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Self-represented litigants (SRLs) have repeatedly identified overly complex court forms as a major source of confusion and frustration. Digital guided pathways have been identified as one possible means to reduce barriers that the public experiences with court forms — but how effective are guided pathways as access to justice measures? Do they make court forms easier to fill out? If so, how can they be optimally designed and evaluated? This article reports on research seeking to answer these questions through a case study of family law guided pathways developed by Community Legal Education Ontario (CLEO). This study yielded two major conclusions. First, guided pathways can significantly reduce complexity for SRLs and, thus, other jurisdictions should consider adopting them as access-enhancing measures. Second, when designing and evaluating the design of court form guided pathways, a functional literacy framework, combined with user data and human testing, can be helpful in identifying barriers.
The proto-oncogene tyrosine kinase receptor encoded by the W locus (CD-117) has been confirmed to be critical to the processes of germ cell proliferation, migration and survival in the rodent. The purpose of the present study was to examine the expression of germ cell-specific CD-117 marker in testis and germ line stem cells (GSCs). The aim of this study was analysis of CD-117 expression as germ cell marker in the seminiferous tubule of mice.
Materials and Methods:
In this experimental study, we employed a comprehensive array of techniques to scrutinize the expression of CD-117. Our analysis encompassed the utilization of immunocytochemistry, immunohistochemistry, Fluidigm real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR), and flow cytometry methodologies.
Results:
The Immuno-history-fluorescent analysis revealed the distribution of the germ cell marker CD-117 in the differentiated compartment of seminiferous tubules. High-magnification of confocal microscopy analysis showed surface expression of CD-117 in testis section. Whereas isolated GSCs colonies clearly express the germ-specific protein CD-117, TSCs (testicular stromal cells) were negative for this marker. Fluidigm real-time RT-PCR result demonstrated a significant expression (P < 0.001) of CD-117 in the neonate and adult GSCs compared to TSCs cells. Similarly, flow cytometry analysis confirmed expression of CD-117 in the GSCs colonies and testis cells.
Conclusion:
These results discriminate in spite of stage-specific ectopic, expression of CD-117 is a specific germ cell marker for proliferation and differentiation of GSCs into sperm, and can be beneficial for understanding of the signalling pathways related to differentiation of GSCs.
Zoroastrians are one of Iran's religious minorities, who managed to survive pressures and adversities during many centuries after the rise of Islam. Despite threats and dangers, this minority always tried to resist the pressures and maintain their identity and social cohesion with some measures. Aqda Cave is one of the examples of material culture left by the Zoroastrians, which can be very helpful for a better understanding of the preservation of their identity and social cohesion over time, a heritage that, based on the assessment of social values, can be effective in the sense of identity, sense of place and sense of belonging of this community. The presentation and preservation of this cultural heritage with the help of Zoroastrians will provide a foundation to acknowledge their rights and construct a respectful character for this minority group. Consequently, the preservation of this heritage could be an attempt to respect cultural diversity, heritage rights and equity as the factors of inclusive social development and world peace.
This study evaluated the validity and reliability of the Persian version of the Disaster Resilience Measuring Tool (DRMT-C19).
Methods
The research was a methodological, psychometric study. Standard translation processes were performed. Face validity and content validity were determined along with construct and convergent validity. To determine the final version of the questionnaire, 483 health care rescuers were selected using a consecutive sampling method. Other resilience-related questionnaires were used to assess concurrent validity. All quantitative data analyses were conducted using SPSS 22 and Jamovi 2.3.28 software.
Results
The content validity and reliability were indicated using Scale’s Content Validity Ratio (S-CVR) = 0.92 and Scale’s Content Validity Index (S-CVI) = 0.93. The comprehensiveness of the measurement tool = 0.875%. Cronbach’s α = 0.89 and the test re-test reliability using interclass correlation coefficients (ICC) = 0.68 to 0.92. Exploratory factor analysis determined 4 factors which accounted for more than 58.54% of the variance among the items. Confirmatory factor analysis determined 12 factors. The concurrent validity between the DRMT-C19 and the Connor-Davidson Resilience Scale (CD-RISC) was r = 0.604 (P ≤ 0.0001).
Conclusions
The DRMT-C19 has satisfactory psychometric properties and is a valid, reliable, and valuable tool for assessing resilience against disasters in Iran’s Persian-speaking health care rescuers.
