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Seventeenth-century Amsterdam was a city of innovations. Explosive economic growth, the expansion of overseas trade, and a high level of religious tolerance sparked great institutional, socioeconomic and legal changes, a period generally known as 'the Dutch Golden Age.' In this book, Maurits den Hollander discusses how insolvency legislation contributed to the rise of a modern commercial order in seventeenth-century Amsterdam. He analyzes the procedure and principles behind Amsterdam's specialized insolvency court (the Desolate Boedelskamer, 1643) from a theoretical perspective as well as through the eyes of citizens whose businesses failed. The Amsterdam authorities created a regulatory environment which solved insolvency more leniently, and thus economically more efficiently, than in previous times or places. Moving beyond the traditional view of insolvency as a moral failure and the debtor as a criminal, the Amsterdam court recognized that business failure was often beyond the insolvent's personal control, and helped restore trust and credit among creditors and debtors.
In clinical practice, health outcomes relevant for economic evaluations, such as health-related quality of life (i.e., utilities), are not always available. However, algorithms can be developed to map available outcome measures to utilities. In the Netherlands, the Health of the Nations Outcomes Scores (HoNOS) is a physician-reported, disease-specific outcome measure frequently used for patients with severe mental illness for which no mapping algorithms for utilities currently exist. The aim of this study was to develop an algorithm to map responses on the HoNOS to EQ-5D utilities for use in economic evaluations.
Methods
A dataset was obtained from the Pharmacotherapy Monitoring and Outcome Survey cohort study containing data from patients with psychotic disorders. The dataset contains EQ-5D-3L domain and HoNOS scores, the age and sex of patients, and additional demographics. Correlation between the EQ-5D-3L and HoNOS was evaluated. To derive mapping functions, least absolute shrinkage and selection operator (LASSO) regression and random forest algorithms were applied with various predictor variables using a machine learning approach, whereby data were split into separate training and test sets. Cross-validation was then used to compare the performance of different models using R-squared and the root mean square error (RMSE).
Results
A total of 2,111 patients were included in the study. Spearman’s correlation coefficients indicated a weak to moderate negative correlation of -0.31. Based on model performance metrics, LASSO models outperformed random forest models on the training set, where the model including all individual HoNOS items and the age and sex of patients showed the best overall performance with an RMSE of 0.237 and an R-squared of 0.218. When applied to the test set, this resulted in an R-squared of 0.233 and a mean absolute error of 0.177.
Conclusions
The HoNOS can be mapped onto EQ-5D-3L utilities with moderate predictive accuracy. The reported mapping algorithm may be sufficient to predict overall population utility scores for use in health economic evaluations but lacks accuracy for individual patient predictions.
This paper outlines the ways in which the project is addressing the colonial legacy of Henry Wellcome as well as presenting the data from the first three field seasons at Jebel Moya, south-central Sudan. These data have substantially revised our chronological and socio-economic understanding of the site. Our excavations, initiated in 2017 and continued in 2019 and 2022, show a longer, more continuous occupation of the site than has been previously recognised. The faunal and botanical remains have implications for the spread of early domesticates in the eastern Sahel and for climate changes, and raise issues of resilience. There is confirmed human burial activity from at least the third millennium BC onwards, while the pottery continues to yield information about the variety of decoration and, for the final Assemblage 3, data on its usage. Overall, the continued importance of the site for the eastern Sahel is re-emphasised.
Two ensembles are frequently used to model random graphs subject to constraints: the microcanonical ensemble (= hard constraint) and the canonical ensemble (= soft constraint). It is said that breaking of ensemble equivalence (BEE) occurs when the specific relative entropy of the two ensembles does not vanish as the size of the graph tends to infinity. Various examples have been analysed in the literature. It was found that BEE is the rule rather than the exception for two classes of constraints: sparse random graphs when the number of constraints is of the order of the number of vertices, and dense random graphs when there are two or more constraints that are frustrated. We establish BEE for a third class: dense random graphs with a single constraint on the density of a given simple graph. We show that BEE occurs in a certain range of choices for the density and the number of edges of the simple graph, which we refer to as the BEE-phase. We also show that, in part of the BEE-phase, there is a gap between the scaling limits of the averages of the maximal eigenvalue of the adjacency matrix of the random graph under the two ensembles, a property that is referred to as the spectral signature of BEE. We further show that in the replica symmetric region of the BEE-phase, BEE is due to the coexistence of two densities in the canonical ensemble.
