The effect of aggressive group norms on young adults' conformity behavior in WhatsApp chats: a vignette-based experiment.

Social networking and messaging applications, such as WhatsApp, have become an essential social environment for adolescents and young adults (AYA). While facilitating connectivity, they also bear hazards, including cyber-aggression. This study investigates the impact of (aggressive) group norms on AYA's propensity to expect cyberaggressive behaviors within different group chats. Based on a vignette scenario, realistically simulated WhatsApp group chats enabled scrutinizing, if and how exemplary reactions (funny, aggressive, friendly) of group members influence AYA's conformity to cyber-aggression (N = 500, aged 16 to 29). Additionally, we examined the effect of chat group type-close friends versus fellow students-on the anticipation of aggressive reactions. Sociodemographic, social, and developmental-psychological factors were evaluated for potential effects. Multilevel logistic regression analyses indicated that aggressive group norms significantly predict cyber-aggression anticipation, while no effect of chat group type was observed. Controlling for the size and vivacity of participant's friend group, gender, age, and educational status were significant predictors: males, younger participants, and non-university students expected higher levels of cyber-aggression conformity. This study underlines the importance of group dynamics on perceptions of cyber-aggression and hints at individual risk factors for AYA's digital communication behavior.

Application to combine questioning, stimulus presentation and external measurements in a real-life music eye tracking experiment.

Studying people in real-life situations, such as making music in a vocal group, requires flexible and integrative measurement technology. Therefore, a digital browser-based survey instrument was developed for this study. It was designed to seamlessly introduce questions on participants' mobile devices through external control immediately after relevant events, aiming to achieve high accuracy in self-administered situational questions. In addition, chronological synchronization with supplementary measurements (here eye-tracking and audio recording) was incorporated. Digital features of this web app offer convenient integration into everyday situations, synchronous interviewing of multiple people, and gathering time-based data. Due to the numerous possibilities of the browser-based development interface, various other application areas can be opened up. The contribution of this article is:-App - explanation and offer for use-Feasibility report on the implementation of the app in an eye-tracking study with vocal groups.

A Mobile-Based Preventive Intervention for Young, Arabic-Speaking Asylum Seekers During the COVID-19 Pandemic in Germany: Design and Implementation.

BACKGROUND: Most individuals seeking asylum in Germany live in collective housing and are thus exposed to a higher risk of contagion during the COVID-19 pandemic. OBJECTIVE: In this study, we aimed to test the feasibility and efficacy of a culture-sensitive approach combining mobile app-based interventions and a face-to-face group intervention to improve knowledge about COVID-19 and promote vaccination readiness among collectively accommodated Arabic-speaking adolescents and young adults. METHODS: We developed a mobile app that consisted of short video clips to explain the biological basis of COVID-19, demonstrate behavior to prevent transmission, and combat misconceptions and myths about vaccination. The explanations were provided in a YouTube-like interview setting by a native Arabic-speaking physician. Elements of gamification (quizzes and rewards for solving the test items) were also used. Consecutive videos and quizzes were presented over an intervention period of 6 weeks, and the group intervention was scheduled as an add-on for half of the participants in week 6. The manual of the group intervention was designed to provide actual behavioral planning based on the health action process approach. Sociodemographic information, mental health status, knowledge about COVID-19, and available vaccines were assessed using questionnaire-based interviews at baseline and after 6 weeks. Interpreters assisted with the interviews in all cases. RESULTS: Enrollment in the study proved to be very challenging. In addition, owing to tightened contact restrictions, face-to-face group interventions could not be conducted as planned. A total of 88 participants from 8 collective housing institutions were included in the study. A total of 65 participants completed the full-intake interview. Most participants (50/65, 77%) had already been vaccinated at study enrollment. They also claimed to comply with preventive measures to a very high extent (eg, "always wearing masks" was indicated by 43/65, 66% of participants), but practicing behavior that was not considered as effective against COVID-19 transmission was also frequently reported as a preventive measure (eg, mouth rinsing). By contrast, factual knowledge of COVID-19 was limited. Preoccupation with the information materials presented in the app steeply declined after study enrollment (eg, 12/61, 20% of participants watched the videos scheduled for week 3). Of the 61 participants, only 18 (30%) participants could be reached for the follow-up interviews. Their COVID-19 knowledge did not increase after the intervention period (P=.56). CONCLUSIONS: The results indicated that vaccine uptake was high and seemed to depend on organizational determinants for the target group. The current mobile app-based intervention demonstrated low feasibility, which might have been related to various obstacles faced during the delivery. Therefore, in the case of future pandemics, transmission prevention in a specific target group should rely more on structural aspects rather than sophisticated psychological interventions.

