Future emergence of new ecosystems caused by glacial retreat

Glacier shrinkage and the development of post-glacial ecosystems related to anthropogenic climate change are some of the fastest ongoing ecosystem shifts, with marked ecological and societal cascading consequences1-6. Yet, no complete spatial analysis exists, to our knowledge, to quantify or anticipate this important changeover7,8. Here we show that by 2100, the decline of all glaciers outside the Antarctic and Greenland ice sheets may produce new terrestrial, marine and freshwater ecosystems over an area ranging from the size of Nepal (149,000 ± 55,000 km2) to that of Finland (339,000  ±  99,000  km2). Our analysis shows that the loss of glacier area will range from 22 ± 8% to 51 ± 15%, depending on the climate scenario. In deglaciated areas, the emerging ecosystems will be characterized by extreme to mild ecological conditions, offering refuge for cold-adapted species or favouring primary productivity and generalist species. Exploring the future of glacierized areas highlights the importance of glaciers and emerging post-glacial ecosystems in the face of climate change, biodiversity loss and freshwater scarcity. We find that less than half of glacial areas are located in protected areas. Echoing the recent United Nations resolution declaring 2025 as the International Year of Glaciers' Preservation9 and the Global Biodiversity Framework10, we emphasize the need to urgently and simultaneously enhance climate-change mitigation and the in situ protection of these ecosystems to secure their existence, functioning and values.

Glacier retreat reorganizes river habitats leaving refugia for Alpine invertebrate biodiversity poorly protected

Alpine river biodiversity around the world is under threat from glacier retreat driven by rapid warming, yet our ability to predict the future distributions of specialist cold-water species is currently limited. Here we link future glacier projections, hydrological routing methods and species distribution models to quantify the changing influence of glaciers on population distributions of 15 alpine river invertebrate species across the entire European Alps, from 2020 to 2100. Glacial influence on rivers is projected to decrease steadily, with river networks expanding into higher elevations at a rate of 1% per decade. Species are projected to undergo upstream distribution shifts where glaciers persist but become functionally extinct where glaciers disappear completely. Several alpine catchments are predicted to offer climate refugia for cold-water specialists. However, present-day protected area networks provide relatively poor coverage of these future refugia, suggesting that alpine conservation strategies must change to accommodate the future effects of global warming.

Improved storage mitigates vulnerability to food-supply shocks in smallholder agriculture during the COVID-19 pandemic

Millions of smallholder farmers in low-income countries are highly vulnerable to food-supply shocks, and reducing this vulnerability remains challenging in view of climatic changes. Restrictions to limit the spread of the COVID-19 pandemic produced a severe supply-side shock in rural areas of Sub-Saharan Africa, including through frictions in agricultural markets. We use a large-scale field experiment to examine the effects of improved on-farm storage on household food security during COVID-19 restrictions. Based on text message survey data we find that the prevalence of food insecurity increased in control group households during COVID-19 restrictions (coinciding with the agricultural lean season). In treatment households, equipped with an improved on-farm storage technology and training in its use, food insecurity was lower during COVID-19 restrictions. This underscores the benefits of improved on-farm storage for mitigating vulnerability to food-supply shocks. These insights are relevant for the larger, long-term question of climate change adaptation, and also regarding trade-offs between public health protection and food security.

German validation of the Conners Adult ADHD Rating Scales (CAARS) II: Reliability, validity, diagnostic sensitivity and specificity

Background

The German version of the Conners Adult ADHD Rating Scales (CAARS) has proven to show very high model fit in confirmative factor analyses with the established factors inattention/memory problems, hyperactivity/restlessness, impulsivity/emotional lability, and problems with self-concept in both large healthy control and ADHD patient samples. This study now presents data on the psychometric properties of the German CAARS-self-report (CAARS-S) and observer-report (CAARS-O) questionnaires.

Methods

CAARS-S/O and questions on sociodemographic variables were filled out by 466 patients with ADHD, 847 healthy control subjects that already participated in two prior studies, and a total of 896 observer data sets were available. Cronbach's-alpha was calculated to obtain internal reliability coefficients. Pearson correlations were performed to assess test-retest reliability, and concurrent, criterion, and discriminant validity. Receiver Operating Characteristics (ROC-analyses) were used to establish sensitivity and specificity for all subscales.

Results

Coefficient alphas ranged from .74 to .95, and test-retest reliability from .85 to .92 for the CAARS-S, and from .65 to .85 for the CAARS-O. All CAARS subscales, except problems with self-concept correlated significantly with the Barrett Impulsiveness Scale (BIS), but not with the Wender Utah Rating Scale (WURS). Criterion validity was established with ADHD subtype and diagnosis based on DSM-IV criteria. Sensitivity and specificity were high for all four subscales.

Conclusion

The reported results confirm our previous study and show that the German CAARS-S/O do indeed represent a reliable and cross-culturally valid measure of current ADHD symptoms in adults.