Digital treatment for neurodevelopmental disorders is being developed in order to treat patients online when possible, to reduce waitinglists, and to improve efficiency of treatment. In this workshop, first experiences with the so called Start Programme of the Super Brains app for ADHD in adults are presented. The Super Brains app has been developed by Rutger den Hollander, who himself has ADHD and owns an ICT company in the Netherlands, in cooperation with the speaker of this workshop and Parnassiagroep. The Start Programme is a new part of the Super Brains app, meant for patients referred for treatment that have to wait on often long waitinglists. Now they have no longer to wait, but can start immediately preparing for assessment by filling in questionnaires, and with psycho-education, lifestyle tips and support by experience experts that welcome them in the app and show them around. First data on the use of different parts of the Start Programme, the activity of patients in the app, and the satisfaction of patients will be presented. We also aim to study whether the Start Progamme is effective in reducing severity of ADHD symptoms. Super Brains can be adjusted for use in patients with other (neurodevelopmental) disorders easily.
The aim of the current study was to develop scales that assess symptoms of depression and anxiety and can adequately differentiate between depression and anxiety disorders, and also can distinguish within anxiety disorders. As point of departure, we used the tripartite model of Clark and Watson that discerns three dimensions: negative affect, positive affect and physiological hyperarousal.
Methods
Analyses were performed on the data of 1449 patients, who completed the Mood and Anxiety Symptoms Questionnaire (MASQ) and the Brief Symptom Inventory (BSI). From this, 1434 patients were assessed with a standardized diagnostic interview.
Results
A model with five dimensions was found: depressed mood, lack of positive affect, somatic arousal, phobic fear and hostility. The scales appear capable to differentiate between patients with a mood and with an anxiety disorder. Within the anxiety disorders, somatic arousal was specific for patients with panic disorder. Phobic fear was associated with panic disorder, simple phobia and social anxiety disorder, but not with generalized anxiety disorder.
Conclusions
We present a five-factor model as an extension of the tripartite model. Through the addition of phobic fear, anxiety is better represented than in the tripartite model. The new scales are capable to accurately differentiate between depression and anxiety disorders, as well as between several anxiety disorders.
It is likely that’real-life patients’ differ from randomized controlled trial (RCT) patients and from non-treatment seeking populations. However, much of what is known about characteristics of patients with depression and anxiety is based on RCTs and studies in the general population. Data on’naturalistic’ or’real-life patients’ are scarce.
Objectives & aims
In several studies so far, we investigated specific characteristics of patients with depression and anxiety in routine psychiatric specialty care. We studied gender differences in depression, and differences in age of onset of depression. Another study aimed to establish predictors for deliberate self-harm and suicidal ideation (DSHI) in patients with depression and anxiety.
Methods
We used baseline data of the Routine Outcome Monitoring (ROM) study. From 2004–2007, 3798 patients had been routinely assessed with ROM, by specially trained nurses. ROM consists of both self report and observational instruments.
Results
Female patients with depression reported more severe complaints on self-report instruments, as well as worse general health. Observational instruments showed no differences. In addition, patients with depression onset before the age of 18 reported more current suicidality and previous suicide attempts. Finally, low education, being unmarried, comorbidity, more severe symptoms of anxiety and depression, and emotional instability were independent predictors of DSHI.
Conclusions
Our findings in naturalistic outpatients differed from previous findings based on RCTs and studies in the general population. Since our findings are based on routinely obtained measurements in treatment seeking patients, these data may reflect the phenomenology of real life patients more closely.
The Hamming graph H(d, n) is the Cartesian product of d complete graphs on n vertices. Let ${m=d(n-1)}$ be the degree and $V = n^d$ be the number of vertices of H(d, n). Let $p_c^{(d)}$ be the critical point for bond percolation on H(d, n). We show that, for $d \in \mathbb{N}$ fixed and $n \to \infty$,
which extends the asymptotics found in [10] by one order. The term $O(m^{-1}V^{-1/3})$ is the width of the critical window. For $d=4,5,6$ we have $m^{-3} =O(m^{-1}V^{-1/3})$, and so the above formula represents the full asymptotic expansion of $p_c^{(d)}$. In [16] we show that this formula is a crucial ingredient in the study of critical bond percolation on H(d, n) for $d=2,3,4$. The proof uses a lace expansion for the upper bound and a novel comparison with a branching random walk for the lower bound. The proof of the lower bound also yields a refined asymptotics for the susceptibility of a subcritical Erdös–Rényi random graph.