Detecting Heterogeneity of Intervention Effects in Comparative Judgments.

Comparative measures such as paired comparisons and rankings are frequently used to evaluate health states and quality of life. The present article introduces log-linear Bradley-Terry (LLBT) models to evaluate intervention effectiveness when outcomes are measured as paired comparisons or rankings and presents a combination of the LLBT model and model-based recursive partitioning (MOB) to detect treatment effect heterogeneity. The MOB LLBT approach enables researchers to identify subgroups that differ in the preference order and in the effect an intervention has on choice behavior. Applicability of MOB LLBT models is demonstrated using an artificial data example with known data-generating mechanism and a real-world data example focusing on drug-harm perception among music festival visitors. In the artificial data example, the MOB LLBT model is able to adequately recover the "true" (population) model. In the real-world data example, the standard LLBT model confirms the existence of a situational willingness among festival visitors to trivialize drug harm when peer consumption behavior is made cognitively accessible. In addition, MOB LLBT results suggest that this trivialization effect is highly context-dependent and most pronounced for participants with low-to-moderate alcohol intoxication who also proactively contacted a substance counselor at the festival venue. Both data examples suggest that MOB LLBT models allow for more nuanced statements about the effectiveness of interventions. We provide R code examples to implement MOB LLBT models for paired comparisons, rankings, and rating (Likert-type) data.

Assessing Heterogeneity in Students' Visual Judgment: Model-Based Partitioning of Image Rankings.

Differences in the ability of students to judge images can be assessed by analyzing the individual preference order (ranking) of images. To gain insights into potential heterogeneity in judgement of visual abstraction among students, we combine Bradley-Terry preference modeling and model-based recursive partitioning. In an experiment a sample of 1,020 high-school students ranked five sets of images, three of which with respect to their level of visual abstraction. Additionally, 24 art experts and 25 novices were given the same task, while their eye movements were recorded. Results show that time spent on the task, the students' age, and self-reported interest in visual puzzles had significant influence on rankings. Fixation time of experts and novices revealed that both groups paid more attention to ambiguous images. The presented approach makes the underlying latent scale of visual judgments quantifiable.

PeterPandemic: A Serious Game for Pandemic Management.

The COVID-19 situation shows that a deep understanding of how pandemics spread and how they can be managed is important in a multitude of domains. Various studies have shown that students benefit from game-based learning approaches. Therefore, we introduce the concept of a web-based serious game to teach students important aspects when dealing with pandemic situations.

Exploring the Usability of the German COVID-19 Contact Tracing App in a Combined Eye Tracking and Retrospective Think Aloud Study.

In the course of the corona virus (COVID-19) pandemic, many digital solutions for mobile devices (e.g., apps) were presented in order to provide additional resources supporting the control of the pandemic. Contact tracing apps (i.e., identify persons who may have been in contact with a COVID-19 infected) constitute one of the most popular as well as promising solutions. However, as a prerequisite for an effective application, such apps highly depend on being used by large numbers of the population. Consequently, it is important that these apps offer a high usability for everyone. We therefore conducted an exploratory study to learn more about the usability of the German COVID-19 contact tracing app Corona-Warn-App (CWA). More specifically, N = 15 participants assessed the CWA, relying on a combined eye tracking and retrospective think aloud approach. The results indicate, on the one hand, that the CWA leaves a promising impression for pandemic control, as essential functions are easily recognized. However, on the other hand, issues were revealed (e.g., privacy policy) that could be addressed in future updates more properly.

How Do Art Skills Influence Visual Search? - Eye Movements Analyzed With Hidden Markov Models.

