bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery: A retrospective review of 237 Asian patients
Authors: Oh Yeongjoo , Kim Jemin , Zheng Zhenlong , Kim Sang Kyem , Chung Kee Yang , Roh Mi Ryung
Published: November 2019

Even after complete removal with Mohs micrographic surgery (MMS), cutaneous squamous cell carcinoma (cSCC) may recur; however, information about risk factors for recurrence in Asian patients is limited. This retrospective study reviewed cSCC patients treated with MMS at a single tertiary referral center from 2000 to 2017. Two hundred and thirty‐seven patients were included and 36 showed recurrence (20 with local recurrence, 16 with distant metastasis). History of organ transplantation, diabetes, other malignancies and poorly differentiated histology correlated with cSCC recurrence. History of organ transplantation and cryotherapy at the cSCC site were related to higher local recurrence rates, and poor differentiation related to higher distant metastasis in Asian cSCC patients treated with MMS.
A clockwork fish: Age prediction using DNA methylation‐based biomarkers in the European seabass
Authors: Anastasiadi Dafni , Piferrer Francesc
Published: November 2019

Age‐related changes in DNA methylation do occur. Taking advantage of this, mammalian and avian epigenetic clocks have been constructed to predict age. In fish, studies on age‐related DNA methylation changes are scarce and no epigenetic clocks have been constructed. However, in fisheries and population dynamics studies there is a need for accurate estimation of age, something that is often impossible for some economically important species with the currently available methods. Here, we used the European sea bass, a marine fish the age of which can be determined with accuracy, to construct a piscine epigenetic clock, the first one in a cold‐blooded vertebrate. We used targeted bisulfite sequencing to amplify 48 CpGs from four genes in muscle samples and applied penalized regressions to predict age. We thus developed an age predictor in fish that is highly accurate (0.824) and precise (2.149 years). In juvenile fish, accelerated growth due to elevated temperatures had no effect on age prediction, indicating that the clock is able to predict the chronological age independently of environmentally‐driven perturbations. An epigenetic clock developed using muscle samples accurately predicted age in samples of testis but not ovaries, possibly reflecting the reproductive biology of fish. In conclusion, we report the development of the first piscine epigenetic clock, paving the way for similar studies in other species. Piscine epigenetic clocks should be of great utility for fisheries management and conservation purposes, where age determination is of crucial importance.
Development of a Scale to Measure an Unemployment Syndrome: Items Generation and Content Validity
Authors: Bocchino Anna , Lepiani Diaz Isabel , Medialdea Maria Jesus , Gilart Cantizano Ester , Dueñas Rodríguez María
Published: November 2019

PURPOSE

To develop a scale for a group of symptoms based on the unemployment syndrome.

METHODS

The development consisted of four phases: (I) review of literature, (II) concept elicitation, (III) concept selection and item construction, and (IV) content validation.

FINDINGS

Twenty final items that were established as adequate for being included in the instrument.

CONCLUSION

The unemployment syndrome scale could be used to identify the needs and sintomatology of unemployed people and support the identification of the syndrome.

IMPLICATIONS FOR NURSING PRACTICE

The instrument makes it possible to assess the symptomatology specific to the syndrome and to record properly the assessment of the biopsychosocial conditions on the part of the nursing profession for providing quality comprehensive care.
Stressing Out About the Heart: A Narrative Review of the Role of Psychological Stress in Acute Cardiovascular Events
Authors: Musey Paul I. , Schultebraucks Katharina , Chang Bernard P.
Published: November 2019

Objectives

Survivors of acute cardiovascular disease (CVD) events, such as acute coronary syndrome (ACS) and stroke, may experience significant psychological distress during and following the acute event. Long‐term adverse effects may follow, including the development of posttraumatic stress disorder (PTSD), increased overall all‐cause mortality, and recurrent cardiac events. The goal of this concepts paper is to describe and summarize the rates of adverse psychological outcomes, such as PTSD, following cardiovascular emergencies, to review how these psychological factors are associated with increased risk of future events and long‐term health and to provide a theoretical framework for future work.

Methods

A panel of two board‐certified emergency physicians, one with a doctorate in experimental psychology, along with one PhD clinical psychologist with expertise in psychoneuroendocrinology were co‐authors involved in the paper. Each author used various search strategies (e.g., PubMed, Psycinfo, Cochrane, and Google Scholar) for primary research and reviewed articles related to their section. The references were reviewed and evaluated for relevancy and included based on review by the lead authors

Results

A meta‐analysis of 24 studies (N > 2,300) found the prevalence of ACS‐induced PTSD at nearly 12%, while a meta‐analysis of nine studies (N = 1,138) found that 25% of survivors of transient ischemic attack and stroke report PTSD symptoms. The presence of PTSD doubles 3‐year risk of CVD/mortality risk in ACS survivors. Cardiac patients treated during periods of ED overcrowding, hallway care, and perceived poor clinician–patient communication appear at greater risk for subsequent PTSD.

