Clinical characteristics and possible phenotypes of an adult severe asthma population

Background: Currently, there are no studies of well-characterized severe asthmatics in Brazil. We aimed to study a population of severe treated asthmatics still uncontrolled to characterize them and define possible phenotypes. Methods: Descriptive cross-sectional outpatient study of severe asthmatics, evaluating functional and inflammatory markers, health-related quality of life, anxiety and depression symptoms, clinical control status, and characteristics related to atopy, age of asthma onset, induced sputum eosinophil levels, and airflow limitation. We also grouped the subgroups characteristics to identify phenotypes. The study is registered on ClinicalTrial.gov NCT 01089322. Results: From 128 eligible patients with severe/uncontrolled asthma, 74 fulfilled the inclusion criteria. The cohort was comprised of 85% women, frequently with a body mass index higher than 31 kg m(-2), atopy (60%), early-onset disease (50%), sputum eosinophilia (80%), comorbidities, and reduced quality of life. Nonatopics had significant higher asthma onset (19 y.a.) and twice level of induced sputum eosinophil. Late-onset patients had significantly less atopy (57%) and higher levels of induced sputum eosinophils. Non-eosinophilics had lower levels of inflammatory markers. Patients with airflow limitation had more intensive care unit admissions (56%) and 1.5 times more airway resistance. Subgroups characteristics identified a priori four well-characterized phenotypes, with 55% presenting sputum eosinophilia. Conclusion: Our data emphasize the high burden of disease, the persistence of inflammation and the existence of clinical possible phenotypes population sharing common features with published cohorts. Despite the necessity of further investigation into pathogenic mechanisms, this study with clinically difficult patient group may help to improve future asthma care. (C) 2011 Elsevier Ltd. All rights reserved.

Longitudinal familial analysis of blood pressure involving parametric (co)variance functions

Abstract Background For analyzing longitudinal familial data we adopted a log-linear form to incorporate heterogeneity in genetic variance components over the time, and additionally a serial correlation term in the genetic effects at different levels of ages. Due to the availability of multiple measures on the same individual, we permitted environmental correlations that may change across time. Results Systolic blood pressure from family members from the first and second cohort was used in the current analysis. Measures of subjects receiving hypertension treatment were set as censored values and they were corrected. An initial check of the variance and covariance functions proposed for analyzing longitudinal familial data, using empirical semi-variogram plots, indicated that the observed trait dispersion pattern follows the assumptions adopted. Conclusion The corrections for censored phenotypes based on ordinary linear models may be an appropriate simple model to correct the data, ensuring that the original variability in the data was retained. In addition, empirical semi-variogram plots are useful for diagnosis of the (co)variance model adopted.

The Emergence of the Post-Socialist Welfare State - The Case of the Baltic States : Estonia, Latvia and Lithuania