The results of two experiments are analyzed to find out how artistic expertise influences visual search. Experiment I comprised survey data of 1,065 students on self-reported visual memory skills and their ability to find three targets in four images of artwork. Experiment II comprised eye movement data of 50 Visual Literacy (VL) experts and non-experts whose eye movements during visual search were analyzed for nine images of artwork as an external validation of the assessment tasks performed in Sample I. No time constraint was set for completion of the visual search task. A latent profile analysis revealed four typical solution patterns for the students in Sample I, including a mainstream group, a group that completes easy images fast and difficult images slowly, a fast and erroneous group, and a slow working student group, depending on task completion time and on the probability of finding all three targets. Eidetic memory, performance in art education and visual imagination as self-reported visual skills have significant impact on latent class membership probability. We present a hidden Markov model (HMM) approach to uncover underlying regions of attraction that result from visual search eye-movement behavior in Experiment II. VL experts and non-experts did not significantly differ in task time and number of targets found but they did differ in their visual search process: compared to non-experts, experts showed greater precision in fixating specific prime and target regions, assessed through hidden state fixation overlap. Exploratory analysis of HMMs revealed differences between experts and non-experts in image locations of attraction (HMM states). Experts seem to focus their attention on smaller image parts whereas non-experts used wider parts of the image during their search. Differences between experts and non-experts depend on the relative saliency of targets embedded in images. HMMs can determine the effect of expertise on exploratory eye movements executed during visual search tasks. Further research on HMMs and art expertise is required to confirm exploratory results.

The Relationship between Change of Direction Tests in Elite Youth Soccer Players.

Change of direction (COD) is a performance-limiting factor in team sports. However, there are no exact definitions describing which physical abilities limit COD performance in soccer. Nevertheless, different COD tests are used or have been recommended as being equally effective in the professional practice of measuring COD performance. Therefore, the aim of this study was to evaluate the relationship between different COD tests, and to test the independence and generalizability of these COD tests in soccer. As such, 27 elite youth soccer players were randomly recruited and were tested in different COD tests (i.e., Illinois agility test (IAT), T agility test (TT), 505 agility test (505), Gewandtheitslauf (GewT), triangle test (Tri-t), and square test (SQT)). Bivariate Pearson correlation analysis was used to assess the relationships between the COD tests. The Benjamini-Hochberg method was used to control for the false discovery rate of the study at 0.05. This investigation calculated explained variances of 10% to 55% between performances in the different COD tests. This suggested that the tests covered different aspects or task-specific characteristics of the COD. Therefore, coaches and sport scientists should review and select different tests with a logical validity, based on the requirement profiles of the corresponding sport.

Effect of Developmentally Adapted Cognitive Processing Therapy for Youth With Symptoms of Posttraumatic Stress Disorder After Childhood Sexual and Physical Abuse: A Randomized Clinical Trial.

Importance: Despite the high prevalence, evidence-based treatments for abuse-related posttraumatic stress disorder (PTSD) in adolescents have rarely been studied. Objective: To examine whether developmentally adapted cognitive processing therapy (D-CPT) is more effective than a wait-list condition with treatment advice (WL/TA) among adolescents with PTSD related to childhood abuse. Design, Setting, and Participants: This rater-blinded, multicenter, randomized clinical trial (stratified by center) enrolled treatment-seeking adolescents and young adults (aged 14-21 years) with childhood abuse-related PTSD at 3 university outpatient clinics in Germany from July 2013 to June 2015, with the last follow-up interview conducted by May 2016. Of 194 patients, 88 were eligible for randomization. Interventions: Participants received D-CPT or WL/TA. Cognitive processing therapy was enhanced by a motivational and alliance-building phase, by including emotion regulation and consideration of typical developmental tasks, and by higher session frequency in the trauma-focused core CPT phase. In WL/TA, participants received treatment advice with respective recommendations of clinicians and were offered D-CPT after 7 months. Main Outcomes and Measures: All outcomes were assessed before treatment (baseline), approximately 8 weeks after the start of treatment, after the end of treatment (posttreatment), and at the 3-month follow-up. The primary outcome, PTSD symptom severity, was assessed in clinical interview (Clinician-Administered PTSD Scale for Children and Adolescents for DSM-IV [CAPS-CA]). Secondary outcomes were self-reported PTSD severity, depression, borderline symptoms, behavior problems, and dissociation. Results: The 88 participants (75 [85%] female) had a mean age of 18.1 years (95% CI, 17.6-18.6 years). In the intention-to-treat analysis, the 44 participants receiving D-CPT (39 [89%] female) demonstrated greater improvement than the 44 WL/TA participants (36 [82%] female) in terms of PTSD severity (mean CAPS-CA scores, 24.7 [95% CI, 16.6-32.7] vs 47.5 [95% CI, 37.9-57.1]; Hedges g = 0.90). This difference was maintained through the follow-up (mean CAPS-CA scores, 25.9 [95% CI, 16.2-35.6] vs 47.3 [95% CI, 37.8-56.8]; Hedges g = 0.80). Treatment success was greatest during the trauma-focused core phase. The D-CPT participants also showed greater and stable improvement in all secondary outcomes, with between-groups effect sizes ranging from 0.65 to 1.08 at the posttreatment assessment (eg, for borderline symptoms, 14.1 [95% CI, 8.0-20.2] vs 32.0 [95% CI, 23.8-40.2]; Hedges g = 0.91). Conclusions and Relevance: Adolescents and young adults with abuse-related PTSD benefited more from D-CPT than from WL/TA. Treatment success was stable at the follow-up and generalized to borderline symptoms and other comorbidities. Trial Registration: German Clinical Trials Register identifier: DRKS00004787.