Conclusions

Psychological stress is often present in patients undergoing evaluation for acute CVD events. Understanding such associations provides a foundation to appreciate the potential contribution of psychological variables on acute and long‐term cardiovascular recovery, while also stimulating future areas of research and discovery.
Are medium‐scale farms driving agricultural transformation in sub‐Saharan Africa?
Authors: Jayne T. S. , Muyanga Milu , Wineman Ayala , Ghebru Hosaena , Stevens Caleb , Stickler Mercedes , Chapoto Antony , Anseeuw Ward , van der Westhuizen Divan , Nyange David
Published: November 2019

This study presents evidence of profound farm‐level transformation in parts of sub‐Saharan Africa, identifies major sources of dynamism in the sector, and proposes an updated typology of farms that reflects the evolving nature of African agriculture. Repeat waves of national survey data are used to examine changes in crop production and marketed output by farm size. Between the first and most recent surveys (generally covering 6 to 10 years), the share of national marketed crop output value accounted for by medium‐scale farms rose in Zambia from 23% to 42%, in Tanzania from 17% to 36%, and in Nigeria from 7% to 18%. The share of land under medium‐scale farms is not rising in densely populated countries such as Kenya, Uganda, and Rwanda, where land scarcity is impeding the pace of medium‐scale farm acquisitions. Medium‐scale farmers are a diverse group, reflecting distinct entry pathways into agriculture, encouraged by the rapid development of land rental, purchase, and long‐term lease markets. The rise of medium‐scale farms is affecting the region in diverse ways that are difficult to generalize. Findings indicate that these farms can be a dynamic driver of agricultural transformation but this does not reduce the importance of maintaining a clear commitment to supporting smallholder farms. Strengthening land tenure security of local rural people to maintain land rights and support productivity investments by smallholder households remains crucial.
Radioactive iodine ablation post differentiated thyroid cancer surgery: an analysis of use and impact of the American Thyroid Association guidelines
Authors: Sia Yi , Dave Rajiv V. , Nour Daniel , Miller Julie A. , Skandarajah Anita R. , Tasevski Robert
Published: November 2019

Background

The 2009 American Thyroid Association (ATA) three‐tiered risk stratification, and its updated version in 2015, provided clearer guidance on the use of radioactive iodine (RAI) ablation in differentiated thyroid cancer (DTC) patients. This study examines the impact of these guidelines on RAI use in our institution.

Methods

Patients diagnosed with DTC during three different time periods (group 1: 2002–2006, group 2: 2010–2014 and group 3: 2017–2018) were identified and risk stratified according to the ATA guidelines. RAI use and extent of surgery were compared between the three groups. Categorical variables were analysed using Fisher's exact (2 × 2) and chi‐squared (>2 × 2) tests.

Results

A total of 415 patients were included (group 1 = 88, group 2 = 215, group 3 = 112). The proportion of patients having total thyroidectomy were 84.6, 84.7 and 69.6% in groups 1, 2 and 3, respectively (P = 0.003). Central lymph node dissection was significantly higher in the more contemporary groups compared to group 1 (9.1 versus 41.9 versus 64.3%, P < 0.001). Overall, fewer patients received RAI in more recent times (76.6 versus 54.8 versus 26.8%, P < 0.001), most evident in the low‐risk patients (70 versus 29.1 versus 5.1%, P < 0.001). In the high risk group, the majority received RAI, with no difference between the groups.

Conclusion

Comparing DTC patients treated in our unit before and after publications of the 2009 and 2015 ATA guidelines, more nodal surgery was performed with less RAI administered in the latter groups. Better risk stratification according to the ATA guidelines has allowed more judicious use of RAI ablation.
Prognostic factors of revitrectomy for complications in eyes with proliferative diabetic retinopathy: a retrospective multicentre study
Authors: Takayama Kei , Someya Hideaki , Yokoyama Hiroshi , Kimura Takeshi , Takamura Yoshihiro , Morioka Masakazu , Sameshima Seiji , Ueda Tetsuo , Ogata Nahoko , Kitano Shigehiko , Tashiro Maki , Sugimoto Masahiko , Kondo Mineo , Sakamoto Taiji , Takeuchi Masaru
Published: November 2019

Purpose

To identify prognostic factors for revitrectomy in patients who underwent vitrectomy for complications with proliferative diabetic retinopathy (PDR) in multicentre study.

Methods

Consecutive 452 eyes of 452 patients with PDR undergoing 25‐gauge microincision vitrectomy system (MIVS) in seven centres were retrospectivity reviewed. Preoperative ocular factors (baseline visual acuity [VA], vitreous haemorrhage [VH], tractional retinal detachment [TRD] and retinal photocoagulation), general factors (sex, age, diabetes duration, HbA1c level, hypertension, anti‐coagulant medication and estimated glomerular filtration rate), surgical procedures (preoperative anti‐vascular endothelial growth factor injection, internal limiting membrane peeling, combined cataract surgery, retinal break, and tamponade), postoperative complications for revitrectomy and postoperative VA at 6 months were evaluated.

Results

In the follow‐up period of 6 months, revitrectomy was performed in 56 eyes (26.3%), and postoperative complications for revitrectomy were VH in 31 eyes (15%), TRD in 13 eyes (6.2%) and membrane proliferation in 12 eyes (5.2%). The mean LogMAR improvement from baseline to 6 months in revitrectomy group (0.39) was significantly worse than in single vitrectomy group (0.74). Diabetic duration, low baseline VA, less simple VH, TRD and air tamponade were statistical risk factors of revitrectomy, and logistic regression analysis identified low baseline VA and air tamponade also as prognostic factors of revitrectomy.

