the genotoxicity testing of biotechnology-derived products.

Body dysmorphic disorder, an often-secret preoccupation with an imagined or slight defect in appearance, is an underrecognized disorder that is unknown to many clinicians. This disorder has gone virtually unmentioned in the adolescent literature, despite the fact that it often occurs during adolescence. Body dysmorphic disorder is more common than is realized and causes significant distress and impairment in functioning. This report presents four cases of adolescents with body dysmorphic disorder, all of who responded to a serotonin reuptake inhibitor. The clinical features of body dysmorphic disorder are reviewed, as are available data on the treatment of this distressing and often-disabling disorder.

Recently, mutagenic activity on several strains of Salmonella typhimurium has been found in many heat-processed foodstuffs. The previously reported direct-acting mutagenic activity of coffee in Salmonella typhimurium TA100 (Ames assay) was confirmed in our study. In addition to TA100, a mutagenic effect of coffee was also found by using the newly developed strain TA102. The mutagenic activity was abolished by the addition of rat-liver homogenate. 10% S9 mix completely eliminated the mutagenic activity of 30 mg of coffee per plate. The addition of reduced glutathione to active S9 further decreased the mutagenic activity and also reduced the mutagenicity together with inactivated S9. The compound or compounds responsible for this inactivation are heat-labile and seem to be located in the cytosol fraction of the S9. Part of the mutagenicity of coffee was also lost spontaneously upon incubation at temperatures between 0 degrees and 50 degrees C. The loss of activity was dependent on temperature, being more pronounced at 50 degrees C compared to 0 degrees C (at 50 degrees C approximately 50% of the mutagenic activity was lost after 6 h). As anaerobic conditions prevented this loss of mutagenicity almost totally, oxidative processes are probably responsible for the inactivation. The stability of the mutagen was not influenced by incubation at low pH values (pH 1-3), with or without the addition of pepsinogen. The mutagenic properties of methylglyoxal, which to some extent could be responsible for the mutagenic activity of coffee, were compared with those of coffee. Methylglyoxal was strongly mutagenic towards Salmonella typhimurium TA100 and TA102. Its mutagenic activity was partially inactivated by the addition of 10% S9. Glyoxalase I and II together with reduced glutathione abolished the mutagenic activity of methylglyoxal but reduced the mutagenicity of coffee by only 80%. Since these enzymes occur in mammalian cells, the mutagenic compound(s) of coffee could also be degraded in vivo. This conclusion is supported by the fact that a long-term carcinogenicity study with rats was negative. These results clearly demonstrate that the effects observed in vitro do not necessarily also occur in vivo, but that in vitro experiments may contribute to the understanding of fundamental mechanisms of chemical carcinogenesis.

Mutagenic products can be formed during the processing of food and especially as a result of heat treatment. Direct acting mutagenic activity was found in extracts of instant coffee and roasted coffee beans using Salmonella typhimurium TA100 in vitro. The mutagenic activities of the four pure coffee varieties examined (Coffea arabica Santos, Coffea arabica Columbia, Coffee robusta Indonesia, Coffee robusta Camerun) were within the same range. Twenty milligrams per plate freeze-dried powder prepared from aqueous roast coffee extracts induced between six and ten times the number of revertants found in the negative controls. Green coffee beans had no mutagenic activity. Mutagenicity increased with roasting time up to 4 min in the Probat drum roaster and then remained constant (i.e. no further increase after 8 min, the time normally used to roast coffee). The genotoxic compounds were quickly formed at temperatures below 220 degrees C (in normally roasted coffee the beans must reach a temperature of 220 degrees C). Mutagenic activity was independent of the roasting procedure (Jetzon procedure v. Probat drum roaster).