Recovery from alcohol dependence: Do smoking indicators predict abstinence?

BACKGROUND AND OBJECTIVES: There is inconsistent evidence about the potential influence of smoking on recovery from alcohol dependence. Our study aimed at assessing the impact of smoking-behavior on relapse during a 12 months follow-up period following a detoxification in patients with Alcohol Use Disorder (AUD). METHODS: Three hundred Patients with AUD (74.9% smoking) were recruited from two inpatient detoxification units in psychiatric hospitals in Germany and their alcohol consumption was prospectively followed for 1 year. Data on different indicators of smoking behavior was gathered. Cox regression model was used to evaluate potential risk factors on time to relapse of alcohol consumption. Two hundred seventy-nine participants (n = 279) were included in the final analysis. RESULTS: Smoking increased the risk for alcohol relapse (hazard ratio = 3.962, 95% CI 1.582-9.921). However, this increased risk is slightly reduced with higher numbers of daily consumed cigarettes (hazard ratio per cigarette = .986, 95% CI .976-.995). CONCLUSION: Smoking reduced the probability of maintaining alcohol abstinence significantly, whereas higher number of cigarettes smoked daily diminished the increased risk of alcohol relapse in alcohol-dependent patients. SCIENTIFIC SIGNIFICANCE: Coordinated psychiatric and substance abuse interventions for different subgroups of patients with AUD in the post-acute treatment phase are necessary. Individualized treatment planning is especially important in smoking patients with AUD who are vulnerable for a relapse to alcohol drinking and for somatic complications. Our findings might support individualized treatment plans. (Am J Addict 2017;26:366-373).

Different Patterns of Hearing Loss among Tinnitus Patients: A Latent Class Analysis of a Large Sample.

BACKGROUND: The heterogeneity of tinnitus is a major challenge for tinnitus research. Even if a complex interaction of many factors is involved in the etiology of tinnitus, hearing loss (HL) has been identified as the most relevant etiologic factor. Here, we used a data-driven approach to identify patterns of hearing function in a large sample of tinnitus patients presenting in a tinnitus clinic. METHODS: Data from 2,838 patients presenting at the Tinnitus Center of the University Regensburg between 2007 and 2014 have been analyzed. Standard audiometric data were frequency-wise categorized in four categories [a: normal hearing (0-20 dB HL); b: moderate HL (25-50 dB HL; representing outer hair cell loss); c: severe HL (>50 dB HL; representing outer and inner hair cell loss); d: no data available] and entered in a latent class analysis, a statistical method to find subtypes of cases in multivariate categorical data. To validate the clinical relevance of the identified latent classes, they were compared with respect to clinical and demographic characteristics of their members. RESULTS: The classification algorithm identified eight distinct latent classes with an excellent separation. Patient classes differed with respect to demographic (e.g., age, gender) and clinical characteristics (e.g., tinnitus location, tinnitus severity, gradual, or abrupt onset, etc.). DISCUSSION: Our results demonstrate that data-driven categorization of hearing function seems to be a promising approach for profiling tinnitus patients, as it revealed distinct subtypes that reflect prototypic forms of HL and that differ in several relevant clinical characteristics.

