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This review aims to explore the potential role of folate and related B vitamins (B12, B6 and riboflavin) in maintaining cognitive health in ageing, focusing particularly on their interactions with the gut microbiota and inflammation. Low B-vitamin status, common in older adults, is associated with poorer cognitive function and dementia. Furthermore, people with dementia are observed to have increased abundance of pro-inflammatory microbes and concomitant higher concentrations of cytokines in their circulation. Therefore, gut dysbiosis and chronic inflammation have been proposed as contributors of cognitive dysfunction. Although many observational studies report that low B-vitamin status, especially vitamin B6, is associated with a worse inflammatory state, the role of the gut microbiota is much less investigated. Pre-clinical evidence suggests higher B-vitamin intakes may beneficially modulate the gut bacterial profile and its metabolic activity, positively influencing inflammation. The evidence, however, is inconsistent, and the few human intervention studies available are confined to clinical populations or are limited by small sample size or to a single B-vitamin at high supplementation doses. Of note, one study in rats with Alzheimer’s-type dementia reported an association of folate and vitamin B12 deficiency with disturbed gut bacterial composition, neuroinflammation and impaired memory. In conclusion, optimising B-vitamin status may help promote cognitive health during ageing through modulation of the gut microbiota and immune function. Well-designed human studies are, however, required to confirm these relationships and inform evidence-based nutritional strategies for healthy ageing.
Sexually transmitted infections (STIs) are common among people living with human immunodeficiency virus (HIV) (PLWH). This nationwide register study linked HIV and STI registries to examine STI trends before and after HIV diagnosis in Finland 1995–2019 among all PLWH residing in the country. Analysed STIs were chlamydia, gonorrhoea, syphilis, and hepatitis B and C. An extended Cox model assessed factors associated with STI events. Among 3,775 PLWH (mean follow-up 17.9 person-years), 71% had no STIs, 17% had one, and 12% had two or more. Overall, 10.7% had an STI before HIV diagnosis and 18.1% after. STI incidence was 32 per 1,000 person-years and increased over time, although chlamydia and gonorrhoea declined. STI risk was highest among men who have sex with men (MSM) and lowest among people who inject drugs; it remained stable or declined after HIV diagnosis. STIs before HIV diagnosis offer opportunities for HIV testing and pre-exposure prophylaxis promotion. As most had no STIs other than HIV, HIV testing should not be limited to STI screening but also performed in other indicator conditions. After HIV diagnosis, accessible low-threshold STI testing, particularly for MSM, and consideration of doxycycline prophylaxis may benefit those at highest risk.
Transnational anti-trans actors fall into two camps: traditionally conservative actors who pursue transphobia to extend patriarchy and feminists who pursue transphobia to challenge patriarchy. This article investigates how shared language and practices of anti-trans feminist and traditionalist coalitions enact opposing sex/gender orders. I explain this alliance through grounded theory generated from a critical discourse analysis of my dataset of 1016 anti-trans texts from 175 organizations. I develop my Affective Orientation Threat Structure, which explains the affective governing process of this coalition, and then apply this framework to anti-trans discourses about trans threats to womanhood. I find that anti-trans feminists and traditionalists generate fear via shared threat constructions but frame threat differently in order to mobilize affective energy in service of diverging regulative regimes and sex/gender orders. I argue that the illogics produced by contradictions within this incompatible coalition benefit both camps by maximizing affective disorientation and generating momentum through paradox.
This paper is in line with research that analyzes the careers of European parliamentarians, adopting a comparative and cross-sectional approach and taking into account previous and subsequent political experiences in a multilevel perspective. Indeed, we propose a comparison between two similar cases, namely two southern European countries that have a quasi-federal system or are affected by an important regionalization process – Spain and Italy – and we examine a rather long time period ranging from the IV to the IX EP legislature. Our dataset consists of 508 observations, 195 relating to Spanish members of the European Parliament (MEPs) and 313 to Italian ones. By relying on the recent systematization, we propose to classify MEPs’ career models – which are our dependent variable – into four types: the EU shorter-termers, the ‘stepping stone’ MEPs, the EU long-termers, and the ‘multilevel surfers’. A multinominal regression analysis was conducted to understand which political factors (party affiliation of MEPs, length of previous career, critical European Parliament [EP] elections) may have a specific impact on each career type. We found that, after the 2014 EP critical election, the probability of MEPs engaging in the EP decreases, as they are more likely to develop a short-term career model than a long-term one. In addition, previous national experience and a regional executive career are the best predictors of a multilevel career.