This dissertation takes a step towards providing a better understanding of post-socialist welfare state development from a theoretical as well as an empirical perspective. The overall analytical goal of this thesis has been to critically assess the development of social policies in Estonia, Latvia and Lithuania using them as illustrative examples of post-socialist welfare state development in the light of the theories, approaches and typologies that have been developed to study affluent capitalist democracies. The four studies included in this dissertation aspire to a common aim in a number of specific ways. The first study tries to place the ideal-typical welfare state models of the Baltic States within the well-known welfare state typologies. At the same time, it provides a rich overview of the main social security institutions in the three countries by comparing them with each other and with the previous structures of the Soviet period. It examines the social insurance institutions of the Baltic States (old-age pensions, unemployment insurance, short-term benefits, sickness, maternity and parental insurance and family benefits) with respect to conditions of eligibility, replacement rates, financing and contributions. The findings of this study indicate that the Latvian social security system can generally be labelled as a mix of the basic security and corporatist models. The Estonian social security system can generally also be characterised as a mix of the basic security and corporatist models, even if there are some weak elements of the targeted model in it. It appears that the institutional changes developing in the social security system of Lithuania have led to a combination of the basic security and targeted models of the welfare state. Nevertheless, as the example of the three Baltic States shows, there is diversity in how these countries solve problems within the field of social policy. In studying the social security schemes in detail, some common features were found that could be attributed to all three countries. Therefore, the critical analysis of the main social security institutions of the Baltic States in this study gave strong supporting evidence in favour of identifying the post-socialist regime type that is already gaining acceptance within comparative welfare state research. Study Two compares the system of social maintenance and insurance in the Soviet Union, which was in force in the three Baltic countries before their independence, with the currently existing social security systems. The aim of the essay is to highlight the forces that have influenced the transformation of the social policy from its former highly universal, albeit authoritarian, form, to the less universal, social insurance-based systems of present-day Estonia, Latvia and Lithuania. This study demonstrates that the welfare–economy nexus is not the only important factor in the development of social programs. The results of this analysis revealed that people's attitudes towards distributive justice and the developmental level of civil society also play an important part in shaping social policies. The shift to individualism in people’s mentality and the decline of the labour movement, or, to be more precise, the decline in trade union membership and influence, does nothing to promote the development of social rights in the Baltic countries and hinders the expansion of social policies. The legacy of the past has been another important factor in shaping social programs. It can be concluded that social policy should be studied as if embedded not only in the welfare-economy nexus, but also in the societal, historical and cultural nexus of a given society. Study Three discusses the views of the state elites on family policy within a wider theoretical setting covering family policy and social policy in a broader sense and attempts to expand this analytical framework to include other post-socialist countries. The aim of this essay is to explore the various views of the state elites in the Baltics concerning family policy and, in particular, family benefits as one of the possible explanations for the observed policy differences. The qualitative analyses indicate that the Baltic States differ significantly with regard to the motives behind their family policies. Lithuanian decision-makers seek to reduce poverty among families with children and enhance the parents’ responsibility for bringing up their children. Latvian policy-makers act so as to increase the birth rate and create equal opportunities for children from all families. Estonian policy-makers seek to create equal opportunities for all children and the desire to enhance gender equality is more visible in the case of Estonia in comparison with the other two countries. It is strongly arguable that there is a link between the underlying motives and the kinds of family benefits in a given country. This study, thus, indicates how intimately the attitudes of the state bureaucrats, policy-makers, political elite and researchers shape social policy. It confirms that family policy is a product of the prevailing ideology within a country, while the potential influence of globalisation and Europeanisation is detectable too. The final essay takes into account the opinions of welfare users and examines the performances of the institutionalised family benefits by relying on the recipients’ opinions regarding these benefits. The opinions of the populations as a whole regarding government efforts to help families are compared with those of the welfare users. Various family benefits are evaluated according to the recipients' satisfaction with those benefits as well as the contemporaneous levels of subjective satisfaction with the welfare programs related to the absolute level of expenditure on each program. The findings of this paper indicate that, in Latvia, people experience a lower level of success regarding state-run family insurance institutions, as compared to those in Lithuania and Estonia. This is deemed to be because the cash benefits for families and children in Latvia are, on average, seen as marginally influencing the overall financial situation of the families concerned. In Lithuania and Estonia, the overwhelming majority think that the family benefit systems improve the financial situation of families. It appears that recipients evaluated universal family benefits as less positive than targeted benefits. Some universal benefits negatively influenced the level of general satisfaction with the family benefits system provided in the countries being researched. This study puts forward a discussion about whether universalism is always more legitimate than targeting. In transitional economies, in which resources are highly constrained, some forms of universal benefits could turn out to be very expensive in relative terms, without being seen as useful or legitimate forms of help to families. In sum, by closely examining the different aspects of social policy, this dissertation goes beyond the over-generalisation of Eastern European welfare state development and, instead, takes a more detailed look at what is really going on in these countries through the examples of Lithuania, Latvia and Estonia. In addition, another important contribution made by this study is that it revives ‘western’ theoretical knowledge through ‘eastern’ empirical evidence and provides the opportunity to expand the theoretical framework for post-socialist societies.