Global glacier mass changes and their contributions to sea-level rise from 1961 to 2016

Glaciers distinct from the Greenland and Antarctic ice sheets cover an area of approximately 706,000 square kilometres globally¹, with an estimated total volume of 170,000 cubic kilometres, or 0.4 metres of potential sea-level-rise equivalent². Retreating and thinning glaciers are icons of climate change³ and affect regional runoff⁴ as well as global sea level^5,6. In past reports from the Intergovernmental Panel on Climate Change, estimates of changes in glacier mass were based on the multiplication of averaged or interpolated results from available observations of a few hundred glaciers by defined regional glacier areas^7-10. For data-scarce regions, these results had to be complemented with estimates based on satellite altimetry and gravimetry¹¹. These past approaches were challenged by the small number and heterogeneous spatiotemporal distribution of in situ measurement series and their often unknown ability to represent their respective mountain ranges, as well as by the spatial limitations of satellite altimetry (for which only point data are available) and gravimetry (with its coarse resolution). Here we use an extrapolation of glaciological and geodetic observations to show that glaciers contributed 27 ± 22 millimetres to global mean sea-level rise from 1961 to 2016. Regional specific-mass-change rates for 2006-2016 range from -0.1 metres to -1.2 metres of water equivalent per year, resulting in a global sea-level contribution of 335 ± 144 gigatonnes, or 0.92 ± 0.39 millimetres, per year. Although statistical uncertainty ranges overlap, our conclusions suggest that glacier mass loss may be larger than previously reported¹¹. The present glacier mass loss is equivalent to the sea-level contribution of the Greenland Ice Sheet¹², clearly exceeds the loss from the Antarctic Ice Sheet¹³, and accounts for 25 to 30 per cent of the total observed sea-level rise¹⁴. Present mass-loss rates indicate that glaciers could almost disappear in some mountain ranges in this century, while heavily glacierized regions will continue to contribute to sea-level rise beyond 2100.

Coping with stress in medical students: results of a randomized controlled trial using a mindfulness-based stress prevention training (MediMind) in Germany

BACKGROUND

High prevalence rates of psychological distress in medical training and later professional life indicate a need for prevention. Different types of intervention were shown to have good effects, but little is known about the relative efficacy of different types of stress management interventions, and methodological limitations have been reported. In order to overcome some of these limitations, the present study aimed at evaluating the effect of a specifically developed mindfulness-based stress prevention training for medical students (MediMind) on measures of distress, coping and psychological morbidity.

METHODS

We report on a prospective randomized controlled trial with three study conditions: experimental treatment (MediMind), standard treatment (Autogenic Training) and a control group without treatment. The sample consisted of medical or dental students in the second or eighth semester. They completed self-report questionnaires at baseline, after the training and at one year follow-up. Distress (Trier Inventory for the Assessment of Chronic Stress, TICS) was assessed as the primary outcome and coping (Brief COPE) as a co-primary outcome. Effects on the psychological morbidity (Brief Symptom Inventory, BSI) as a secondary outcome were expected one year after the trainings.

RESULTS

Initially, N = 183 students were randomly allocated to the study groups. At one year follow-up N = 80 could be included into the per-protocol analysis: MediMind (n =31), Autogenic Training (n = 32) and control group (n = 17). A selective drop-out for students who suffered more often from psychological symptoms was detected (p = .020). MANCOVA's on TICS and Brief COPE revealed no significant interaction effects. On the BSI, a significant overall interaction effect became apparent (p = .002, η2partial = .382), but post hoc analyses were not significant. Means of the Global Severity Index (BSI) indicated that MediMind may contribute to a decrease in psychological morbidity.

CONCLUSION

Due to the high and selective dropout rates, the results cannot be generalized and further research is necessary. Since the participation rate of the trainings was high, a need for further prevention programs is indicated. The study gives important suggestions on further implementation and evaluation of stress prevention in medical schools.

TRIAL REGISTRATION

This trial is recorded at German Clinical Trials Register under the number DRKS00005354 (08.11.2013).

Use of coffee, caffeinated drinks and caffeine tablets for cognitive enhancement in pupils and students in Germany

INTRODUCTION

Substance use for cognitive enhancement (CE) is a topic of increasing importance. There are only few data about substances, prevalence rates and factors associated with CE. The aim of this study was to assess first data about the use of coffee, caffeinated drinks and caffeine tablets for CE at school and university.

METHODS

A self-report questionnaire was developed to analyze 1 547 pupils and students about their use of coffee, caffeine tablets, and caffeinated drinks for CE and factors associated with this use.

RESULTS

Lifetime, past-year, and past-month prevalence for the use of coffee for CE was 53.2%, 8.5%, and 6.3%, for the use of caffeinated drinks 39%, 10.7%, and 6.3%, and for the use of caffeine tablets 10.5%, 3.8%, and 0.8%. Use of caffeinated substances for CE was influenced by gender and school grades.

DISCUSSION

The use of coffee and caffeinated drinks for CE was found to be widespread in the surveyed population. Although the use of caffeine tablets was found to be smaller than the above-mentioned means, it still indicates a relatively high disposition for using tablets for purposes of CE.