Chia seeds have gained attention for their potential anti-inflammatory properties, which may be attributed to their high content of omega-3 fatty acids, dietary fibre, and antioxidants. This study aims to provide an overview of the current understanding regarding the effects of chia seeds on inflammatory markers, specifically C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α). A comprehensive literature search was conducted on PubMed, Scopus, Web of Science, Cochrane, and Google Scholar up to June 2024. Randomized controlled trials (RCTs) assessing the effect of chia seed on CRP or/and IL-6 or/and TNF-α. Data were extracted and analysed using a random-effects model, and reported as weighted mean differences (WMD) with 95% confidence intervals (CI). Subgroup and sensitivity analyses were also performed. Four RCTs involving 210 participants were included in the meta-analysis. The results showed that chia consumption significantly decreased CRP (WMD: –0.64 mg/dl; 95% CI: –1.24, –0.04; P = 0.03). But it had no significant effect on IL-6 (WMD: 0.29 pg/dl; 95% CI: –0.40, 0.98; P = 0.41), and TNF-α (WMD: 0.05%; 95% CI: –0.21 to 0.30; P = 0.72). Chia consumption can significantly decrease CRP, but no significant effect was observed on IL-6 and TNF-α. To prove our findings, more studies with a larger sample size are needed.
To assess associations between dietary fat quality indices and risk of pre-diabetes and type 2 diabetes mellitus (T2DM) among Iranian adults.
Design:
Daily intakes of fatty acids were estimated using a validated FFQ with 168 food items. Adjusted hazard ratios (HR) and 95 % CI for pre-diabetes and T2DM were calculated across tertile categories of dietary fat quality indices including the atherogenic index, thrombogenic index, health-promoting index, ratio of PUFA to SFA (PUFA:SFA) and ratio of hypo- and hypercholesterolaemia (h:H).
Setting:
Tehran Lipid and Glucose Study.
Participants:
Iranian men and women.
Results:
The mean (sd) age of the 2042 pre-diabetes-free participants in pre-diabetes analysis was 38·84 (12·97), and 55·2 % were women. In T2DM analysis, the mean (sd) age of the 2295 T2DM-free participants was 40·06 (13·42), and 54·6 % of them were women. In the crude model, the PUFA:SFA ratio was positively associated with T2DM incidence (HR = 1·43; 95 % CI 1·04, 1·98). However, after adjustment for confounding variables, there were no significant associations between dietary fat quality indices and risk of pre-diabetes and T2DM.
Conclusions:
We found no significant association between fat quality indices and risk of pre-diabetes and T2DM. Further prospective and clinical trial studies are needed to clarify the issue.
Spontaneous abortion (SA) is considered one of the most prevalent adverse outcomes of pregnancy. SA may occur due to genetic susceptibility and various maternal factors such as nutritional status. The aim of this study was to assess how dietary carotenoids and the FTO gene are related to SA. This case–control study included 192 women with a history of SA as the case group and 347 healthy women without history of SA as the control group. To evaluate carotenoid intake, a valid 168-item food frequency questionnaire (FFQ) was used. The FTO gene was genotyped for the presence of the rs9939609 polymorphism using the tetra-primer amplification refractory mutation system-polymerase chain (ARMS-PCR). The results indicated a significant negative association between dietary intake of β-cryptoxanthin and SA in carriers of the TT genotype of the FTO rs9939609 polymorphism after adjustment for age, BMI, physical activity, smoking, alcohol drinking, and calorie intake (β = −0.28, P = 0.02). No association was found between SA with dietary intake of beta-carotene, alpha-carotene, lutein, and lycopene among carriers of different FTO genotypes. The FTO genotype may have an effect on the association between SA and carotenoid intake. Dietary intake of β-cryptoxanthin may act as a protective factor against SA only in carriers of the TT genotype of the FTO rs9939609 polymorphism.