Conclusion

Our results indicated that prognosis of VA was worse in PDR patients with revitrectomy and low baseline VA and air as the tamponade material were the potential prognostic factors of revitrectomy.
The clinical challenges of synthetic cathinones
Authors: Schifano Fabrizio , Napoletano Flavia , Arillotta Davide , Zangani Caroline , Gilgar Liam , Guirguis Amira , Corkery John Martin , Vento Alessandro
Published: November 2019

Aims

Within the new psychoactive substances (NPS) scenario, several hundred different molecules, mostly including synthetic cannabinoids and cathinones, have been identified so far. The aims of the paper were to: (i) identify the number of synthetic cathinones mentioned in a range of psychonaut, NPS‐related, online sources; and (ii) describe the associated acute/long term clinical scenario and the related treatment/management plan.

Methods

After about 18 months of operation and exclusion of false positives/duplicates, some 4204 unique NPS molecules were included in the NPSfinder® crawling/navigating software database. Most popular NPS included: 1265 psychedelic phenethylamines (30.1%; confidence interval [CI] 95%: 28.7–31.5%); 1253 synthetic cannabinoids (29.8%; CI 95%: 28.4–31.2%); 429 synthetic opioids (10.2%; CI 95%: 9.3–10.2%); and 171 synthetic cathinones (4.1%; CI 95% 3.5–4.7%). Conversely, the United Nations Office on Drugs and Crime and the European Monitoring Centre for Drugs and Drug Addiction databases respectively included 169 and 140 cathinones. Overall, the 3 databases reported some 222 synthetic cathinones, and 41 were uniquely identified by the NPSfinder®.

Results

In terms of clinical scenarios, synthetic cathinone ingestion is initially associated with stimulant effects; however, psychopathological disturbances, violence, suicidal behaviour, hyperthermia, coma and death have also been described.

Conclusion

The proportion of cathinones commented on by psychonaut fora appeared to be relatively small, and similar to those reported by both the United Nations Office on Drugs and Crime and European Monitoring Centre for Drugs and Drug Addiction. This may be associated with a recent significant decline in both cathinone‐related consumption and acute medical presentation. Due to their complex behavioural and medical toxicity issues, healthcare professionals should be, however, be educated to recognise the signs and symptoms of NPS, including synthetic cathinone, ingestion.
Human leukocyte antigen (HLA) class I antibodies and transfusion support in paediatric HLA‐matched haematopoietic cell transplant for sickle cell disease
Authors: Nickel Robert S. , Horan John T. , Abraham Allistair , Qayed Muna , Haight Ann , Ngwube Alexander , Liang Hua , Luban Naomi L. C. , Hendrickson Jeanne E.
Published: November 2019

The relevance of donor‐specific human leukocyte antigen (HLA) antibodies in HLA‐mismatched haematopoietic cell transplant (HCT) is known, but the importance of HLA antibodies in HLA‐matched HCT is unclear. We hypothesized that HLA antibodies detected before HCT would cause platelet transfusion refractoriness during HCT and investigated this in a multi‐centre study. Pre‐HCT samples from 45 paediatric patients with sickle cell disease (SCD) undergoing HLA‐matched HCT were tested for HLA class I antibodies. The number of platelet transfusions received before day +45 was compared between those with and without antibodies. Thirteen of 45 (29%) patients had a positive HLA class I antibody screen, and these patients received significantly more platelet transfusions than patients without antibodies (median 19 vs. 7·5, P = 0·028). This platelet transfusion association remained significant when controlling for conditioning regimen. Among alloimmunized patients, there was no association between the panel‐reactive antibody and the number of platelet transfusions. Patients with HLA class I antibodies also had a higher incidence of acute graft‐versus‐host disease (GVHD): 6/13 (46%) vs. 3/32 (9%), P = 0·011. Pre‐HCT HLA class I alloimmunization is associated with increased platelet transfusion support and acute GVHD in paediatric HLA‐matched HCT for SCD. Further studies are needed to investigate the pathobiology of this association.
Immunohistochemical detectability of cyclooxygenase‐2 expression in cells of human melanocytic skin lesions: A methodological review
Authors: Kuźbicki Łukasz , Brożyna Anna A.
Published: November 2019

Increased cyclooxygenase‐2 (COX‐2) expression is thought to support tumorigenesis through various mechanisms and is analyzed as a potential cancer marker. In 18 studies, COX‐2 expression in melanocytic lesions of human skin was examined immunohistochemically. However, results obtained by individual research groups differ in terms of detection frequency and level of this protein, as well as localization of stained cells within tumor. Possible reasons for the discrepancies are analyzed in this review: the application of different antibodies, the use of standard histopathological sections or tissue microarrays and the analyzes of staining results based on different algorithms. COX‐2 level is significantly lower in nevi than in melanomas, increases gradually with progression of these malignant cancers and reaches the highest values in metastases. These gradual changes in COX‐2 expression appear to be difficult to analyze based only on subjective assessment of staining intensity. The most convergent data were obtained using antibodies for N‐terminal fragments of COX‐2 protein and analyzing results based on calculation of percentage fraction of positive cells. The extent of stained area in specimen thus appears to be more important than the intensity of staining in terms of evaluation of COX‐2 performance as a diagnostic and prognostic marker of cutaneous melanoma.
Intra‐ and interspecific variation in trophic ecology of ‘predatory’ ants in the subfamily Ponerinae
Authors: Hanisch Priscila E. , Drager Kim , Yang Wendy H. , Tubaro Pablo L. , Suarez Andrew V.
Published: November 2019

1. The characterisation of energy flow through communities is a primary goal of ecology. Furthermore, predator–prey interactions can influence both species abundance and community composition. The ant subfamily Ponerinae includes many predatory species that range from generalist insectivores to highly specialised hunters that target a single prey type. Given their high diversity and ubiquity in tropical ecosystems, measuring intra‐ and interspecific variation in their trophic ecology is essential for understanding the role of ants as predators of insect communities.