[Stimulant and non-stimulant medication in current and future therapy for ADHD]

The current pharmacotherapy for attention-deficit hyperactivity disorder (ADHD) is mainly based on the stimulant methylphenidate and to a small extent on amphetamines which are not approved in Germany. The only approved non-stimulant so far is atomoxetin (Strattera®), a norepinephrine reuptake inhibitor. There is no approved pharmacotherapy for adults. The aim of the available medication is a reduction of impulsivity, hyperactivity, and attention deficits. Neurobiological correlates of these effects are still not fully understood, however, a functional implication of dopaminergic and noradrenergic systems is known. To date there is no disease-modifying therapy. The currently available substances have limitations due to the short half-life of stimulants, the unknown pathomechanisms, and the use of stimulants in developing brains with possible long-term side-effects. Moreover, the abuse potential of stimulants is still controversially discussed. The recently developed Lisdexamfetamin and SPD-465 have stimulant effects, too. A number of different developmental substances in preclinical and clinical phases show other mechanisms: SPD-503 represents an α(2)A-adrenozeptoragonist, ABT-089 and ABT-418 have partial agonistic effects to the α(4)β(2)-subtype of nicotinic acetylcholinreceptors, CX-717, -1739, -1942 and -1796 are glutamatergic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-receptor agonists and PF-3 654 746 exhibits antagonistic properties to histaminergic H(3)-receptors. The α(2)A-adrenoceptor-agonist Guanfacine (Intuniv®) and the hepatic metabolised amphetamine prodrug Lisdexamfetamin (Vyvanse®) are yet approved for ADHD treatment in the USA. The aim of this review is to summarise established pharmacological treatment options and the stage of development of upcoming symptomatic stimulant and non-stimulant substances in ADHD therapy.

Non-medical use of prescription stimulants and illicit use of stimulants for cognitive enhancement in pupils and students in Germany

INTRODUCTION

The aim of this study was to assess for the first time the prevalence and factors associated with stimulant use exclusively for cognitive enhancement among pupils and university students in Germany.

METHODS

A sample of 1 035 pupils (vocational and grammar schools) in small and big cities and 512 university students of 3 Departments (Medicine, Pharmacy, Economics) completed a questionnaire regarding knowledge and use of stimulants for cognitive enhancement and factors associated with their use.

RESULTS

Lifetime prevalence for use of prescription stimulants (methylphenidate, amphetamines) for cognitive enhancement in pupils was 1.55% and in students 0.78%. Last-year and last-month prevalence rates were significantly lower. 2.42% of pupils and 2.93% of students reported lifetime illicit use of stimulants (amphetamines, cocaine, ecstasy) for cognitive enhancement with lower last-year and last-month rates. Prevalence was higher in male pupils, pupils from vocational schools and pupils with bad marks.

DISCUSSION

The illicit use of stimulants for cognitive enhancement is significantly higher than non-medical use of prescription stimulants among pupils and students. Stimulant use is determined by gender, school type, and school marks. The potential risks associated with stimulant use require early awareness and intervention strategies.

[Risk factors of mesh exposure after transvaginal repair of genital prolapse]

OBJECTIVES

We analysed the risk factors of vaginal surgery of pelvic organ prolapse with non resobable prothesis.

PATIENTS AND METHODS

This is a continuous, retrospective study of the 208 patients who had surgery between 2003 and 2007. Depending on the localisation of the prolapse, they had a prothesis under the bladder and/or a posterior tape through the sacrospinous ligament. An hysterectomy and a levator myorraphy were done if necessary.

RESULTS

After a 3 years follow-up, we found 16.8% mesh exposure (23% were treated by a conservative way). The highest rate of incidence was at 4 and 10 months. The independent risk factors of exposure were the kind of prothesis, age under 60 and concomitant hysterectomy. Women treated by vaginal estrogens and those operated by the most experienced surgeon had less exposure. We had 5% of complications during the surgery.

DISCUSSION AND CONCLUSION

Hysterectomy, kind of prothesis and inverted T colpotomy of Crossen are well known risk factors. Age, stage of prolapse, size of prothesis and surgeon experience are discussed. Vaginal surgery of pelvic organ prolapse with non resobable prothesis must be used only when prolapse stage is higher than 3, hysterectomy has to be avoid and vaginal estrogens must be prescribed.

No increase in long-term risk for nicotine use disorders after treatment with methylphenidate in children with attention-deficit/hyperactivity disorder (ADHD): evidence from a non-randomised retrospective study

OBJECTIVE

To evaluate long-term effects of methylphenidate (MPH) treatment in ADHD children on the development of nicotine use disorders (SUD-N).

METHODS

Multisite retrospective non-randomised longitudinal study with 215 ADHD children (diagnosis at 9.2 years of age; reassessment for SUD-N at 21.9 years of age) strictly parallel allocated to MPH treated (n = 106) and drug naive (n = 109) children.

RESULTS

There was no difference between the groups with respect to frequency (84% MPH; 89% non-MPH; chi(2) = 1.6; p = 0.21) and age of onset for first cigarette smoking (log rank 1.68; p = 0.19). Continuous smoking was reached by 51% (MPH) and 61% (non-MPH) of the patients. Survival analyses revealed a small and nominally significant delay in age of onset for continuous smoking in the MPH-group (log rank = 3.85; p = 0.049). Nicotine dependency was reached by 20% (MPH) and 27% (non-MPH). Age of onset does not differ between groups (log rank = 2.24; p = 0.13).

DISCUSSION

Limited evidence due to the non-randomised nature of the study is given that MPH does not induce SUD-N. The data suggests there may be a beneficial effect of MPH on delay of onset for continuous nicotine consumption in ADHD patients.