Temoporfin improves efficacy of photodynamic therapy in advanced biliary tract carcinoma: A multicenter prospective phase II study.

UNLABELLED: Photodynamic therapy using porfimer (P-PDT) improves palliation and survival in nonresectable hilar bile duct cancer. Tumoricidal penetration depth of temoporfin-PDT (T-PDT) is twice that of P-PDT. In a single-arm phase II study we investigated the safety, efficacy, survival time, and adverse events of T-PDT compared with previous data on P-PDT. Twenty-nine patients (median 71 [range 47-88] years) with nonresectable hilar bile duct cancer were treated with T-PDT (median 1 [range 1-4] sessions) plus stenting and followed up every 3 months. The PDT was well tolerated. In patients with occluded segments at baseline (n=28) a reopening of a median of 3 (range 1-7) segments could be achieved: n=16 local response and n=11 stable local disease, one progressive disease. Cholestasis and performance significantly improved when impaired at baseline. Time to local tumor progression was a median of 6.5 (2.7-41.0) months. Overall survival time was a median of 15.4 (range 4.4-62.4) months. Patients died from tumor progression (55%), cholangitis (18%), pneumonia (7%), hemobilia (7%), esophagus variceal hemorrhage (3%), and vascular diseases (10%). Adverse events were cholangitis (n=4), liver abscess (n=2), cholecystitis (n=2), phototoxic skin (n=5), and injection site reactions (n=7). Compared to previous P-PDT, T-PDT shows prolonged time to local tumor progression (median 6.5 versus 4.3 months, P<0.01), fewer PDT treatments needed (median 1 versus 3, P<0.01), a higher 6-month survival rate (83% versus 70%, P<0.01), and a trend for longer overall median survival (15.4 versus 9.3 months, P=0.72) yet not significantly different. The risk of adverse events is not increased except for (avoidable) subcutaneous phototoxicity at the injection site. CONCLUSION: Temoporfin-PDT can safely be delivered to hilar bile duct cancer patients and results in prolonged patency of hilar bile ducts, a trend for longer survival time, and similar palliation as with P-PDT.

People with alcohol use disorders in specialized care in eight different European countries.

AIM: To provide a description of patients receiving alcohol treatment in eight different European countries, including the level of comorbidities and functional limitations. METHODS: Drinking behaviours, DSM-IV alcohol use disorder (AUD), mental and somatic comorbidities, disability and health services utilization of 1767 patients from various specialized treatment settings were assessed as representative for regions of eight European countries. Severity of alcohol dependence (AD) in terms of drinking level was compared with a large representative US sample. RESULTS: Patients in specialized care for AUDs showed high levels of consumption [average level of daily ethanol intake: 141.1 g, standard deviation (SD): 116.0 g], comorbidity [e.g. liver problems: 19.6%, 95% confidence interval (CI): 17.5-21.6%; depression: 43.2%, 95% CI: 40.7-45.8%; anxiety: 50.3%, 95% CI: 47.8-52.9%], disability and health services utilization (average number of nights spent in hospital(s) during the last 6 months: 8.8, SD: 19.5 nights). Severity of AD was similar to the US sample, but European men consumed on average more alcohol daily. CONCLUSIONS: High levels of consumption, somatic and mental comorbidities, disability and functional losses were found in this representative treatment sample, indicating that treatment was initiated only at severe stages of AUDs. Earlier initiation of treatment could help avoid some of the health and social burden.

Prevalence of and potential influencing factors for alcohol dependence in Europe.

Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and was significantly impacted by drinking cultures and social norms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking, such as liver cirrhosis or injury, were moderate. These results suggest a need to rethink the definition of AUDs.

Burden of disease associated with alcohol use disorders in the United States.