2. The stable isotopic composition of nitrogen of 22 species from the ant subfamily Ponerinae was measured, relative to plants and other predatory and herbivorous insects at two Atlantic Forest sites in Argentina. The study tested the general assumption that ponerine ants are all predatory, and examined intra‐ and interspecific variation in trophic ecology relative to habitat, body size and cytochromecoxidase subunit 1 sequences (DNA barcoding).

3. Stable isotope analysis revealed that most ponerines occupy high trophic levels (primary and secondary predators), but some species overlapped with known insect herbivores. Species residing at low trophic levels were primarily arboreal and may rely heavily on nectar or other plant‐based resources in their diet. In addition, larger species tend to occupy lower trophic positions than smaller species.

4. Although some of the species were divided into two or more genetic clusters by DNA barcoding analysis, these clusters did not correspond to intraspecific variation in trophic position; therefore, colony dietary flexibility most probably explains species that inhabit more than one trophic level.
Range edges in heterogeneous landscapes: Integrating geographic scale and climate complexity into range dynamics
Authors: Oldfather Meagan F. , Kling Matthew M. , Sheth Seema N. , Emery Nancy C. , Ackerly David D.
Published: November 2019

The impacts of climate change have re‐energized interest in understanding the role of climate in setting species geographic range edges. Despite the strong focus on species' distributions in ecology and evolution, defining a species range edge is theoretically and empirically difficult. The challenge of determining a range edge and its relationship to climate is in part driven by the nested nature of geography and the multidimensionality of climate, which together generate complex patterns of both climate and biotic distributions across landscapes. Because range‐limiting processes occur in both geographic and climate space, the relationship between these two spaces plays a critical role in setting range limits. With both conceptual and empirical support, we argue that three factors—climate heterogeneity, collinearity among climate variables, and spatial scale—interact to shape the spatial structure of range edges along climate gradients, and we discuss several ways that these factors influence the stability of species range edges with a changing climate. We demonstrate that geographic and climate edges are often not concordant across species ranges. Furthermore, high climate heterogeneity and low climate collinearity across landscapes increase the spectrum of possible relationships between geographic and climatic space, suggesting that geographic range edges and climatic niche limits correspond less frequently than we may expect. More empirical explorations of how the complexity of real landscapes shapes the ecological and evolutionary processes that determine species range edges will advance the development of range limit theory and its applications to biodiversity conservation in the context of changing climate.
Towards the integration of animal‐borne instruments into global ocean observing systems
Authors: March David , Boehme Lars , Tintoré Joaquín , Vélez‐Belchi Pedro Joaquín , Godley Brendan J.
Published: November 2019

Marine animals are increasingly instrumented with environmental sensors that provide large volumes of oceanographic data. Here, we conduct an innovative and comprehensive global analysis to determine the potential contribution of animal‐borne instruments (ABI) into ocean observing systems (OOSs) and provide a foundation to establish future integrated ocean monitoring programmes. We analyse the current gaps of the long‐term Argo observing system (>1.5 million profiles) and assess its spatial overlap with the distribution of marine animals across eight major species groups (tuna and billfishes, sharks and rays, marine turtles, pinnipeds, cetaceans, sirenians, flying seabirds and penguins). We combine distribution ranges of 183 species and satellite tracking observations from >3,000 animals. Our analyses identify potential areas where ABI could complement OOS. Specifically, ABI have the potential to fill gaps in marginal seas, upwelling areas, the upper 10 m of the water column, shelf regions and polewards of 60° latitude. Our approach provides the global baseline required to plan the integration of ABI into global and regional OOS while integrating conservation and ocean monitoring priorities.
Prevalence and associated factors influencing depression in older adults living in rural Thailand: A cross‐sectional study
Authors: Charoensakulchai Sakarn , Usawachoke Sirawich , Kongbangpor Worrawit , Thanavirun Phatklao , Mitsiriswat Apaporn , Pinijnai Onnicha , Kaensingh Sittarat , Chaiyakham Napat , Chamnanmont Chatchaya , Ninnakala Nichada , Hiri‐o‐Tappa Parit , Ponginsee Veeravit , Atichatpongsuk Veeraya , Asawathepmetha Eng‐Orn , Thongprayoon Charat , Mao Michael A , Cheungpasitporn Wisit , Varothai Narittaya , Kaewput Wisit
Published: November 2019

Aim

Depression is a major disease burden in Thailand. In rural areas, young adults will leave home to work in cities, and older adults are left behind. Loneliness and comorbidities can lead to depression in older adults. The present study aimed to evaluate the prevalence and associated factors for geriatric depression.