The aim of this study was to evaluate the cost-effectiveness of exposure in vivo (EXP, a cognitive-behavioral treatment targeting pain-related fear) in Complex Regional Pain Syndrome Type I (CRPS-I), as compared to pain-contingent physical therapy (PPT).
Methods:
Data from a randomized controlled trial were used to compare the cost-effectiveness of EXP versus PPT from a societal perspective. Intervention costs, other healthcare costs, costs to patient and family, and productivity losses were included. The main outcomes were changes in the SF-36 physical component scale and quality-adjusted life-years. Changes were followed until 6 months after treatment. Uncertainty was estimated using nonparametric bootstrap analysis, cost-effectiveness acceptability curves and cost-effectiveness planes. Sensitivity analyses were performed to check robustness of findings.
Results:
Forty-six patients were randomized and thirty-eight completed the study. Over 6 months, EXP resulted in greater improvement in physical health-related quality of life and quality-adjusted life-years than PPT. Despite higher initial treatment costs, EXP showed a tendency to reduce all costs compared with PPT; healthcare costs were significantly reduced. Furthermore, the cost-effectiveness planes were in favor of EXP. Sensitivity analyses, for different program costs and complete cases only, confirmed robustness of these findings.
Conclusions:
EXP, a cognitive-behavioral treatment, seems more cost-effective than PPT in CRPS patients with pain-related fear. The initial higher costs for EXP are offset by a long-term reduction of costs for healthcare use, and a tendency to lower work absenteeism and reduced societal costs. Due to low sample sizes, replication of findings is required to confirm results.
Causal inference lies at the heart of many legal questions. Yet in the context of complicated disease litigation, in particular, the causal inquiry is beset with difficulties due to gaps in scientific knowledge concerning the precise biological processes underlying such diseases. Civil courts across the globe, faced with increased litigation on such matters, struggle to adhere to their judicial fact-finding and decision-making role in the face of such scientific uncertainty. An important difficulty in drawing evidentially sound causal inferences is the binary format of the traditional legal test for factual causation, being the ‘but for’ test, which is based on the condicio-sine-qua-non principle. To the question ‘would the damage have occurred in the absence of the defendant's wrongful behaviour’ the ‘but for’ test requires a simple yes or no answer. This is increasingly deemed unsatisfactory in cases in which, given the state of science, true causation cannot possibly be determined with certainty.
The production of Dutch-language Bibles in the second half of the fifteenth century was largely determined by the book culture of the Low Countries in the late Middle Ages. At that time the handwritten book still held the most important place, and the printed book was only gradually developing into a distinct and independent medium. This development is also evident in the earliest selection of Dutch Bibles that were printed. The texts printed first were the most popular Bible texts: texts for which the demand exceeded the supply. Of the thirty-three Dutch editions of the Bible printed before 1500, the majority (twenty-six) are made up of texts from the Epistles and Gospels, which give the Scripture passages to be used for the readings during the liturgical year. Most of the remaining printed editions are Psalters. In both cases these printed editions are popular works that would have been relatively risk-free for the publisher on account of guaranteed sales in an already existing market. These genres continued to be popular in the first two decades of the sixteenth century, comprising 75 percent of the twenty Dutch Bibles printed in total.
The growing interest in vernacular Bibles is also reflected in the booming production of handwritten Dutch biblical texts in this period, which were not limited only to Psalters and the Epistles and Gospels. The number of hand-written copies produced is naturally significantly lower than the number of printed editions. What is striking is that, during this phase, certain existing types of texts, which used biblical material and had been developed in previous centuries, only finally began to flourish in this period. Thus the genre of the Middle Dutch Life of Jesus, which dates from the last quarter of the thirteenth century, became unprecedentedly popular in the fifteenth century. Furthermore, the fourteenth-century translation of the New Testament by Johan Scutken also grew gradually in popularity, most significantly among lay brothers and sisters from (semi-) religious communities which were influenced by the Devotio Moderna. The vast majority of the manuscripts of this New Testament were produced during the fifteenth century.
Pre-adult onset of major depressive disorder (MDD) may predict a more severe phenotype of depression. As data from naturalistic psychiatric specialty care settings are scarce, we examined phenotypic differences between pre-adult and adult onset MDD in a large sample of consecutive out-patients.