Currency and commodity metabolites: their identification and relation to the modularity of metabolic networks

The large-scale shape and function of metabolic networks are intriguing topics of systems biology. Such networks are on one hand commonly regarded as modular (i.e. built by a number of relatively independent subsystems), but on the other hand they are robust in a way not necessarily expected of a purely modular system. To address this question, we carefully discuss the partition of metabolic networks into subnetworks. The practice of preprocessing such networks by removing the most abundant substances, 'currency metabolites', is formalized into a network-based algorithm. We study partitions for metabolic networks of many organisms and find cores of currency metabolites and modular peripheries of what we call 'commodity metabolites'. The networks are found to be more modular than random networks but far from perfectly divisible into modules. We argue that cross-modular edges are the key for the robustness of metabolism.

Prise en charge en Assistance médicale à la procréation des femmes de 38 ans et plus: résultats d'une enquête à propos de 84 couples

OBJECTIVE

More and more young women are delaying childbearing until the fourth decade of life: thus, Assisted Reproductive Techniques centres receive more and more requests from ageing women. The aim of the study is to analyse the purpose of these requests, the biological and clinical features of these patients and the results in our infertility centre.

PATIENTS AND METHODS

A retrospective study was carried out at the CHU of Saint-Etienne from 01.01.01 to 31.12.04. We analysed the social, clinical and biological features of 84 couples when the woman's age was equal or superior to 38 years, representing 218 cycles. A questionnaire was used to collect social data.

RESULTS

Several factors can explain the increasing number of ageing women consulting for infertility: extend university time and professional career, professional stability, contraception and late meeting of the partner, false reassuring information concerning progress in ART, second child desire after a late first pregnancy, but also second marital unions and child desire in the redefined couple. In our study, above 40 years old, the pregnancy (19.4 versus 10.5%) and delivery rates (16.7 versus 5.8%) clearly decreased in IUI. Thus, most of the clinicians propose, in first choice, an IVF cycle to a 40 year-old woman. The ultrasound measurement of antral follicle count can accurately evaluate the prognosis in terms of pregnancy (P<0.01) and delivery rate (P=0.03). For patients with unfavourable prognosis, oocyte donation, embryo donation, or adoption can be considered.

DISCUSSION AND CONCLUSION

ART cannot compensate for the natural decrease in pregnancy rates and the increase in early miscarriages in ageing women. Therefore, it is essential to inform young women of the negative effects of age on their potential fertility.

Die Prävalenz der Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) bei Kindern und Jugendlichen in Deutschland

The cardinal symptoms of attention-deficit/hyperactivity disorder (ADHD) are inattention, hyperactivity and impulsivity. Etiologically, ADHD is mainly put down to genetic causes; it entails a considerable range of psychosocial problems for those affected and their social environment. The parents of a total of 7,569 boys (B) and 7,267 girls (G) aged 3-17 who took part in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) answered a self-administered questionnaire including an ADHD diagnosis question and the Strengths and Difficulties Questionnaire (SDQ). In addition behavioural observations of 7,919 children (aged 3-11) were carried out during the medical and physical tests. Participants whose parents reported that they had ever been given an ADHD diagnosis by a doctor or psychologist were classified as ADHD cases. Participants were classified as suspected cases of ADHD if they had a value of > or =7 on the SDQ inattention/hyperactivity scale. ADHD had ever been diagnosed in 4.8 % of the children and adolescents altogether (B: 7.7 %, G: 1.8 %). Another 4.9 % of the participants can be considered as suspected cases. Already 1.8 % of the preschoolers had been given an ADHD diagnosis. At primary school age (7-10 years old) the frequency of diagnosis rises sharply. At age 11-17, ADHD had ever been diagnosed in 1 in 10 boys and 1 in 43 girls. ADHD had been diagnosed significantly more frequently among participants of low socio-economic status (SES) than among participants of high SES. A diagnosis of ADHD is reported less often for migrants, they rank more frequently among the suspected cases. The discrepancy between confirmed and suspected cases of ADHD among migrants may point to lower diagnosis rates or lower utilization of medical services. The short- and long-term medical, social and health-economic effects of ADHD illustrate the major public health relevance of the disorder. As for prevention, the high share of genetic factors in ADHD etiology primarily suggests secondary prevention (early support and early diagnosis) and tertiary prevention measures. Further analysis of the KiGGS data could prospectively identify risk groups more precisely and refine preventional approaches.

[Long-term courses in children with attention deficit hyperactivity disorder (ADHD)]

ADHD was long considered to be the attention deficit disorder of childhood. Observations over the long-term have, however, shown that some one-third of victims also continue to meet the criteria for ADHD in adulthood too. In many cases, such additional psychiatric conditions as depression or an addictive illness are also to be seen. Today, ADHD is believed to be a mainly heritable disorder with deviations in the dopaminergic system. Re-evaluation of the condition now focuses attention on the attention-related, rather than the hyperactivity-related aspects of the problem. Currently, the best therapeutic results are achieved through the use of stimulants coupled with intensive paediatric psychiatric care.