Aflatoxin B1 (AFB1) had a reversible inhibitory effect on the assembly of porcine brain tubulin in vitro. The 30%-inhibition concentration was 0.3 mM AFB1. The 8 tumor promoters showed different effects. Five of them, anthralin, cholic acid, gamma-hexachlorocyclohexane (lindane, gamma-HCH), lithocholic acid and phenobarbital (PB), enhanced the in vitro assembly. The effect was reversible in the case of PB and anthralin, only partially reversible in the case of cholic acid and gamma-HCH, whereas the stimulating effects of lithocholic acid led to an irreversible modification of the tubulin structure, as shown by the insolubility of the microtubules at 0 degrees C. This could be confirmed by an electron microscopic study. The doses necessary for a 30% enhancement of the steady-state level were 3 mM (PB), 0.2 mM (anthralin), 6 mM (cholic acid), 0.7 mM (gamma-HCH) and less than 0.2 mM (lithocholic acid). The other 3 tumor promoters tested - diethylstilbestrol (DES), 4,4'-dichloro-diphenyl-trichloro-ethane (DDT) and saccharin - inhibited the assembly. The concentrations necessary for a 30% inhibition varied within a wide range: 0.025 mM, 0.4 mM and 7.5 mM for DES, DDT and saccharin, respectively. Five of the 9 miscellaneous compounds, namely asbestos (crocidolite), bavistan, colchicine, chloropropham and ethylacetate, showed inhibitory effects, whereas Fe2+ (a constituent of asbestos) and 5-azacytidine did not influence the assembly process. The 30%-inhibition concentrations for colchicine, ethylacetate and asbestos were 10 microM, 0.153 M and 0.19 mM, respectively. For bavistan and chloropropham the 30%-inhibition values were 0.7 mM and 2.0 mM, respectively. The inhibitory effects of chloropropham and asbestos were reversible. For colchicine and bavistan the reversibility of the effects was not assayed. In agreement with published data, dimethylsulfoxide (DMSO) and acetone enhanced the in vitro assembly of porcine brain tubulin. The doses needed for a 30% enhancement by DMSO and acetone were 0.4 mM and 0.136 M, respectively. The effect of DMSO was irreversible whereas acetone led to a reversible stimulation. Some compounds were tested for their influence on preformed microtubules (interaction with the equilibrium between assembly and disassembly). Anthralin, cholic acid, PB and DMSO showed no effect on the steady-state plateau. A slight reduction was induced by DDT and bavistan, whereas DES, colchicine and chloropropham led to a pronounced reduction.

Phenobarbital (PB) specifically induces mitotic chromosomal malsegregation in the diploid Saccharomyces cerevisiae strain D61.M but no other genetic events such as mitotic recombination or point mutations. In accordance with the hypothesis that PB exerts its genotoxic activity by an interaction with tubulin, it stimulates the GTP-promoted assembly or porcine brain tubulin in vitro. This process is reversible thus excluding an unspecific denaturation of the tubulin protein by PB.

A case of agranulocytosis associated with Imipramine use is reported. A review of the literature suggests that this is a rare but hazardous complication of tricyclic use. The authors present characteristic findings, treatment suggestions and a possible pathogenesis for this syndrome.

Recently, mutagenic activity on several strains of Salmonella typhimurium has been found in many heat-processed foodstuffs. The previously reported direct-acting mutagenic activity of coffee in Salmonella typhimurium TA100 (Ames assay) was confirmed in our study. In addition to TA100, a mutagenic effect of coffee was also found by using the newly developed strain TA102. The mutagenic activity was abolished by the addition of rat-liver homogenate. 10% S9 mix completely eliminated the mutagenic activity of 30 mg of coffee per plate. The addition of reduced glutathione to active S9 further decreased the mutagenic activity and also reduced the mutagenicity together with inactivated S9. The compound or compounds responsible for this inactivation are heat-labile and seem to be located in the cytosol fraction of the S9. Part of the mutagenicity of coffee was also lost spontaneously upon incubation at temperatures between 0 degrees and 50 degrees C. The loss of activity was dependent on temperature, being more pronounced at 50 degrees C compared to 0 degrees C (at 50 degrees C approximately 50% of the mutagenic activity was lost after 6 h). As anaerobic conditions prevented this loss of mutagenicity almost totally, oxidative processes are probably responsible for the inactivation. The stability of the mutagen was not influenced by incubation at low pH values (pH 1-3), with or without the addition of pepsinogen. The mutagenic properties of methylglyoxal, which to some extent could be responsible for the mutagenic activity of coffee, were compared with those of coffee. Methylglyoxal was strongly mutagenic towards Salmonella typhimurium TA100 and TA102. Its mutagenic activity was partially inactivated by the addition of 10% S9. Glyoxalase I and II together with reduced glutathione abolished the mutagenic activity of methylglyoxal but reduced the mutagenicity of coffee by only 80%. Since these enzymes occur in mammalian cells, the mutagenic compound(s) of coffee could also be degraded in vivo. This conclusion is supported by the fact that a long-term carcinogenicity study with rats was negative. These results clearly demonstrate that the effects observed in vitro do not necessarily also occur in vivo, but that in vitro experiments may contribute to the understanding of fundamental mechanisms of chemical carcinogenesis.