Methods

A cross‐sectional study was carried out. Questionnaires including the Thai Geriatric Depression Scale and family relationship were obtained by healthcare professions by face‐to‐face interviews of 584 older people aged ≥60 years in Ban Nayao community, Chachoengsao Province, Thailand. Geriatric depression can be defined as depressive syndromes that arise in adults aged ≥60 years. We excluded those who had visual or auditory disabilities or did not pass the Thai Mini‐Mental Status Examination. The prevalence and associated factors for geriatric depression were obtained. Associated factors were analyzed by multivariate logistic regression.

Results

A total of 433 older people were eligible. The prevalence of geriatric depression was 18.5%. Of the participants, 54.1% lived in an imbalanced family type. Multivariate analysis showed the significance for female sex (adjusted OR 2.78, 95% CI 1.54–7.49, P = 0.01), illiteracy (adjusted OR 2.86, 95% CI 1.19–6.17, P‐value 0.04), current smoker (adjusted OR 4.25, 95% CI 2.12–10.18, P = 0.009) and imbalanced family type (low attachment, low cooperation and poor alignment between each member; adjusted OR 4.52, 95% CI 2.14–7.86, P < 0.001) as risk factors for depression.

Conclusions

The prevalence of geriatric depression in rural Thailand is high. Imbalanced family type is an important risk factor for geriatric depression in the rural community. Geriatr Gerontol Int 2019; 19: 1248–1253.
Lower limb muscle mass is associated with insulin resistance more than lower limb muscle strength in non‐diabetic older adults
Authors: Seko Toshiaki , Akasaka Hiroshi , Koyama Masayuki , Himuro Nobuaki , Saitoh Shigeyuki , Miura Tetsuji , Mori Mitsuru , Ohnishi Hirofumi
Published: November 2019

Aim

We examined the association of muscle mass and muscle strength with insulin resistance, focusing on lower limb muscles.

Methods

This was a cross‐sectional study, and participants were registered in 2017 from the Tanno‐Sobetsu Study, a population‐based cohort study. After excluding individuals aged <64 years or with a history of diabetes mellitus, 272 non‐diabetic older adults (116 men, 156 women) met the inclusion criteria. According to the homeostasis model assessment of insulin resistance, the participants were divided into two groups; that is, the insulin resistance group (homeostasis model assessment of insulin resistance ≥1.73) and non‐insulin resistance group (homeostasis model assessment of insulin resistance <1.73). Muscle mass (lower limb, upper limb, appendicular and trunk) and muscle strength (grip strength and knee extension torque) were measured and divided by the weight, and then multiplied by 100 to calculate the weight ratio (%). The adjusted odds ratio (OR) of each muscle index for risk of insulin resistance was calculated separately for both men and women.

Results

Lower limb muscle mass (OR 0.72, 95% CI 0.55–0.92 in men; OR 0.69, 95% CI 0.51–0.96 in women, respectively) and appendicular muscle mass (OR 0.75, 95% CI 0.61–0.94 in men; OR 0.72, 95% CI 0.54–0.95 in women, respectively), but not other muscle indexes, were associated with risk of insulin resistance, after adjusting for age, body mass index, highly sensitive C‐reacting protein and smoking habits.

Conclusions

Lower limb muscle mass of non‐diabetic older adults is independently related to insulin resistance. Geriatr Gerontol Int 2019; 19: 1254–1259.
The impact of infertility on men's work and finances: Findings from a qualitative questionnaire study
Authors: Hanna Esmée , Gough Brendan
Published: November 2019

The impact of infertility on the emotional, social and relational aspects of men's lives is now more widely understood. Yet the impact of infertility on men's working lives and financial status remains largely overlooked. Drawing on a qualitative questionnaire study into men's experiences of infertility (n= 41), this article examines how work and finances are managed and negotiated during infertility, including treatment cycles. Three key themes were identified from our thematic analysis: managing infertility in the workplace; compromised job performance, (in)security and progression; the financial burden of infertility, suggesting that infertility can have significant implications for men's working lives, including their identities as productive workers. The impact had a gendered dimension, with threats to masculine‐relevant breadwinner roles and career ambitions. Awareness and management of infertility as a chronic health condition could be a useful way for employers to support disclosure of infertility and to allow men to navigate infertility and their working lives and identities in less stress‐inducing ways. This article contributes to our growing understanding of the stigma men experience in relation to infertility and how such stigma may intersect with masculinity in general and breadwinning in particular.
Work–family arrangements and the crisis in Spain: Balkanized gender contracts?
Authors: Sánchez‐Mira Núria
Published: November 2019

This article looks at the changing configuration of work–family arrangements (WFA) in Spain through the lens of labour market segmentation. Using European Union Statistics on Income and Living Conditions (EU‐SILC) data for 2005, 2007, 2010 and 2012, it examines occupational differences in WFA comparing the period of prosperity to the period of recession and the implementation of austerity policies. The findings show that the dynamics of labour market segmentation produce differential employment opportunities and degrees of job security for men and women across occupational groups, significantly shaping WFA. The crisis reinforced already balkanized gender contracts, with working‐class households suffering most from job losses and pressing economic needs. Couples whose members were services employees and/or manual workers saw the greatest increases in dual activity over the whole period, as dual earners during the prosperity period and as added workers during the crisis. The economic crisis and austerity policies have reinforced the social divide across work‐poor and work‐rich households, and dual‐earning skilled couples versus those earning out of economic necessity.
Embodiment, care and practice in a community kitchen
Authors: Phillips Mary , Willatt Alice
Published: November 2019

