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

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

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

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

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

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

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

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

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

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

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

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

Exploitation of distributed solar radiation databases through a smart network: the project SoDa

The project SoDa answers the needs of industry and research for information on solar radiation parameters with a satisfactory quality. The methodology is user-driven with a large involvement of users in the project, who will gauge the progresses and achievements. A prototype service will be developed, using Internet technology, that will integrate and efficiently exploit diverse networked information sources to supply value-added information. A multi-disciplinary consortium has been assembled, which gathers companies and researchers with the necessary expertise in solar radiation and information and communication technologies. Customers and potential users are also represented as partners in the consortium via the involvement of commercial private vendors of solar radiation databases and of representatives of large research and development programs. A call is launched to recruit customers to assess the prototype. The project SoDa builds on the expertise gained in previous projects, such as the digital atlases MeteoNorm and European Solar Radiation Atlas, the Web servers Satel-Light and Helioserve, and the Guide of the Chartered Institute of Building Services Engineers of United Kingdom. Access to data and applications will be improved; efforts will be made on interpolation methods and satellite data processing to achieve better quality; emphasis will be put on applications to supply information actually needed by customers, instead of raw data

Bifactor analysis of motivation for charity sport event participation

The purpose of this study was to examine the utility of the existing subscales of charity sport events (CSEs) participation motivation by adopting both a second-order modeling and a bifactor modeling approaches. The results with 488 college students revealed that the bifactor model provided a better interpretation of the data compared to second-order model. The five-factor CSE motivation significantly predict the intention to participate in CSEs along with two domain-specific motivations, namely ‘sport and event’ and ‘cause’ while other three domain-specific motivations including ‘philanthropic’, ‘social interaction’, and ‘reference group’ are not statistically significant predictors. The results suggest that the bifactor model is more useful in predicting this group’s participation in charity sport events. © 2015, Springer-Verlag Berlin Heidelberg

Mudflat surface morphology as a structuring agent of algae and associated macroepifauna communities: a case study in the Ria Formosa

Although mudflats seem relatively planar, closer inspection reveals a succession of meso-topographical features, including consecutive convex and concave meso- and micro-topographical features. The objective of this study was to determine the influence of meso-scale surface sediment morphology on the dynamics of the macroalgae Ulvales (Chlorophyta) and associated macroepifauna in the Ria Formosa tidal lagoon (southern coast of Portugal). Four sites in the Ria Formosa were sampled monthly. Two were located on convex sections (mounds) of the mudflat and the other two on concave sections (depressions). Macroalgae and related macroepifauna were sampled at each station. Biomass was quantified by determination of the ash-free dry weight (AFDW). Data were analysed using the software package ‘PRIMER’ (Plymouth Routines In Multivariate Ecological Research). Results show a clear distinction between convex and concave areas. In convex sections, Enteromorpha dominated, to the point of being the only algal species present during part of the year. Conversely, biomass and dynamics of Enteromorpha and Ulva were almost the same in concave sections. The associated macroepifauna was also different in protruding or depressed sections of the mudflat. In the convex areas, the macroepifauna population showed less diversity and was dominated by the snail Hydrobia ulvae. In concave areas, the species diversity was larger, but dominated in terms of biomass by the amphipod Melita palmata and the gastropod Nassarius pfeifferi. Results of the study indicate that the benthic communities associated with concave or convex features were different. No relevant differences in texture and sediment physico-chemical characteristics were found between convex and concave sections. The inference is that the morphological nature of the bottom in tidal mudflats can act as a structuring agent of benthic communities