Sostanzialismo e relazionalismo dello spaziotempo alla luce della relatività generale

Until recently the debate on the ontology of spacetime had only a philosophical significance, since, from a physical point of view, General Relativity has been made "immune" to the consequences of the "Hole Argument" simply by reducing the subject to the assertion that solutions of Einstein equations which are mathematically different and related by an active diffeomorfism are physically equivalent. From a technical point of view, the natural reading of the consequences of the "Hole Argument” has always been to go further and say that the mathematical representation of spacetime in General Relativity inevitably contains a “superfluous structure” brought to light by the gauge freedom of the theory. This position of apparent split between the philosophical outcome and the physical one has been corrected thanks to a meticulous and complicated formal analysis of the theory in a fundamental and recent (2006) work by Luca Lusanna and Massimo Pauri entitled “Explaining Leibniz equivalence as difference of non-inertial appearances: dis-solution of the Hole Argument and physical individuation of point-events”. The main result of this article is that of having shown how, from a physical point of view, point-events of Einstein empty spacetime, in a particular class of models considered by them, are literally identifiable with the autonomous degrees of freedom of the gravitational field (the Dirac observables, DO). In the light of philosophical considerations based on realism assumptions of the theories and entities, the two authors then conclude by saying that spacetime point-events have a degree of "weak objectivity", since they, depending on a NIF (non-inertial frame), unlike the points of the homogeneous newtonian space, are plunged in a rich and complex non-local holistic structure provided by the “ontic part” of the metric field. Therefore according to the complex structure of spacetime that General Relativity highlights and within the declared limits of a methodology based on a Galilean scientific representation, we can certainly assert that spacetime has got "elements of reality", but the inevitably relational elements that are in the physical detection of point-events in the vacuum of matter (highlighted by the “ontic part” of the metric field, the DO) are closely dependent on the choice of the global spatiotemporal laboratory where the dynamics is expressed (NIF). According to the two authors, a peculiar kind of structuralism takes shape: the point structuralism, with common features both of the absolutist and substantival tradition and of the relationalist one. The intention of this thesis is that of proposing a method of approaching the problem that is, at least at the beginning, independent from the previous ones, that is to propose an approach based on the possibility of describing the gravitational field at three distinct levels. In other words, keeping the results achieved by the work of Lusanna and Pauri in mind and following their underlying philosophical assumptions, we intend to partially converge to their structuralist approach, but starting from what we believe is the "foundational peculiarity" of General Relativity, which is that characteristic inherent in the elements that constitute its formal structure: its essentially geometric nature as a theory considered regardless of the empirical necessity of the measure theory. Observing the theory of General Relativity from this perspective, we can find a "triple modality" for describing the gravitational field that is essentially based on a geometric interpretation of the spacetime structure. The gravitational field is now "visible" no longer in terms of its autonomous degrees of freedom (the DO), which, in fact, do not have a tensorial and, therefore, nor geometric nature, but it is analyzable through three levels: a first one, called the potential level (which the theory identifies with the components of the metric tensor), a second one, known as the connections level (which in the theory determine the forces acting on the mass and, as such, offer a level of description related to the one that the newtonian gravitation provides in terms of components of the gravitational field) and, finally, a third level, that of the Riemann tensor, which is peculiar to General Relativity only. Focusing from the beginning on what is called the "third level" seems to present immediately a first advantage: to lead directly to a description of spacetime properties in terms of gauge-invariant quantites, which allows to "short circuit" the long path that, in the treatises analyzed, leads to identify the "ontic part” of the metric field. It is then shown how to this last level it is possible to establish a “primitive level of objectivity” of spacetime in terms of the effects that matter exercises in extended domains of spacetime geometrical structure; these effects are described by invariants of the Riemann tensor, in particular of its irreducible part: the Weyl tensor. The convergence towards the affirmation by Lusanna and Pauri that the existence of a holistic, non-local and relational structure from which the properties quantitatively identified of point-events depend (in addition to their own intrinsic detection), even if it is obtained from different considerations, is realized, in our opinion, in the assignment of a crucial role to the degree of curvature of spacetime that is defined by the Weyl tensor even in the case of empty spacetimes (as in the analysis conducted by Lusanna and Pauri). In the end, matter, regarded as the physical counterpart of spacetime curvature, whose expression is the Weyl tensor, changes the value of this tensor even in spacetimes without matter. In this way, going back to the approach of Lusanna and Pauri, it affects the DOs evolution and, consequently, the physical identification of point-events (as our authors claim). In conclusion, we think that it is possible to see the holistic, relational, and non-local structure of spacetime also through the "behavior" of the Weyl tensor in terms of the Riemann tensor. This "behavior" that leads to geometrical effects of curvature is characterized from the beginning by the fact that it concerns extensive domains of the manifold (although it should be pointed out that the values of the Weyl tensor change from point to point) by virtue of the fact that the action of matter elsewhere indefinitely acts. Finally, we think that the characteristic relationality of spacetime structure should be identified in this "primitive level of organization" of spacetime.