Guidelines and algorithms for the use of methylphenidate in children with Attention-Deficit/ Hyperactivity Disorder

OBJECTIVE

To review published algorithms for guiding the use of methylphenidate (MPH) in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents.

METHODS

A consensus roundtable of 12 experts was convened to review the evidence for the safety and efficacy of MPH in the treatment of ADHD, as well as the published algorithms and practice guidelines for using MPH. The experts reviewed the algorithms for practicality and acceptability by clinicians.

RESULTS

Algorithms that included MPH commonly selected it as the initial medication to be employed in the treatment of children with ADHD. Factors involved included its high efficacy, good safety record, and the ubiquitous nature of its appearance in the ADHD treatment literature.

CONCLUSIONS

MPH should be considered as the first medication to be used in a treatment algorithm for children and adolescents with ADHD.

Methylphenidate and substance abuse: a review of pharmacology, animal, and clinical studies

This article reviews pharmacological, animal, and human evidence regarding the abuse liability of methylphenidate (MPH). Findings are not always consistent, but evidence converges to suggest that although intravenous methylphenidate has some abuse potential, there is very little potential for oral MPH abuse. Furthermore, the available data suggests that children with Attention-Deficit/Hyperactivity Disorder (ADHD) who are treated with MPH are at lower risk for substance use disorder later in life. More longitudinal, prospective studies are needed to assess the long term effects of MPH treatment in ADHD.

Discriminant validity of the child behaviour checklist CBCL-4/18 in German samples

This study examined the discriminant validity of the German version of CBCL in two large samples of referred and non-referred children and adolescents which were matched for age, sex and socio-economic status. The combined sample that was used for statistical analysis consists of 2,058 referred and 2,058 non-referred boys and girls between 4 and 18 years of age (mean age: referred boys= 10.9 years, non-referred boys = 10.9 years, referred girls=11.3 years, non-referred girls=11.1 years). Referral status was used as validity criterion. Statistical procedures included Odds Ratios, Total Predictive Values, ROC analyses and discriminant analyses. Results indicated that the discriminant validity of the German version of CBCL is comparable to the original English version. With the use of CBCL Total Problem Score as predictor (cut-off T > or = 60) 83.8% of children and adolescents could correctly be classified (sensitivity 83.6%, specificity 83.9%). Symptoms of the "Attention Problems Scale" show the highest discriminative power to distinguish between disturbed and undisturbed children and adolescents.

[Cross-cultural comparison of Conners Scales: Can the US-American factorial structure be replicated on German clinical sample?]

OBJECTIVE

International networks in child psychiatry research increasingly rely on the cross-cultural generalizability of commonly used questionnaire factor structures. The aim of this study is to analyze whether the U.S. factor structure of the Conners Parent Rating Scale (CPRS) can be replicated in a German clinical sample.

METHOD

A German child psychiatry sample of 1394 children children and adolescents was randomly splitted into halves. One sub-sample was used to calculate a German factor model by means of exploratory factor analysis. This model is tested in comparison with he U.S. model constructed according to Conners (1989) in the second sub-sample by means of a confirmatory factor analysis (LISREL 8).

RESULTS

87% of the path relations in the German and U.S.-American models are identical. Both models show limitations with regard to their predictive power. As expected, the goodness of fit indices for the German model are somewhat better than for the U.S. model (GFI = .81; AGFI = .75 versus GFI = .76; AGFI = .71).

CONCLUSIONS

The goodness of fit indices of the CPRS model are less satisfactory than those of other studies on the cross-cultural generalizability of factor structures of dimensional questionnaires (i.e., De Groot et al., 1994). However, this is mainly due to restrictions within the model (no multiple factor loadings). With respect to the cross-cultural generalizability differences were found in the impulsiveness/hyperactivity scale. All other scales could be well replicated.

[Cross-cultural comparison of Conners Scales: Can the US-American factorial structure be replicated on German clinical sample?]

OBJECTIVE

International networks in child psychiatry research increasingly rely on the cross-cultural generalizability of commonly used questionnaire factor structures. The aim of this study is to analyze whether the U.S. factor structure of the Conners Parent Rating Scale (CPRS) can be replicated in a German clinical sample.

METHOD

A German child psychiatry sample of 1394 children children and adolescents was randomly splitted into halves. One sub-sample was used to calculate a German factor model by means of exploratory factor analysis. This model is tested in comparison with he U.S. model constructed according to Conners (1989) in the second sub-sample by means of a confirmatory factor analysis (LISREL 8).

RESULTS

87% of the path relations in the German and U.S.-American models are identical. Both models show limitations with regard to their predictive power. As expected, the goodness of fit indices for the German model are somewhat better than for the U.S. model (GFI = .81; AGFI = .75 versus GFI = .76; AGFI = .71).

CONCLUSIONS

The goodness of fit indices of the CPRS model are less satisfactory than those of other studies on the cross-cultural generalizability of factor structures of dimensional questionnaires (i.e., De Groot et al., 1994). However, this is mainly due to restrictions within the model (no multiple factor loadings). With respect to the cross-cultural generalizability differences were found in the impulsiveness/hyperactivity scale. All other scales could be well replicated.