Penicillins are the most frequently prescribed antibiotics for a broad range of infections. In North America, up to 15% of hospitalized patients report a penicillin allergy, but research has shown that 98% of these patients can tolerate penicillins. Removing inaccurate allergy labels is an essential component of antimicrobial stewardship. While allergy delabelling used to be complex or require an allergist referral, the emergence of new tools, such as the PEN-FAST score, facilitates direct delabeling of low-risk patients.
Objectives:
The primary objective of this study was to trial the use of the PEN-FAST scoring tool at a major tertiary care center in Canada. Secondary objectives included measuring the pharmacy workload associated with the delabeling process.
Methods:
A prospective pilot study was implemented at a Canadian tertiary care hospital to identify new patients with a penicillin allergy label, perform a review of their medical history, obtain a PEN-FAST score, and if applicable, implement an oral challenge with amoxicillin.
Results:
Most of the 155 screened patients were delabeled based on their medical history. Twenty-nine patients were eligible for an oral challenge, and three challenges were conducted.
Conclusion:
PEN-FAST scoring in combination with direct oral challenge is a practical tool that can be prospectively implemented by pharmacists.
Comorbid obsessive–compulsive disorder (OCD) or obsessive–compulsive symptoms (OCS) are common in people with severe mental illness (SMI; including schizophrenia, bipolar disorder and schizoaffective disorder), with little known about associations with smoking.
Aims
To estimate the association between OCD/OCS and smoking status among people with SMI in a huge electronic database.
Method
Using the Clinical Records Interactive Search (CRIS) platform for data of service users in the South London and Maudsley (SLaM) NHS Foundation Trust, tobacco smoking status was retrospectively detected through an algorithm of natural language processing technique, categorising into ‘current smoker’, ‘ex-smoker’ and ‘non-smoker’ by the clinical notes of SMI individuals during 2007–2015. A hierarchical assignment rule was applied following the order of ‘smoker’, ‘ex-smoker’ and then ‘non-smoker’ in an individual. Logistic regression was used to examine the association between smoking and OCS in people with SMI for univariable and multivariable analyses.
Results
We identified 15 479 SMI individuals (56% male; mean age 41 years old), with 90.4% ever smoked. Among them, 2320 (15%) had OCS (without OCD), while 2174 (14%) had a clinical diagnosis of comorbid OCD. After adjusting for demographics and functional status as confounders, both SMI individuals with OCS only and an OCD diagnosis were significantly more likely to have ever smoked (adj. odds ratio 1.47, 95% CI 1.23, 1.76 and adj. odds ratio 1.33, 95% CI 1.11, 1.60, respectively) compared with those without OCD/OCS.
Conclusions
In this large-scale analysis of people with SMI, we found that individuals with OCS or OCD were more likely to have ever smoked.
Newfoundland and Labrador (NL) introduced Canada’s first excise tax on sugar-sweetened beverages (SSB) in 2022. Industry marketing practices in response to SSB taxation may affect public health impacts. We examined changes in posted beverage pricing and marketing of taxable and non-taxable beverages in NL before and after the SSB tax was implemented.
Design:
Pre-/post-observational study with in-store audits of beverage prices and marketing. Changes including pricing discounts and promotions were assessed at the individual beverage level for pre/post-tax implementation years.
Setting:
Eighty food stores (grocery, convenience, drug and dollar) in NL, Canada.
Results:
There was no evidence of a change in posted shelf prices between pre/post years. There was a significant increase (+2·5 %, χ2 = 9·693, P = 0·002) in proportion of discounted taxable SSB with no change in non-taxable beverages (P = 0·350). There were no significant differences in change of number of promotions for taxable SSB (+5·2 [−0·1, 10·5], F = 3·789, P = 0·053) nor non-taxable beverages (+3·4 [–1·0, 7·7], F = 2·268, P = 0·134).