Molecular mechanisms involved in the pathogenesis of beet soil-borne viruses.

The genus Benyvirus includes the most important and widespread sugar beet viruses transmitted through the soil by the plasmodiophorid Polymyxa betae. In particular Beet necrotic yellow vein virus (BNYVV), the leading infectious agent that affects sugar beet, causes an abnormal rootlet proliferation known as rhizomania. Beet soil-borne mosaic virus (BSBMV) is widely distributed in the United States and, up to date has not been reported in others countries. My PhD project aims to investigate molecular interactions between BNYVV and BSBMV and the mechanisms involved in the pathogenesis of these viruses. BNYVV full-length infectious cDNA clones were available as well as full-length cDNA clones of BSBMV RNA-1, -2, -3 and -4. Handling of these cDNA clones in order to produce in vitro infectious transcripts need sensitive and expensive steps, so I developed agroclones of BNYVV and BSBMV RNAs, as well as viral replicons allowing the expression of different proteins. Chenopodium quinoa and Nicotiana benthamiana plants have been infected with in vitro transcripts and agroclones to investigate the interaction between BNYVV and BSBMV RNA-1 and -2 and the behavior of artificial viral chimeras. Simultaneously I characterized BSBMV p14 and demonstrated that it is a suppressor of post-transcriptional gene silencing sharing common features with BNYVV p14.

La tratta di donne a fini di sfruttamento sessuale: strumenti di contrasto e possibilità di intervento.

L’obiettivo della ricerca è, da un lato, quello di definire un quadro conoscitivo di sfondo rispetto al fenomeno della tratta e dello sfruttamento sessuale di donne che approdano nel contesto italiano, dall’altro quello di esaminare gli interventi politici e legislativi posti in essere per contrastare il fenomeno e per tutelarne le vittime. Dopo uno sguardo alle caratteristiche strutturali della tratta, alla normativa italiana, europea e internazionale connessa al suo contrasto e alla protezione delle vittime e ai modelli di intervento sociale nel settore posti in essere nel nostro Paese, l’analisi si è concretizzata prendendo in considerazione i risultati emersi dall’attività di ricerca. L’analisi delle storie di vita delle vittime, di nazionalità nigeriana, albanese e serba ha permesso, da un lato, di evidenziare la complessità dei loro percorsi di vita e dall’altro di tracciare un quadro delle modalità organizzative e di sfruttamento utilizzate dal racket nigeriano e da quello albanese. Sul versante legislativo, invece, le interviste ai ricercatori svedesi sono state volte a comprendere se la normativa che punisce l’acquisto di prestazioni sessuali potesse avere un potere deterrente e, quindi, se potesse rappresentare una risposta efficace per arginare il fenomeno della prostituzione schiavizzata. In ultimo, dal punto di vista processuale, l’analisi delle sentenze giudiziarie penali emesse dal Tribunale di Rimini è stata utile per individuare le principali dinamiche che caratterizzano il rapporto tra l’autore e la vittima di reato e, non di meno, per sottolineare l’importanza del ruolo della vittima nel processo penale.