BACKGROUND: Alcohol use disorders (AUD) have long been considered to be some of the most disabling mental disorders; however, empirical data on the burden of disease associated with AUD have been sparse. The objective of this article is to quantify the burden of disease (in disability-adjusted life years [DALYs] lost), deaths, years of life lost due to premature mortality (YLL), and years of life lost due to disability (YLD) associated with AUD for the United States in 2005. METHODS: Statistical modeling was based on epidemiological indicators derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Formal consistency analyses were applied. Risk relations were taken from recent meta-analyses and the disability weights from the burden of disease study of the National Institutes of Health. Monte Carlo simulations were used to derive confidence intervals. All analyses were performed by sex and age. Sensitivity analyses were undertaken on key indicators. RESULTS: In the United States in 2005, 65,000 deaths, 1,152,000 YLL, 2,443,000 YLD, and 3,595,000 DALYs were associated with AUD. For individuals 18 years of age and older, AUD were associated with 3% of all deaths (5% for men and 1% for women), and 5% of all YLL (7% for men and 2% for women). The majority of the burden of disease associated with AUD stemmed from YLD, which accounted for 68% of DALYs associated with AUD (66% for men and 74% for women). The youngest age group had the largest proportion of DALYs associated with AUD stemming from YLD. CONCLUSIONS: Using data from a large representative survey (checked for consistency) and by combining these data with the best available evidence, we found that AUD were associated with a larger burden of disease than previously estimated. To reduce this disease burden, implementation of prevention interventions and expansion of treatment are necessary.

The revolving door phenomenon revisited: time to readmission in 17'145 [corrected] patients with 37'697 hospitalisations at a German psychiatric hospital.

OBJECTIVE: Despite the recurring nature of the disease process in many psychiatric patients, individual careers and time to readmission rarely have been analysed by statistical models that incorporate sequence and velocity of recurrent hospitalisations. This study aims at comparing four statistical models specifically designed for recurrent event history analysis and evaluating the potential impact of predictor variables from different sources (patient, treatment process, social environment). METHOD: The so called Andersen-Gil counting process model, two variants of the conditional models of Prentice, Williams, and Peterson (gap time model, conditional probability model), and the so called frailty model were applied to a dataset of 17'145 [corrected] patients observed during a 12 years period starting from 1996 and leading to 37'697 psychiatric hospitalisations Potential prognostic factors stem from a standardized patient documentation form. RESULTS: Estimated regression coefficients over different models were highly similar, but the frailty model best represented the sequentiality of individual treatment careers and differing velocities of disease progression. It also avoided otherwise likely misinterpretations of the impact of gender, partnership, historical time and length of stay. A widespread notion of psychiatric diseases as inevitably chronic and worsening could be rejected. Time in community was found to increase over historical time for all patients. Most important protective factors beyond diagnosis were employment, partnership, and sheltered living situation. Risky conditions were urban living and a concurrent substance use disorder. CONCLUSION: Prognostic factors for course of diseases should be determined only by statistical models capable of adequately incorporating the recurrent nature of psychiatric illnesses.

Establishing disability weights from pairwise comparisons for a US burden of disease study.

To determine valid and reliable disability weights for a U.S. burden of disease study, a convenience sample of 68 clinical experts was recruited, including representatives from over 20 NIH institutes and Centers for Disease Control and Prevention. Experts were given various health state valuation tasks including pairwise comparison, ranking, and Person Trade Off. Materials consisted of standardized descriptions of 11 attributes per health state (Classification and Measurement System of Functional Health, CLAMES). Attributes comprised up to 5 ordinal levels of disability. All states were displayed either with or without health state labels. Health state descriptions were taken from an existing comprehensive Canadian system. Conditional Logistic (CLR) and Probit Regression (PR) were used to derive disability weights. CLR and PR converged in yielding stable regression weights to construct disability weights, with a correlation of 0.816. The overall test-retest reliability amounted to 92.5% identical decisions. No significant difference was found for the presentation of health states with or without labels. A comparison of the expert valuations from our study with a standard gamble based valuation in the general population resulted in agreement of r = 0.61. The chosen methodology yielded valid and reliable and disability weights. As it is based on a modularized set of attributes, this methodology will allow derivation of disability weights on the basis of existing descriptions using the CLAMES.