Conclusions:
The lack of change in posted prices of taxable SSB indicates that the NL SSB tax was not communicated at the point of decision-making. While some marketing changes post-tax were observed, results should be interpreted cautiously as they cannot be attributed definitively to the tax. Existing literature implies that industry may adapt marketing conduct to counteract beverage taxes. Such changes were limited in NL, suggesting retailers may have opted not to display the tax rather than attempt to actively counteract it. Lack of transparency surrounding the tax may neutralise intended behavioural effects.
Major depressive disorder (MDD) is the leading cause of disability worldwide, affecting roughly 322 million people. Recently, doses of psilocybin have shown promise in treating mood disorders, sparking interest in other dosing practices. According to anecdotal reports and observational studies, microdosing psilocybin yields benefits to mental health; however, rigorously controlled trials have failed to produce compelling evidence for this.
Aims
To conduct a phase II, double-blind, placebo-controlled, randomised partial crossover trial to compare microdosing psilocybin to placebo for MDD, evaluating its safety, tolerability and preliminary antidepressant effects.
Method
Forty adults with MDD will be randomised to four doses of psilocybin (2 mg) or placebo (maltodextrin) once weekly over 4 weeks, then four doses of psilocybin (2 mg) once weekly for an additional 4 weeks. The primary efficacy end-point will be change in depression symptoms, as measured at baseline (0 weeks), after the experimental phase (4 weeks), and after the open-label phase (8 weeks). A battery of mood, well-being, attention, creativity, mindfulness and pro-sociality measures will be administered at each time point. Follow-ups will occur every 6 months for up to 2 years after the trial start date, as part of a long-term extension study.
Results
The results of the primary outcome of this trial will be published as a manuscript in a peer-reviewed science or medical journal regardless of the magnitude or direction of effect.
Conclusions
Findings will inform future research on microdosing psilocybin for MDD, regarding dose regimens, effect sizes and expectancy bias. Findings will also facilitate discussions on the comparable benefits of sub- versus threshold doses of psilocybin and the therapeutic value of radically altered perception.
Climate Justice: Resisting Marginalisation examines the impact of climate change on marginalized communities across the globe and the different ways of resisting these impacts. The book underlines the imbalanced consequences of climate change, driven by the power disparities between the global North and South. It investigates how climate change aggravates structural inequalities, focusing on the intersectionality of gender, race, technology, and politics. Through a study of resistance and marginalization, the book analyses how these systemic injustices are perpetuated, while offering understandings into the struggles and strategies to build a justice oriented approach to combating climate change. This title is also available as open access on Cambridge Core.
At the core of nationalism, the nation has always been defined and celebrated as a fundamentally cultural community. This pioneering cultural history shows how artists and intellectuals since the days of Napoleon have celebrated and taken inspiration from an idealized nationality, and how this in turn has informed and influenced social and political nationalism. The book brings together tell-tale examples from across the entire European continent, from Dublin and Barcelona to Istanbul and Helsinki, and from cultural fields that include literature, painting, music, sports, world fairs and cinema as well as intellectual history. Charismatic Nations offers unique insights into how the unobtrusive soft power of nationally-inspired culture interacts with nationalism as a hard-edged political agenda. It demonstrates how, thanks to its pervasive cultural and 'unpolitical' presence, nationalism can shape-shift between romantic insurgency and nativist populism. This title is also available as Open Access on Cambridge Core.
This Element seeks to develop an empirical research agenda that explores the applicability of the growth model perspective in comparative political economy to emerging capitalist economies (ECEs). Such an approach emphasizes the variety of possible growth models and their implications for development, providing an alternative to universalizing economic models as prevalent in mainstream development discourse. Using national accounts data for several large ECEs in the period from 2001 to 2022, the authors first propose a typology of peripheral growth models with varying degrees of economic vulnerability. Most notably, they add an investment-led model to the prevalent juxtaposition of consumption-led and export-led growth models. Subsequently, they employ several case vignettes from Brazil, Indonesia, South Africa, Turkey, Thailand and Vietnam to unpack the effects of volatile international interdependencies, such as commodity cycles, and diverse political underpinnings on peripheral growth models. This title is also available as open access on Cambridge Core.