A Robust Parser of Czech

Mr. Kubon's project was inspired by the growing need for an automatic, syntactic analyser (parser) of Czech, which could be used in the syntactic processing of large amounts of texts. Mr. Kubon notes that such a tool would be very useful, especially in the field of corpus linguistics, where creating a large-scale "tree bank" (a collection of syntactic representations of natural language sentences) is a very important step towards the investigation of the properties of a given language. The work involved in syntactically parsing a whole corpus in order to get a representative set of syntactic structures would be almost inconceivable without the help of some kind of robust (semi)automatic parser. The need for the automatic natural language parser to be robust increases with the size of the linguistic data in the corpus or in any other kind of text which is going to be parsed. Practical experience shows that apart from syntactically correct sentences, there are many sentences which contain a "real" grammatical error. These sentences may be corrected in small-scale texts, but not generally in the whole corpus. In order to be able to complete the overall project, it was necessary to address a number of smaller problems. These were; 1. the adaptation of a suitable formalism able to describe the formal grammar of the system; 2. the definition of the structure of the system's dictionary containing all relevant lexico-syntactic information, and the development of a formal grammar able to robustly parse Czech sentences from the test suite; 3. filling the syntactic dictionary with sample data allowing the system to be tested and debugged during its development (about 1000 words); 4. the development of a set of sample sentences containing a reasonable amount of grammatical and ungrammatical phenomena covering some of the most typical syntactic constructions being used in Czech. Number 3, building a formal grammar, was the main task of the project. The grammar is of course far from complete (Mr. Kubon notes that it is debatable whether any formal grammar describing a natural language may ever be complete), but it covers the most frequent syntactic phenomena, allowing for the representation of a syntactic structure of simple clauses and also the structure of certain types of complex sentences. The stress was not so much on building a wide coverage grammar, but on the description and demonstration of a method. This method uses a similar approach as that of grammar-based grammar checking. The problem of reconstructing the "correct" form of the syntactic representation of a sentence is closely related to the problem of localisation and identification of syntactic errors. Without a precise knowledge of the nature and location of syntactic errors it is not possible to build a reliable estimation of a "correct" syntactic tree. The incremental way of building the grammar used in this project is also an important methodological issue. Experience from previous projects showed that building a grammar by creating a huge block of metarules is more complicated than the incremental method, which begins with the metarules covering most common syntactic phenomena first, and adds less important ones later, especially from the point of view of testing and debugging the grammar. The sample of the syntactic dictionary containing lexico-syntactical information (task 4) now has slightly more than 1000 lexical items representing all classes of words. During the creation of the dictionary it turned out that the task of assigning complete and correct lexico-syntactic information to verbs is a very complicated and time-consuming process which would itself be worth a separate project. The final task undertaken in this project was the development of a method allowing effective testing and debugging of the grammar during the process of its development. The problem of the consistency of new and modified rules of the formal grammar with the rules already existing is one of the crucial problems of every project aiming at the development of a large-scale formal grammar of a natural language. This method allows for the detection of any discrepancy or inconsistency of the grammar with respect to a test-bed of sentences containing all syntactic phenomena covered by the grammar. This is not only the first robust parser of Czech, but also one of the first robust parsers of a Slavic language. Since Slavic languages display a wide range of common features, it is reasonable to claim that this system may serve as a pattern for similar systems in other languages. To transfer the system into any other language it is only necessary to revise the grammar and to change the data contained in the dictionary (but not necessarily the structure of primary lexico-syntactic information). The formalism and methods used in this project can be used in other Slavic languages without substantial changes.

A Comparative Study on Higher Education Acts in Bulgaria, Hungary, Poland, Romania and Russia

The original aim of this project was to describe and analyse the higher education acts in force in five Central and Eastern European countries at present, trying to understand the dependence of higher education on the historical traditions, national peculiarities and all-European tendencies. The description and comparison of the main aspects of higher education was supplemented by a study of the possibilities of transferring experience in the field between the five countries and possible solutions to implementing foreign structural and functional models. Questions covered included the role of the state in the management of higher education, the structures of the higher education systems and the organisation of institutions, academic autonomy and the classifications of academic teaching staff, the main trends in the recent development of research, academic degrees, the accreditation of higher education institutions, and the financing of higher education. Popov found that it was almost impossible to understand the dependence of higher education on historical traditions and national peculiarities purely through a study of the relevant legislation. Education traditions in these countries have twice been broken, once with the start of communism (1917 in Russia and 1944-45 in Bulgaria, Hungary, Poland and Romania) and for a second time at the beginning of the 1990s. The most recent higher education acts in all five countries studied have abandoned many of their historical and national traditions, following instead all-European trends as determined by Western Europe, and the project included a study of the dependence on these trends. There were also difficulties in comparing some aspects of higher education as it depended on how far a given aspect has different or common features in the different countries and to what extent the application is comparable. While many possible areas for transferring experience between the five countries were identified, Popov concentrated on those where he felt that there was a real practical possibility of application in view of national academic differences. He concluded by defining some of the challenges facing each country in the field of higher education and by making some predictions as to the developments in the different countries.