Method
Altogether, 1552 out-patients, mean age 39.2±11.6 years, were diagnosed with current MDD on the Mini-International Neuropsychiatric Interview Plus diagnostic interview as part of the usual diagnostic procedure. A total of 1105 patients (71.2%) had complete data on all variables of interest. Pre-adult onset of MDD was defined as having experienced the signs and symptoms of a first major depressive episode before the age of 18 years. Patients were stratified according to the age at interview (20–40/40–65 years). Correlates of pre-adult onset were analysed using logistic regression models adjusted for age, age squared and gender.
Results
Univariate analyses showed that pre-adult onset of MDD had a distinct set of demographic (e.g. less frequently living alone) and clinical correlates (more co-morbid DSM-IV – Text Revision diagnoses, more social phobia, more suicidality). In the multivariate model, we found an independent association only for a history of suicide attempts [odds ratio (OR) 3.15, 95% confidence intervals (CI) 1.97–5.05] and current suicidal thoughts (OR 1.81, 95% CI 1.26–2.60) in patients with pre-adult versus adult onset MDD.
Conclusions
Pre-adult onset of MDD is associated with more suicidality than adult onset MDD. Age of onset of depression is an easy to ascertain characteristic that may help clinicians in weighing suicide risk.
The probing activities of the most important leafhopper vector of maize streak virus, Cicadulina mbila (Naudé) (Hemiptera: Cicadellidae) were studied on different host-plants. Host preference was determined by giving the insects a choice of six plants, Digitaria sanguinalis, Zea mays, Zea perennis, Paspalum conjugatum, Oryza sativa and Saccharum officinarum (all Gramineae). Cicadulina mbila showed a strong preference for D. sanguinalis. Histological examination of plant tissues for salivary sheaths was used to reveal the preferred tissue. Cicadulina mbila tended to ingest from the phloem of its preferred hosts, and switch to mesophyll or xylem tissue on less preferred hosts. The suitability of each host was assessed by measuring the weight gain and amount of honeydew produced on each host by newly emerged adult females. Both parameters were greatest on the preferred host. Probing behaviour was also monitored electronically by recording the different waveform patterns produced when insects were probing, ingesting or not probing on the selected hosts. Cicadulina mbila probed less frequently, ingested longer and spent less time in non-probing activities on its preferred host, D. sanguinalis, although these responses were similar on maize and sugarcane. Rice induced poor probing responses and altered behaviour. This interpretation of the waveforms was supported by histological examination. As maize streak virus (MSV) is not found in phloem sieve elements, prolonged ingestion from sieve cells would not account for efficient acquisition from maize, which would require ingestion from other types of cells. D. sanguinalis was the host in which most ingestion from the phloem occurred, but it is the poorest source of MSV.
When the Habsburg dynasty had finally driven back the Turks, repopulation of the Alföld (the Great Hungarian Plain) began. The policies that were adopted reshaped the whole ethnic structure of the region. Under Turkish rule the Hungarians had become not only impoverished but greatly depleted in numbers. In Slavonia there were no Hungarians left at all and very few were left in the southern hahf of de Bácska, between the Franz Joseph Canal and the Danube, or in the Bánát, or in the counties of Tolna and Baranya in Transdanubia, or in the north.
The Nagy-Magyar Alföld, the Great Hungarian Plain, lies within the Carpathian crescent, between the last foothills of the Alps and the South Slavic and Transylvanian mountain ranges. The Danube and the Tisza meander slowly through it, carrying their muddy waters to the narrow passage of the Iron Gates. The landscape here—the wide horizons shimmering in the heat of summer with unreal outlines, the crossed well-poles like slanting T's, the endless fields alternately of wheat and maize, the alkali-rimmed lakes, the lack of trees, the occasional stretches of empty steppe with not a single human being in sight—is to anyone from the tree-clad mountain slopes across the Danube a startling contrast. The visitor will soon discover that the character of the region and the traditions of its people have combined in the course of history to create here unique social forms.
Social reality which is remote in time or in space has a charm of its own. A desire to escape one's own time and environment, the longing for the exotic and bygone (a longing that, at times, is reinforced by the spirit of the time, as during the romantic movement), residual dreams of adolescence, the lure which distance offers to the freely roaming fantasy, the urge for new experience, the turning away from daily and trivial matters, the tendency to criticize oneself through the foreign — there are many and subtle motivations that make the distant and the foreign fascinating. Novalis did not only state that everything becomes romantic and poetic “when it is moved into remoteness”; he also spoke of the “dignity of the unknown”.