[Day treatment in German child and adolescent psychiatry: analysis of data from a nationwide survey with respect to cost effectiveness]

Day treatment plays an increasingly important role in German child and adolescent psychiatry. In spite of a steady and ongoing increase of day treatment facilities over the past 15 years only few empicial data on the structure of German day treatment are available. The study refers to an Germany wide assessment of all day treatment centers (DTC). 45 out of 61 DTC responded (reply rate 74%). Analyses were done over 560 treatment places used by 69% male and 31% female patients mean ages 10 years and 2 months. Mean treatment duration is 104 days without differences with respect to the primary psychotherapeutic orientation (behavioral, psychodynamic, family therapy, other). Personnel is in 80.5% of the DTC below the governmental guidelines. Rates per day vary between 280 DM and 617 DM with a mean of 389 DM. Mean treatment costs per patient are 36.303 DM (min.: 12.825 DM; max.: 89.793 DM). Rates per day and duration of treatment are negatively correlated: The higher the rate per day, the shorter the treatment (explained variance: 17%). This correlation can only be explained indirectly by more personnel as associated with higher daily rates. However, more influential is the amount of time the children are present in day treatment per week: The longer the children are present, the shorter the duration of the whole treatment. Diagnosis, gender, and age only influence duration and costs of the treatment marginally. Network-effects as operationalized by the availability of additional inpatient and outpatient facilities did not influence costs and duration of day treatment.

A test for the diagnosis of dead regions in the cochlea

Hearing impairment may sometimes be associated with complete loss of inner hair cells (IHCs) over a certain region of the basilar membrane. We call this a 'dead region'. Amplification (using a hearing aid) over a frequency range corresponding to a dead region may not be beneficial and may even impair speech intelligibility. However, diagnosis of dead regions is not easily done from the audiogram. This paper reports the design and evaluation of a method for detecting and delimiting dead regions. A noise, called 'threshold equalizing noise' (TEN), was spectrally shaped so that, for normally hearing subjects, it would give equal masked thresholds for pure tone signals at all frequencies within the range 250-10,000 Hz. Its level is specified as the level in a one-ERB (132 Hz) wide band centred at 1000 Hz. Measurements obtained from 22 normal-hearing subjects and TEN levels of 30, 50 and 70 dB/ERB confirmed that the signal level at masked threshold was approximately equal to the noise level/ERB and was almost independent of signal frequency. Masked thresholds were measured for 20 ears of 14 subjects with sensorineural hearing loss, using TEN levels of 30, 50 and 70 dB/ERB. Psychophysical tuning curves (PTCs) were measured for the same subjects. When there are surviving IHCs corresponding to a frequency region with elevated absolute thresholds, a signal in that frequency region is detected via IHCs with characteristic frequencies (CFs) close to that region. In such a case, threshold in the TEN is close to that for normal-hearing listeners, provided that the noise intensity is sufficient to produce significant masking. Also, the tip of the PTC lies close to the signal frequency. When a dead region is present, the signal is detected via IHCs with CFs different from that of the signal frequency. In such a case, threshold in the TEN is markedly higher than normal, and the tip of the PTC is shifted away from the signal frequency. Generally, there was a very good correspondence between the results obtained using the TEN and the PTCs. We conclude that the measurement of masked thresholds in TEN provides a quick and simple method for the diagnosis of dead regions.

Three-dimensional structure and subunit topology of the V(1) ATPase from Manduca sexta midgut

The three-dimensional structure of the Manduca sexta midgut V(1) ATPase has been determined at 3.2 nm resolution from electron micrographs of negatively stained specimens. The V(1) complex has a barrel-like structure 11 nm in height and 13.5 nm in diameter. It is hexagonal in the top view, whereas in the side view, the six large subunits A and B are interdigitated for most of their length (9 nm). The topology and importance of the individual subunits of the V(1) complex have been explored by protease digestion, resistance to chaotropic agents, MALDI-TOF mass spectrometry, and CuCl(2)-induced disulfide formation. Treatment of V(1) with trypsin or chaotropic iodide resulted in a rapid cleavage or release of subunit D from the enzyme, indicating that this subunit is exposed in the complex. Trypsin cleavage of V(1) decreased the ATPase activity with a time course that was in line with the cleavage of subunits B, C, G, and F. When CuCl(2) was added to V(1) in the presence of CaADP, the cross-linked products A-E-F and B-H were generated. In experiments where CuCl(2) was added after preincubation of CaATP, the cross-linked products E-F and E-G were formed. These changes in cross-linking of subunit E to near-neighbor subunits support the hypothesis that these are nucleotide-dependent conformational changes of the E subunit.

Association of the neutral endopeptidase (MME) gene with anxiety

Enkephalins have been implicated in the regulation of mood, anxiety, reward, euphoria and pain. One of the major enzymes for enkephalin degradation is neutral endopeptidase [enkephalinase, membrane metalloendopeptidase (MME)]. We identified a dinucleotide polymorphism in the 5' region of the MME gene. Subjects were placed into three genotypes, 3/3, 3/x, and x/x since the 3 allele was the most common of the six alleles. Using one-way analysis of variance, we examined the association of these genotypes with the mean SCL-90 scores for anxiety, depression, obsessive-compulsive and phobic anxiety symptoms in 120 Caucasian males from an addiction treatment unit. There was a significant association between the MME genotypes and the SCL-90 scores for phobic anxiety, obsessive-compulsive and anxiety at a Bonferroni corrected alpha value of 0.0125. These results support a role of genetic variants of enkephalin metabolism in anxiety.