Brief review on the epidemiology of transmissible spongiform encephalopathies (TSE)

Transmissible spongiform encephalopathies (TSE) form a group of human and animal diseases that share common features such as (a) distinct pathological lesions in the central nervous system, (b) transmissibility at least in experimental settings, and (c) a long incubation period. Considerable differences exist in the host range of individual TSEs, their routes of transmission, and factors influencing the host susceptibility (such as genotype). The objective of this review was to briefly describe the main epidemiological features of TSEs with emphasis on small ruminant (sheep, goats) TSE, bovine spongiform encephalopathy (BSE) in cattle and chronic wasting disease (CWD) in deer and elk.

Concurrent monitoring of cerebral electrophysiology and metabolism after traumatic brain injury: an experimental and clinical study

Multiparameter cerebral monitoring has been widely applied in traumatic brain injury to study posttraumatic pathophysiology and to manage head-injured patients (e.g., combining O(2) and pH sensors with cerebral microdialysis). Because a comprehensive approach towards understanding injury processes will also require functional measures, we have added electrophysiology to these monitoring modalities by attaching a recording electrode to the microdialysis probe. These dual-function (microdialysis/electrophysiology) probes were placed in rats following experimental fluid percussion brain injuries, and in a series of severely head-injured human patients. Electrical activity (cell firing, EEG) was monitored concurrently with microdialysis sampling of extracellular glutamate, glucose and lactate. Electrophysiological parameters (firing rate, serial correlation, field potential occurrences) were analyzed offline and compared to dialysate concentrations. In rats, these probes demonstrated an injury-induced suppression of neuronal firing (from a control level of 2.87 to 0.41 spikes/sec postinjury), which was associated with increases in extracellular glutamate and lactate, and decreases in glucose levels. When placed in human patients, the probes detected sparse and slowly firing cells (mean = 0.21 spike/sec), with most units (70%) exhibiting a lack of serial correlation in the spike train. In some patients, spontaneous field potentials were observed, suggesting synchronously firing neuronal populations. In both the experimental and clinical application, the addition of the recording electrode did not appreciably affect the performance of the microdialysis probe. The results suggest that this technique provides a functional monitoring capability which cannot be obtained when electrophysiology is measured with surface or epidural EEG alone.

Paleomagnetic Study of the Portage Lake Volcanics exposed in the Quincy Mine

A detailed paleomagnetic and rock-magnetic investigation was conducted on thirty six basaltic flows of the ~1095 Ma Portage Lake Volcanics. The flows were sampled along the East Adit of the Quincy Mine (Hancock, MI). Thirty two flows yielded well-defined primary magnetization directions carried by magnetite. A secondary magnetization component carried by hematite was also found in twenty nine flows. After correction for serial correlation between the flows, nineteen independent mean directions were calculated. The corresponding paleomagnetic pole is located at 25.5 °N, 182.1 °W (A95 = 3.5°). The new pole overlaps with the pole from the ~1087 Ma Lake Shore Traps suggesting a standstill of the North American plate during that time period. The low angular dispersion of virtual geomagnetic poles (S = 7.9°) suggests that the flows were erupted within a short time period, or that the strength of geomagnetic secular variation was lower than that of the recent field.

Climate spectrum estimation in the presence of timescale errors

We introduce an algorithm (called REDFITmc2) for spectrum estimation in the presence of timescale errors. It is based on the Lomb-Scargle periodogram for unevenly spaced time series, in combination with the Welch's Overlapped Segment Averaging procedure, bootstrap bias correction and persistence estimation. The timescale errors are modelled parametrically and included in the simulations for determining (1) the upper levels of the spectrum of the red-noise AR(1) alternative and (2) the uncertainty of the frequency of a spectral peak. Application of REDFITmc2 to ice core and stalagmite records of palaeoclimate allowed a more realistic evaluation of spectral peaks than when ignoring this source of uncertainty. The results support qualitatively the intuition that stronger effects on the spectrum estimate (decreased detectability and increased frequency uncertainty) occur for higher frequencies. The surplus information brought by algorithm REDFITmc2 is that those effects are quantified. Regarding timescale construction, not only the fixpoints, dating errors and the functional form of the age-depth model play a role. Also the joint distribution of all time points (serial correlation, stratigraphic order) determines spectrum estimation.