The fossil record of medusozoan cnidarians is relatively sparse and, in some cases, contentious. Here, we describe a new genus and species of a well-preserved, soft-bodied, tubicolous polyp, Paleocanna tentaculum n. gen. n. sp., from the Upper Ordovician (Katian) Neuville Formation in Québec. These fossils, preserved as carbonaceous compressions, were found in association with typical shelly assemblages. Fifteen slabs of shaly limestone containing ~ 135 specimens of Paleocanna tentaculum n. gen. n. sp. were examined. Individual polyps occupied upright tubes, which occur either solitarily or in clusters. Some tubes exhibit a striated periderm near their base. The polyp is elongated, with a rounded aboral end and a consistent ring of tentacles protruding distally from the tube. A phylogenetic analysis of 69 taxa and 236 discrete morphological characters indicated that the species is more closely related to the extant crown group than it is to the other stem-group medusozoans, e.g., conulariids and carinachitids. The uniform orientation of specimens on single slabs suggests rapid burial. Paleocanna tentaculum n. gen. n. sp. represents an exceptionally preserved member of an Ordovician deposit exhibiting Burgess Shale-type soft-tissue preservation.
Vitamin A deficiency (VAD) is common among pregnant women (PW) and has been associated with anaemia and adverse birth outcomes. However, in the Free State Province of South Africa, evidence regarding this is limited. Hence, this cross-sectional study investigated the vitamin A (vitA) intake and status of PW in Bloemfontein and its association with anaemia, iron status and birth outcomes. Blood was taken from 427 PW to assess the status of vitA (retinol-binding protein 4 (RBP4)), iron (ferritin, soluble transferrin receptor (sTfR)) and anaemia (Hb). Sociodemographic, HIV, birth outcomes (birthweight and gestational age) and dietary vitA intake data were obtained using a questionnaire in an interview and medical records. Descriptive statistics and linear regression were used to describe variables and the association between vitA and iron status and birth outcomes. Median vitA intake was 1007 µgRAE/d with 19 % of participants’ intake below the estimated average requirement of 550 µgRAE/d. Median (IQR) RBP4 was 1·51 (0·78) µmol/l. Insufficient vitA status and VAD prevalence were 12·2 % and 1·2 %, respectively. VitA intake was positively associated with RBP4 (β = 0·068; 95 % CI 0·020, 0·116; P = 0·006). RBP4 was positively associated with Hb (β = 0·363; 95 % CI 0·186, 0·539; P < 0·001) and ferritin (β = 0·359; 95 % CI 0·139, 0·579; P = 0·001) but negatively with sTfR (β = −0·125; 95 % CI −0·246, −0·005; P = 0·041). No significant association between plasma RBP4 and birth weight, as well as preterm birth, was observed. There was a low prevalence of VAD in the study population. Nonetheless, the positive association between RBP4 and Hb and ferritin highlights the importance of optimal vitA status in preventing anaemia in pregnancy.
Research teams studying bilingualism often focus on a specific population of bilinguals, which can limit the generalizability of their findings. This study explored how U.S. adolescents who speak a non-English language vary in their language experiences and cognition using data from the Adolescent Brain Cognitive Development (ABCD) study. The sample included 6683 English monolinguals, 1138 heritage bilinguals, 592 dual language education (DLE) bilinguals and 1751 other bilinguals. SES varied across groups: sequential bilinguals (i.e., DLE and other bilinguals) had higher parental education and income than monolinguals, while heritage bilinguals had the lowest SES. Sequential bilinguals reported higher English proficiency and greater English use with family and friends than heritage bilinguals. Sequential bilinguals initially outperformed monolinguals on cognitive tasks, who in turn outperformed heritage bilinguals. However, these differences disappeared once SES was controlled. Findings highlight the importance of considering SES and language experiences when studying bilingualism’s cognitive effects and help explain inconsistencies in prior research.
We compute the Galois groups of the reductions modulo a prime number p of the generating series of Apéry numbers, Domb numbers and Almkvist–Zudilin numbers. We observe in particular that their behaviour is governed by congruence conditions on p.