This article explores activist practices in a community kitchen based in the south of the United Kingdom with a dual focus on social and environmental justice. It draws on these practices to develop further feminist, and specifically ecofeminist, concepts of care ethics by arguing that embodiment is an essential element in lived relationships of care. Moreover, we show that these embodied components enable learning that can disrupt settled understandings of social and environmental injustices, including negotiating tensions relating to class and race. We demonstrate how this disruption combines with imaginative processes to stimulate critical political analysis of the relationship between local contexts of need and broader socio‐political structures and power relations. Crucially, we work towards illuminating how care ethics and social practice combine to stimulate and inform political action.
Early Onset of Efficacy With Fremanezumab for the Preventive Treatment of Chronic Migraine
Authors: Winner Paul K. , Spierings Egilius L. H. , Yeung Paul P. , Aycardi Ernesto , Blankenbiller Tricia , Grozinski‐Wolff Melissa , Yang Ronghua , Ma Yuju
Published: November 2019

Objective

To assess the onset of efficacy for fremanezumab in chronic migraine by evaluating pain‐related clinical measures at different time points.

Background

Faster onset of efficacy of preventive treatments could benefit patients with migraine. Fremanezumab is a fully humanized monoclonal antibody that selectively targets calcitonin gene‐related peptide, a neuropeptide involved in the pathophysiology of migraine. In 12‐week clinical trials, subcutaneous fremanezumab significantly reduced the frequency of migraine headaches, headache hours, and headaches in general, without serious treatment‐related adverse events. New drug classes of migraine preventive treatment demonstrate markedly different clinical profiles from standard‐of‐care treatments.

Methods

In this double‐blind phase III study, eligible patients were randomized 1:1:1 to receive subcutaneous injections of fremanezumab quarterly (675 mg at baseline, placebo at weeks 4 and 8), fremanezumab monthly (675 mg at baseline, 225 mg at weeks 4 and 8), or placebo at each time point. This study included secondary, exploratory, and post hoc analyses of the primary trial, evaluating the change in headache days of at least moderate severity or migraine days during the first 4 weeks of the trial.

Results

A total of 1130 patients were randomized (fremanezumab quarterly, n = 376; fremanezumab monthly, n = 379; or placebo, n = 375). During the 4‐week period after the first dose, the mean number of monthly headache days of at least moderate severity was reduced for the all‐fremanezumab group (mean reduction [95% confidence interval]: −4.6 days [−5.1, −4.1]) compared with the placebo group (−2.3 days [−2.9, −1.6]; P < .0001). Treatment effects were observed at Week 1 for the all‐fremanezumab group (−1.1 days [−1.3, −1.0]) vs placebo (−0.5 days [−0.7, −0.3]; P < .0001), with separation from placebo by Day 2 (P = .003). Similar effects were observed for the monthly average number of migraine days and mean number of monthly headache hours.

Conclusions

The early onset of efficacy of fremanezumab may have the potential to improve patient compliance and clinical outcomes.
Tooth‐Related Pain or Not?
Authors: Renton Tara
Published: November 2019

Dental pain is the most common acute pain presenting in the orofacial region; however, chronic pain conditions are also frequent and include; temporomandibular joint disorders (TMDs), primary headaches (neurovascular pain), painful post‐traumatic trigeminal neuropathy (PPTTN) and less commonly referred pain and idiopathic or centralized pain conditions. All of these conditions can mimic toothache and vice versa. Many of these conditions are comorbid with high levels of tension headache and migraine reported in patients with TMD; however, dentists remain unfamiliar with headaches and medics unfamiliar with toothache's multiple presentations. The anatomical complexity of the region, the potential exhaustive differential diagnoses and the multiple siloed training of specialties, leads to incorrect and delayed diagnosis and often results in patients undergoing inappropriate surgical and medical treatments. The continued inappropriate interventions may also complicate the later presentation of the patient with pain, by changing its phenotype, preventing a timely and correct diagnosis. Due to the variable presentation of toothache, which can mimic many different chronic pains including; episodic throbbing pain of migraine, the dull continuous pain of myofascial and arthrogenous TMDs or centralized facial pain, diagnosis can be complex. Neuralgic pain occurs in the dentition in health and with disease, mimicking conditions like PPTTN, trigeminal neuralgia (TN), and trigeminal autonomic cephalalgias (TACs), many patients are inappropriately diagnosed and treated, either by general medical practitioners assuming that the neuralgia is due to TN rather than more commonly presenting toothache or by a dentists or other surgeons continuing to treat TN or TACs with routine surgical care. Many patients are prescribed countless courses of antibiotics and undergo multiple surgical interventions simply as a result of poor education due to siloed specialty training. This must be addressed to improve patient safety.
The regulation of CD4+ T cells during malaria
Authors: Kumar Rajiv , Loughland Jessica R. , Ng Susanna S. , Boyle Michelle J. , Engwerda Christian R.
Published: November 2019

