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Endoscopic procedures of the large bowel reduce the risk for developing colon and rectal cancer by 50%, their protective influence lasting 6 years.

A mechanism of capsular polysaccharide phase variation in Neisseria meningitidis is described. Meningococcal cells of an encapsulated serogroup B strain were used in invasion assays. Only unencapsulated variants were found to enter epithelial cells. Analysis of one group of capsule-deficient variants indicated that the capsular polysaccharide was re-expressed at a frequency of 10(-3). Measurement of enzymatic activities involved in the biosynthesis of the alpha-2,8 polysialic acid capsule showed that polysialyltransferase (PST) activity was absent in these capsule-negative variants. Nucleotide sequence analysis of siaD revealed an insertion or a deletion of one cytidine residue within a run of (dC)7 residues at position 89, resulting in a frameshift and premature termination of translation. We analysed unencapsulated isolates from carriers and encapsulated case isolates collected during an outbreak of meningococcal disease. Further paired blood-culture isolates and unencapsulated nasopharyngeal isolates from patients with meningococcal meningitis were examined. In all unencapsulated strains analysed we found an insertion or deletion within the oligo-(dC) stretch within siaD, resulting in a frameshift and loss of capsule formation. All encapsulated isolates, however, had seven dC residues at this position, indicating a correlation between capsule phase variation and bacterial invasion and the outbreak of meningococcal disease.

BackgroundGambling and gaming disorders have been included as “disorders due to addictive behaviors” in the International Classification of Diseases (ICD-11). Other problematic behaviors may be considered as “other specified disorders due to addictive behaviors (6C5Y).”MethodsNarrative review, experts' opinions.ResultsWe suggest the following meta-level criteria for considering potential addictive behaviors as fulfilling the category of “other specified disorders due to addictive behaviors”:1. Clinical relevance: Empirical evidence from multiple scientific studies demonstrates that the specific potential addictive behavior is clinically relevant and individuals experience negative consequences and functional impairments in daily life due to the problematic and potentially addictive behavior.2. Theoretical embedding: Current theories and theoretical models belonging to the field of research on addictive behaviors describe and explain most appropriately the candidate phenomenon of a potential addictive behavior.3. Empirical evidence: Data based on self-reports, clinical interviews, surveys, behavioral experiments, and, if available, biological investigations (neural, physiological, genetic) suggest that psychological (and neurobiological) mechanisms involved in other addictive behaviors are also valid for the candidate phenomenon. Varying degrees of support for problematic forms of pornography use, buying and shopping, and use of social networks are available. These conditions may fit the category of “other specified disorders due to addictive behaviors”.ConclusionIt is important not to over-pathologize everyday-life behavior while concurrently not trivializing conditions that are of clinical importance and that deserve public health considerations. The proposed meta-level-criteria may help guide both research efforts and clinical practice.

The Yale Food Addiction Scale (YFAS) measures addiction-like eating of palatable foods based on the seven diagnostic criteria for substance dependence in the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Most recently, a new version of the YFAS has been developed based on the revised eleven diagnostic criteria for substance use disorder in DSM-5. This YFAS 2.0 was translated into German and used among other measures in a study with 455 university students (89% female) and in a study with 138 obese patients presenting for bariatric surgery (78% female). In the student sample, the one-factorial structure of the English version could be replicated and internal consistency was α = 0.90. The diagnostic threshold for 'food addiction' was met by 10% of the sample. 'Food addiction' diagnoses were associated with higher body mass, binge eating frequency, trait food craving, and attentional impulsivity as well as with lower perceived self-regulatory success in dieting. In the obese sample, the diagnostic threshold for 'food addiction' was met by 47% of participants. Again, 'food addiction' symptomatology was associated with higher binge eating frequency and attentional impulsivity. However, those with a 'food addiction' diagnosis did not differ from those without a diagnosis in body mass. To conclude, psychometric properties of the English YFAS 2.0 were replicated for the German YFAS 2.0. Prevalence rates and correlates of 'food addiction' as measured with the YFAS 2.0 were similar to those found with the previous version of the YFAS. Thus, the German YFAS 2.0 appears to be a reliable measure that can be used for the investigation of addiction-like eating behavior, analogous to the original version of the YFAS and the English YFAS 2.0.

The relevance of recognition of CB as mental disorder is undeniable in the face of its estimated prevalence and associated burden. As our understanding of contributing neurobiological and etiological factors is limited, further research should focus on these topics, taking into account the heterogeneity of individuals with CB. There is also a need for specific treatment options and for the development of prevention strategies.

Little research on the prevalence and correlates of adult ADHD has been conducted outside the United States. The aim of the present study was to estimate the prevalence and correlates of adult ADHD in a large representative sample of the German population aged 18-64 years (n = 1,655). Two self-rating screening instruments to assess childhood and adult ADHD symptomatology were used to estimate the prevalence of ADHD. A 4-item screening tool was used to assess probable cases of current depression and anxiety (Patient Health Questionnaire). The estimated crude prevalence rate of current ADHD was 4.7%. Adult ADHD was significantly associated with lower age, low educational level, unemployment, marital status (never married and divorced), and rural residency. No association was found with gender. Adult ADHD was strongly associated with positive screening results for depression and anxiety. ADHD is a common disorder of adulthood, is associated with significant social impairment and psychiatric co-morbidity, and should receive further research attention.