Association between the adrenergic alpha 2A receptor gene (ADRA2A) and measures of irritability, hostility, impulsivity and memory in normal subjects

The noradrenergic system has been implicated in arousal, vigilance, irritability hostility, and memory. This suggests the hypothesis that genetic variants at noradrenergic receptors may be risk factors of these behaviors. To test this hypothesis, the potential association between measures of these traits and genetic variation at the adrenergic2A receptor gene (ADRA2A), using a common single nucleotide polymorphism (SNP) polymorphism of the promoter region, were examined in two independent sets of subjects: university students (student group), and parents of twins in the Minnesota Twin Study (twin group). In the student group, there was a significant linear association by genotype (11 > 12 > 22) for the total Brown ADD score (BADD), and BADD subscores of memory and irritability, and with the total Buss-Durkee Hostility Inventory (BDHI) score and BDHI subscores of indirect hostility, irritability, negativity, and verbal aggression. A multiple analysis of variance (MANOVA) of all the BADD and BDHI subscores was significant at P < or = 0.009. For the twin group, the same genotype associations were significant for the Multidimensional Personality Questionnaire (MPQ) impulsivity scores but not for the MPQ aggression or harm avoidance scores. The ADRA2A gene accounted for 1.8-8.3% of the variance of these scores.

Structure and regulation of insect plasma membrane H(+)V-ATPase

H(+) V-ATPases (V-ATPases) are found in two principal locations, in endomembranes and in plasma membranes. The plasma membrane V-ATPase from the midgut of larval Manduca sexta is the sole energizer of all transepithelial secondary transport processes. At least two properties make the lepidopteran midgut a model tissue for studies of general aspects of V-ATPases. First, it is a rich source for purification of the enzyme and therefore for structural studies: 20 larvae provide up to 0.5 mg of holoenzyme, and soluble, cytosolic V(1) complexes can be obtained in even greater amounts of up to 2 mg. Second, midgut ion-tranport processes are strictly controlled by the regulation of the V-ATPase, which is the sole energizer of all ion transport in this epithelium. Recent advances in our understanding the structure of the V(1) and V(o) complexes and of the regulation of the enzyme's biosynthesis and ion-transport activity will be discussed.

A novel insect V-ATPase subunit M9.7 is glycosylated extensively

Plasma membrane V-ATPase isolated from midgut and Malpighian tubules of the tobacco hornworm, Manduca sexta, contains a novel prominent 20-kDa polypeptide. Based on N-terminal protein sequencing, we cloned a corresponding cDNA. The deduced hydrophobic protein consisted of 88 amino acids with a molecular mass of only 9.7 kDa. Immunoblots of the recombinant 9.7-kDa polypeptide, using a monoclonal anti- body to the 20-kDa polypeptide, confirmed that the correct cDNA had been cloned. The 20-kDa polypeptide is glycosylated, as deduced from lectin staining. Treatment with N-glycosidase A resulted in the appearance of two additional protein bands of 16 and 10 kDa which both were immunoreactive to the 20-kDa polypeptide-specific monoclonal antibody. Thus, extensive N-glycosylation of the novel Vo subunit M9.7 accounts for half of its molecular mass observed in SDS-polyacrylamide gel electrophoresis. M9.7 exhibits some similarities to the yeast protein Vma21p which resides in the endoplasmic reticulum and is required for the assembly of the Vo complex. However, as deduced from immunoblots as well as from activities of the V-ATPase and endoplasmic reticulum marker enzymes in different membrane preparations, M9.7 is, in contrast to the yeast polypeptide, a constitutive subunit of the mature plasma membrane V-ATPase of M. sexta.

The plasma membrane H+-V-ATPase from tobacco hornworm midgut

The midgut plasma membrane V-ATPase from larval Manduca sexta, the tobacco hornworm, is the sole energizer of any epithelial ion transport in this tissue and is responsible for the alkalinization of the gut lumen up to a pH of more than 11. This mini-review deals with those topics of research on this enzyme which may have contributed or are expected to contribute novel and general aspects to the field of V-ATPases. Topics dealt with include novel subunits or the quaternary structure of the V1 complex, as well as the regulation of the enzyme's function by reversible dissociation of the V1 from the V0 complexes and by genetic control on the transcriptional and posttranscriptional level.

Quaternary structure of V1 and F1 ATPase: significance of structural homologies and diversities

The V1 ATPase from the tobacco hornworm Manduca sexta and the Escherichia coli F1 ATPase were characterized by small-angle X-ray scattering (SAXS). The radii of gyration (Rg) of the complexes were 6.2 +/- 0.1 and 4.7 +/- 0.02 nm, respectively. The shape of the M. sexta V1 ATPase was determined ab initio from the scattering data showing six masses, presumed to be the A and B subunits, arranged in an alternating manner about a 3-fold axis. A seventh mass with a length of about 11.0 nm extends perpendicularly to the center of the hexameric unit. This central mass is presumed to be the stalk that connects V1 with the membrane domain (V(O)) in the intact V1V(O)-ATPase. In comparison, the shape of the F1 ATPase from E. coli possesses a quasi-3-fold symmetry over the major part of the enzyme. The overall asymmetry of the structure is given by a stem, assumed to include the central stalk subunits. The features of the V1 and F1 ATPase reveal structural homologies and diversities of the key components of the complexes.