Malaria is a major global health problem. Despite decades of research, there is still no effective vaccine to prevent disease in the majority of people living in malaria‐endemic regions. Additionally, drug treatment options are continually threatened by the emergence of drug‐resistant parasites. Immune responses generated against Plasmodium parasites that cause malaria are generally not sufficient to prevent the establishment of infection and can even contribute to the development of disease, unless individuals have survived multiple infections. Research conducted in experimental models, controlled human malaria infection studies, and with malaria patients from disease‐endemic areas indicate the rapid development of immunoregulatory pathways in response to Plasmodium infection. These “imprinted” immune responses limit inflammation, and likely prevent progression to severe disease manifestations. However, they also cause slow acquisition of immunity and possibly hamper the development of vaccine‐mediated protection against disease. A major target for and mediator of the immunoregulatory pathways established during malaria are CD4+ T cells that play critical roles in priming phagocytic cells to capture and kill malaria parasites, as well as helping B cells produce functional anti‐parasitic antibodies. In this review, we describe mechanisms of CD4+ T cell activation during malaria and discuss the immunoregulatory mechanisms that develop to dampen their anti‐parasitic and pathological functions. We also offer some ideas about how host‐directed approaches might be applied to modulate CD4+ T cell functions to improve vaccine responses and enhance development of natural immunity.
Influence of Zr dopant on polarization in rutile (In0.5Nb0.5)0.005(Ti1‐xZrx)0.995O2 ceramics
Authors: Guo Baochun , Liu Peng , Cui Xiulei , Song Yuechan
Published: November 2019

(In0.5Nb0.5)0.005(Ti1‐xZrx)0.995O2 (INZT, x = 0‐0.10) ceramics were synthesized using a conventional sintering method, and the effects of Zr content on the microstructures, dielectric properties and electron‐pinned defect‐dipoles (EPDD) polarization of the resultant products were investigated. The solubility limit of INZT was x = 0.075, and a secondary ZrTiO4 phase appeared at x = 0.10. Ceramics with x = 0‐0.10 exhibited excellent dielectric properties, ie, colossal permittivity (CP, εʹ > 103) and low dielectric loss (tanδ < 0.1), over a wide range of frequencies (100‐106 Hz at 300 K) and temperatures (50‐350 K at 1 kHz). The dielectric spectra and XPS results confirmed that the CP property of the ceramics could be ascribed to their EPDD polarization. The activation energy (Ea) for EPDD polarization was continuously enhanced by increasing x values. EPDD relaxation parameters at different x values were revealed using Cole‐Cole equation fitting. Moreover, α, which characterize the relaxation time τ distribution, increased with x values, thus indicating that Zr was involved in and affected electron localized states. The high Ea, temperature Tp of the peak εʹʹ at 1 kHz, and dielectric relaxation time τp at 30 K were related to increases in hopping distance of electrons among defect clusters with Zr addition.
Teleconnections and local weather orchestrate the reproduction of tit species in the Carpathian Basin
Authors: Laczi Miklós , Garamszegi László Zsolt , Hegyi Gergely , Herényi Márton , Ilyés Gábor , Könczey Réka , Nagy Gergely , Pongrácz Rita , Rosivall Balázs , Szöllősi Eszter , Tóth László , Török János
Published: November 2019

Variation in climatic conditions is an important driving force of ecological processes. Populations are under selection to respond to climatic changes with respect to phenology of the annual cycle (e.g. breeding, migration) and life‐history. As teleconnections can reflect climate on a global scale, the responses of terrestrial animals are often investigated in relation to the El Niño‐Southern Oscillation and North Atlantic Oscillation. However, investigation of other teleconnections and local climate is often neglected. In this study, we examined over a 33‐year period the relationships between four teleconnections (El Niño‐Southern Oscillation, North Atlantic Oscillation, Arctic Oscillation, East Atlantic Pattern), local weather parameters (temperature and precipitation) and reproduction in great tits Parus major and blue tits Cyanistes caeruleus in the Carpathian Basin, Hungary. Furthermore, we explored how annual variations in the timing of food availability were correlated with breeding performance. In both species, annual laying date was negatively associated with the Arctic Oscillation. The date of peak abundance of caterpillars was negatively associated with local temperatures in December–January, while laying date was negatively related to January–March temperature. We found that date of peak abundance of caterpillars and laying date of great tits advanced, while in blue tits clutch size decreased over the decades but laying date did not advance. The results suggest that weather conditions during the months that preceded the breeding season, as well as temporally more distant winter conditions, were connected to breeding date. Our results highlight that phenological synchronization to food availability was different between the two tit species, namely it was disrupted in blue tits only. Additionally, the results suggest that in order to find the climatic drivers of the phenological changes of organisms, we should analyze a broader range of global meteorological parameters.
Dual regulation of microglia and neurons by Astragaloside IV‐mediated mTORC1 suppression promotes functional recovery after acute spinal cord injury
Authors: Lin Jialiang , Pan Xiangxiang , Huang Chongan , Gu Mingbao , Chen Ximiao , Zheng Xuanqi , Shao Zhenxuan , Hu Sunli , Wang Ben , Lin Hao , Wu Yaosen , Tian Naifeng , Wu Yan , Gao Weiyang , Zhou Yifei , Zhang Xiaolei , Wang Xiangyang
Published: November 2019