Natural history study of arthrogryposis multiplex congenita, amyoplasia type

Arthrogryposis or Arthrogrypsosis Multiplex Congenita (AMC) are terms used to describe the clinical finding of multiple congenital contractures. There are more than 300 distinct disorders associated with arthrogryposis. Amyoplasia is the most common type of arthrogryposis and is often referred to as the “classic” type. There is no known cause of amyoplasia and no risk factors have been identified. Moreover, there is no established diagnostic criteria, which has led to inconsistency and confusion in the medical literature. The purpose of this study was to describe the natural history of amyoplasia, to determine if there are any identifiable risk factors and develop a list of diagnostic criteria. A retrospective chart review of 59 children with arthrogryposis ascertained at the Shriners Hospitals for Children in Houston, Texas was performed and included the following information: prenatal, birth, and family histories, and phenotypic descriptions. Forty-four children were identified with amyoplasia and 15 children with other multiple congenital contractures and other anomalies (MCC) were used as a comparison group. With the exception of abnormal amniotic fluid levels during pregnancy, there were no significant demographic or prenatal risk factors identified. However, we found common features that discriminate amyoplasia from other types of arthrogryposis and developed a diagnostic checklist. This checklist can be used as diagnostic criteria for discriminating amyoplasia from isolated and multiple contracture conditions.

Self-Reported Psychotic-Like Experiences Are a Poor Estimate of Clinician-Rated Attenuated and Frank Delusions and Hallucinations

Background: One reason for the decision to delay the introduction of an Attenuated Psychosis Syndrome in the main text of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders was the concern that attenuated psychotic symptoms (APS) might in fact be common features in adolescents and young adults from the general population of no psychopathological significance in themselves. This concern was based on reports of high prevalence rates of psychotic-like experiences (PLEs) in the general population and the assumption that PLEs are a good estimate of APS. Although the criterion validity of self-reported PLEs had already been studied with respect to clinician-rated psychotic symptoms and found insufficient, it had been argued that PLEs might in fact be more comparable with mild, subclinical expressions of psychotic symptoms and, therefore, with APS. The present paper is the first to specifically study this assumption. Sampling and Methods: The sample consisted of 123 persons seeking help at a service for the early detection of psychosis, of whom 54 had an at-risk mental state or psychosis, 55 had a nonpsychotic mental disorder and 14 had no full-blown mental disorder. PLEs were assessed with the Peters Delusion Inventory and the revised Launay-Slade Hallucination Scale, and psychotic symptoms and APS were assessed with the Structured Interview for Prodromal Syndromes. Results: At a level of agreement between the presence of any PLE (in 98.4% of patients) and any APS (in 40.7%) just exceeding chance (κ = 0.022), the criterion validity of PLEs for APS was insufficient. Even if additional qualifiers (high agreement or distress, preoccupation and conviction) were considered, PLEs (in 52.8%) still tended to significantly overestimate APS, and agreement was only fair (κ = 0.340). Furthermore, the group effect on PLE prevalence was, at most, moderate (Cramer's V ≤ 0.382). Conclusions: The prevalence of APS cannot be deduced from studies of PLEs. Thus, the high population prevalence rate of PLEs does not allow the conclusion that APS are common features of no pathological significance and would lack clinical validity as an Attenuated Psychosis Syndrome in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Rather, the population prevalence rate of APS has to be assumed to be largely unknown at present but is likely lower than indicated by epidemiological studies of PLEs. Therefore, dedicated studies are warranted, in which APS are assessed in a way that equates to their clinical evaluation.

Non-exponential return time distributions for vorticity extremes explained by fractional Poisson processes

Serial correlation of extreme midlatitude cyclones observed at the storm track exits is explained by deviations from a Poisson process. To model these deviations, we apply fractional Poisson processes (FPPs) to extreme midlatitude cyclones, which are defined by the 850 hPa relative vorticity of the ERA interim reanalysis during boreal winter (DJF) and summer (JJA) seasons. Extremes are defined by a 99% quantile threshold in the grid-point time series. In general, FPPs are based on long-term memory and lead to non-exponential return time distributions. The return times are described by a Weibull distribution to approximate the Mittag–Leffler function in the FPPs. The Weibull shape parameter yields a dispersion parameter that agrees with results found for midlatitude cyclones. The memory of the FPP, which is determined by detrended fluctuation analysis, provides an independent estimate for the shape parameter. Thus, the analysis exhibits a concise framework of the deviation from Poisson statistics (by a dispersion parameter), non-exponential return times and memory (correlation) on the basis of a single parameter. The results have potential implications for the predictability of extreme cyclones.