[Incidence of psychiatric symptoms and somatic complaints in 4- to 10-year-old children in Germany as judged by parents--a comparison of norm-oriented and criteria-oriented models]

OBJECTIVES

To analyze the frequency of behavioral/emotional problems and somatic complaints of children aged four to ten as rated by their parents.

METHOD

The analysis is based on the PAK-KID study on behavioural and emotional problems and psychosocial competencies of children and adolescents in Germany. In a nationally representative sample of N = 1030 children aged four to ten years the parents rated their child using the Child Behavior Checklist.

RESULTS

The prevalence rates of the symptoms are presented. Additionally global prevalence rates based on three different models were calculated and compared. They range from 13.1% to 28.3%. The issues of defining cutoffs necessary for the calculation of prevalence rates are discussed.

[Mental disturbances in children and adolescents in Germany. Results of a representative study:age,gender and rater effects]

METHOD

A study on behavioral and emotional problems and competence in children and adolescents in Germany (PAK-KID study) is described. It is the first nationwide representative survey of this kind of children and adolescents aged 4 to 18 years in Germany. For children aged 4 to 10 years the parents completed the German version of Achenbach's Child Behavior Checklist (CBCL 4-18) developed by the Arbeitsgruppe Deutsche Child Behavior Checklist. Children and adolescents aged 11 years and older filled out the German version of the Youth Self-Report that is part of Achenbach's CBCL in addition to the parents completing the German version of the CBCL. A total of 2856 parent questionnaires and 1798 self-report questionnaires completed by children and adolescents were analyzed.

RESULTS

The sample was representative with respect to the main sociodemographic variables. On all problem scales children and adolescents aged 11 to 18 years reported significantly more problems than their parents did. The frequency of internalizing problems (social withdrawal, somatic complaints, anxiety/depression) and delinquent behavior of children and adolescents reported by parents increased with the children's age, whereas aggressive behavior and attention problems decreased with age. Girls reported significantly more problems than boys on all internalizing scales of the Youth Self-Report. The effect was not totally replicated in the parent reports. In the parent reports, boys had more attention problems and more aggressive and delinquent behavior than girls.

Children's ability to delay gratification: longitudinal relations to mother-child attachment

Concurrent and longitudinal mother-child attachment qualities were studied in relation to children's ability to postpone gratification at age 6 years. A sample of 32 children (at ages 12 months and 18 months) and their mothers participated in the strange situation procedure. At age 6 years, they were observed in an attachment situation and administered a standard delay of gratification task. The length of time that children were able to delay gratification at age 6 was predicted both by concurrent attachment quality and by a longitudinal attachment measure. Children with secure attachment were able to wait the longest periods of time, whereas those with insecure-disorganized attachment had the most difficulties in waiting. The effects of longitudinal, but not concurrent, attachment quality on children's total waiting time remained significant when other important variables were considered, including gender and children's cognitive functioning. An interactive effect was found between attachment quality and cognitive functioning. Insecure-avoidantly attached children with high cognitive functioning did not differ in their overall waiting times from securely attached children, but insecure-avoidantly attached children with average or low cognitive functioning did have shorter waiting times. The study provides a basis for the further investigation of mother-child attachment quality as a factor that is linked to children's delay behavior.

[The value of different sources of information in evaluating psychiatric disorders in adolescence--a comparison of parental judgment and self-assessment by adolescents]

Data from the national representative epidemiologic survey (PAK-KID-study) assessed by the German versions of Achenbach'S Child Behavior Checklist and Youth Self-Report of N = 1757 parents and their children aged 11 to 18 years are compared by using the corresponding Cross-Informant-Scales. On all problem scales adolescents report more problems than parents. For some scales the differences between girls and their parents are higher than between boys and their parents (social withdrawal, somatic complaints, anxious/depressed, attention problems, internalizing and total score). Averaged Pearson correlations of the eight subscales are in a moderate rage (r < 0.50). For all problem scales an agreement of 30% in the area of high problems (> PR95) is found. If one informant scores above PR95 the Relative Risk of the other one scoring in this range too is significantly higher than one for nearly all scales.

Regulation of proton-translocating V-ATPases

Vacuolar-type ATPases (V-ATPases) are proton-translocating enzymes that occur in the endomembranes of all eukaryotes and in the plasma membranes of many eukaryotes. They are multisubunit, heteromeric proteins composed of two structural domains, a peripheral, catalytic V1 domain and a membrane-spanning V0 domain. Both the multitude of locations and the heteromultimeric structure make it likely that the expression and the activity of V-ATPases are regulated in various ways. Regulation of gene expression encompasses control of transcription as well as control at the post-transcriptional level. Regulation of enzyme activity encompasses many diverse mechanisms such as disassembly/reassembly of V1 and V0 domains, oxidation of SH groups, control by activator and inhibitor proteins or by small signalling molecules, and sorting of the holoenzyme or its subunits to target membranes.