Inflammation and neuronal apoptosis contribute to the progression of secondary injury after spinal cord injury (SCI) and are targets for SCI therapy; autophagy is reported to suppress apoptosis in neuronal cells and M2 polarization may attenuate inflammatory response in microglia, while both are negatively regulated by mTORC1 signalling. We hypothesize that mTORC1 suppression may have dual effects on inflammation and neuronal apoptosis and may be a feasible approach for SCI therapy. In this study, we evaluate a novel inhibitor of mTORC1 signalling, Astragaloside IV (AS‐IV), in vitro and in vivo. Our results showed that AS‐IV may suppress mTORC1 signalling both in neuronal cells and microglial cells in vitro and in vivo. AS‐IV treatment may stimulate autophagy in neuronal cells and protect them against apoptosis through autophagy regulation; it may also promote M2 polarization in microglial cells and attenuate neuroinflammation. In vivo, rats were intraperitoneally injected with AS‐IV (10 mg/kg/d) after SCI, behavioural and histological evaluations showed that AS‐IV may promote functional recovery in rats after SCI. We propose that mTORC1 suppression may attenuate both microglial inflammatory response and neuronal apoptosis and promote functional recovery after SCI, while AS‐IV may become a novel therapeutic medicine for SCI.
Collective Identities, European Solidarity: Identification Patterns and Preferences for European Social Insurance
Authors: Nicoli Francesco , Kuhn Theresa , Burgoon Brian
Published: November 2019

A degree of collective identity is often perceived to be a requirement for integration of core state powers, and even more so when redistributive measures are at stake. Existing research has shown that European identity is an important correlate of support for European social policy in general. This article explores the ways in which collective identities relate to the multidimensional nature of social policy at the European level. We explore in particular the features of European social policy that receive the most support from European publics, and how local, national and European identity moderates these preferences. We expect that people who have primarily sub‐national or national attachments are less supportive of generous schemes and schemes that involve greater cross‐country redistribution, and are more in favour of decentralized schemes administered by the member states than those with stronger European identities. We find support for these expectations in a conjoint survey experiment fielded in autumn 2018 in 13 EU member states.
Juncker's Curse? Identity, Interest, and Public Support for the Integration of Core State Powers
Authors: Bremer Björn , Genschel Philipp , Jachtenfuchs Markus
Published: November 2019

In this study we analysed the patterns and covariates of public support for the European integration of core state powers based on an original new survey. We found considerable variation across integration instruments, member states and policy issues. Horizontal transfers are supported more than vertical capacity building; member states from the EU's South‐East are more supportive than states from the North‐West; and support increases from debt relief to unemployment assistance, sharing the burdens of refugees, and military defence to disaster aid. Identity is a strong and fairly consistent predictor for individual variations in support. The association with respondents’ interest is less consistent, but can be quite strong with respect to specific policy issues such as debt and unemployment. Overall, support for the integration of core state powers is higher and more variable than expected. This suggests there is considerable room for political agency rather than a general constraining dissensus.
Losing Faith: Religion and Attitudes toward the European Union in Uncertain Times
Authors: Nelsen Brent F. , Guth James L.
Published: November 2019

This paper explores the changing role of religion in forming public attitudes toward integration. We first outline the complex relationship of religion to the development of the European Union, and then use the 2009 and 2014 European Parliamentary Election Studies to examine the changes taking place in those historic patterns. In 2009 traditional religious patterns persisted, with Catholics more positive toward the EU than Protestants, with religiosity reinforcing the respective tendencies. By 2014, however, traditional divisions had virtually disappeared, as the economic crisis (and perhaps the growing refugee problem) had a powerful effect on Catholic majorities in EU countries. Nevertheless, when economic and other assessments are accounted for, Catholic confessional culture still provides ‘deep’ support for the EU. Finally, we discover that EU expansion has not changed old religious patterns as much as we expected, but find those traditional relationships to be virtually absent among millennials.
Evaluating the Determinants of EU Funds Absorption across Old and New Member States – the Role of Administrative Capacity and Political Governance
Authors: Incaltarau Cristian , Pascariu Gabriela Carmen , Surubaru Neculai‐Cristian
Published: November 2019

This article assesses the impact of administrative capacity and political governance factors on the absorption of structural and cohesion funds (SCF). We drew on EU‐27 country level data and developed a dynamic panel data model for the 2007–15 implementation period. By using a tobit estimation technique, the results indicated that government effectiveness and public diversion of funds significantly affect the recipient countries ability to absorb EU funds. The results revealed that increasing government effectiveness and combating corruption had significant stronger boosting effects on the absorption of SCF, especially in the new member states (NMS). This might explain why bottlenecks of administrative capacity and political governance are highly relevant for NMS and why these countries generally faced lower absorption rates, as compared to EU‐15. Moreover, the results also underlined that the recent great recession reduced the ability of countries to absorb SCF. Against our expectations, domestic financial capacity and political decentralization were not shown to be decisive for EU funds absorption. In policy terms, our study suggests a focus on administrative capacity‐building and fighting corruption in NMS and across lagging regions of older member states in order to improve absorption rates, while also focusing more on the efficiency and effectiveness of European cohesion policy. Finally, several suggestions are made on how our analysis can be replicated and taken forward by analysts of the European Union's internal development cohesion policy.