Three genotoxic carcinogens and eight tumor promoters were tested for induction of aneuploidy, specifically chromosome loss, in Saccharomyces cerevisiae D61.M. This is a heterozygous diploid yeast strain that permits the scoring of segregants expressing three linked recessive markers (cyhR2, ade6, and leu1), two of which (ade6 and leu1) are located close to the centromere on opposite arms of chromosome VII. The centromere marker leu was routinely checked, and a positive control (bavistan) was run with every experiment. The three genotoxic carcinogens aflatoxin B1, benzo(a)pyrene, and 7,12-dimethylbenz(a)anthracene did not induce aneuploidy, independent of the presence or absence of an exogenous metabolic activation system (rat liver homogenate; S9). Four of the eight tumor promoters tested induced chromosome loss but not mitotic recombination or mutation: cholic acid, lithocholic acid, phenobarbital, and saccharin. Diethylstilbestrol (DES) led to positive as well as to negative results in several independent experiments. In the case of the positive experiment, DES also induced putative recombinants. Three tumor promoters induced neither chromosome loss nor mitotic recombination: anthralin, 4,4'-dichloro-diphenyl-ethane (DDT) and gamma-hexachlorcyclohexane (lindane). From our experiments it can be concluded that the hypothesis put forward by Parry et al. [Nature; 294:263-265], according to which tumor promoters induce chromosome loss in yeast, is not correct in a general sense. In our set of eight tumor promoters, only one half distinctly induced chromosome loss.

In the fields of Strategic Human Resources Management and Personnel Economics, much attention has been devoted to motivation and incentives. Research in recent years has conceptualized compensation as a motivational tool, relating motivation to performance evaluation. This leads to predict that employees tend to frame their effort in a way that they believe will lead to their most valued work-related rewards and outcomes. However, noise in firm-level performance measures may deter the efficacy of compensation. Evaluation errors may occur that cause a mismatch between effort, performances, and rewards. In line with expectancy-theory and goal-setting theory, in this paper we design a principal-agent model about the impact of type-I and type-II evaluation errors on employees’ motivation. Through results from experimental treatments, we contribute to the debate about incentives and organizational performance.

The paper aims to analyze and discuss the performance determinants of Universities’ networks in 2005-2010 TEMPUS submissions and their connection with the structural dimensions of project consortia. In particular the paper presents the results of the research in progress on the relationships between the project networks performance with the size of projects consortium and the continuity of their partnership in project preparation and submission. The research has been realized within the PRIN 2008 “Governing, managing and developing networks of public administrations and public/private partnerships in labour and knowledgeintensive sectors” on the Subject “Organisation analysis, design, simulation on virtual platform and performance evaluation of public/private networks”. These TEMPUS projects had as the main target the Higher Education Institutions (HEIs) modernisation in Eastern Europe, Central Asia, Western Balkans and Mediterranean regions with particular regard to studies in entrepreneurship and small business start up. This research would contribute to the studies on networks and particularly on the determinants of their performance. It leads to discuss the development of these networks over the time and the more feasible and flexible way to manage the project consortia in the successful submission of international projects.