Even as it passed its seventieth anniversary, the 1953 coup in Iran has remained a hotly debated political topic. This is true in the public spheres of Iran, which saw its last democratically elected prime minister, Mohammad Mosaddeq, overthrown in the coup, and in those of the United States and the United Kingdom, which helped stage the ouster. There also has been an attempt at historical revisionism about the coup, usually by overemphasizing the domestic factors that led to the coup and placing less importance on the role of the CIA or questioning Mossadeq's democratic credentials. This revisionism has been robustly rebutted by the scholarly community, which has held to a general consensus on the basic narrative of the coup: that it overthrew a popular leader and that it took place with significant interventions from London and Washington. The release of the final batch of US documents related to the coup in 2017 (following many years of undue delay) also bolstered evidence for this consensus. But, although most public debates about the coup center on questions such as the constitutional process of Mosaddeq's dismissal or the relative weight given to domestic and international actors behind the coup, there is another historiographical question that has been subject to widely divergent perspectives in the field: the relationship of the coup to the Cold War. In other words, can the 1953 coup be considered a Cold War confrontation, or is this a misleading frame of reference? Both sides of this argument have often focused on the motivations of coup plotters (mostly those in Washington, DC, and London) and whether they are more readily explained by a genuine fear of the communist movement in Iran or whether this was a rhetorical smokescreen, masking the neocolonial drive for the control of Iran's resources. This tension is not limited to scholarship on Iran. Even as new global histories of the Cold War have grown in recent years, some have cautioned against the use of this framework for understanding politics in the Global South. Jeremi Suri, for instance, speaks of a “group of scholars” who have “questioned the very utility of the Cold War as an analytical concept” by pointing to “the ways in which this geopolitical term privileges state actors in the United States and Europe and neglects local forces of change, many of which had little apparent connection to the basic issues and personalities of the Cold War.” In his analysis of the global place of Algeria's drive for independence, Matthew Connelly suggests “taking off the Cold War lens,” arguing that such a lens did less to shape the views of historical actors (such as the Eisenhower administration) than “those of the historians who have studied them.”
To evaluate sex- and age-stratified body composition (BC) parameters in subjects with wide age range of 20–79 years.
Design:
Cross-sectional.
Setting:
Participants of Tehran Lipid and Glucose Study (TLGS).
Participants:
Two thousand nine hundred seventy participants met our inclusion criteria. They were divided into five age groups, and BC parameters were analysed based on sex and age using a bioelectrical impedance analyser (BIA).
Result:
The mean age of the participants was 42·1 ± 12·5 years, and 54 % of them were males. The mean BMI was 26·7 ± 3·7 kg/m2. Obesity indices were significantly higher in females (P < 0·001); however, skeletal muscle mass (SMM) and fat-free mass (FFM) were significantly higher in males (P < 0·001). Both SMM and FFM decreased significantly after the age of 50 years. Obesity indices significantly increased from the age group of 20–29 to 30–39 years in males and the age groups of 30–39 to 40–49 years and 40–49 to 50–59 years in females. The fat mass ratio (fat mass/SMM) showed two peaks in both sexes (after the ages of 30 and 50 years in males and 40 and 50 years in females). A strong correlation was found between BMI and percentage of body fat (r = 0·823 in females v. r = 0·768 in males).
Conclusion:
This is the first community-based study in the MENA region identifying sex- and age-stratified BC values using BIA. Our findings can be used as a reference for comparison in appropriate settings.
The present prospective cohort study aimed to determine whether dietary antioxidants were associated with incident type 2 diabetes mellitus (T2DM). Another objective was to find out whether such associations could be modified by the BMI status. A total of 2188 Tehranian adults aged 21–84 years, free of T2DM with the validated FFQ, was entered in the study. Multivariable Cox proportional hazards models adjusting for confounders were used to assess the association between dietary antioxidants and incident T2DM in total population, as well as in subjects with various BMI statuses. During 8·9 (8·1–9·6) years of follow-up, dietary vitamin E significantly decreased the incident T2DM, after adjustment for confounders. However, other dietary antioxidants were not shown to be significantly associated with incident T2DM. The interaction between dietary vitamin E, Mg and BMI status was found to influence the risk of T2DM (Pfor interaction < 0·05). After stratification of subjects based on BMI status, it was found that vitamin E and Mg decreased the risk of T2DM only among normal-weight individual. Also, an inverse association was found among dietary vitamin C, dietary Zn and the risk of T2DM in individuals with normal weight but not in overweight and obese individuals; however, the interaction test tended to be significant for these dietary variables. Dietary antioxidants including vitamin E, vitamin C, Zn and Mg when accompanied by healthy weight, may bring benefits to the prevention of T2DM.
The application of integrative taxonomic approaches is useful to species delineation based on a combination of distinct types of characters, here morphological features and ribosomal DNA sequences. In this study, we surveyed ectoparasitic nematodes of the subfamily Merliniinae in cultivated and natural environments in Iran. Results of morphological and morphometrical studies, light and scanning electron microscopic observations, and molecular analyses allowed us the identification of fourteen known and one unknown species including representatives of the genera Amplimerlinius (five species), Geocenamus (one species), Merlinius (three species), Nagelus (two species), Paramerlinius (one species), Scutylenchus (two species), and Telomerlinius (one species). The unknown species, Scutylenchus sp., characterized by having 35–50 incisures at mid-body; lateral field with 6 longitudinal incisures; lip region slightly offset by a constriction, flattened at front end; bearing 5–7 annuli; cephalic framework not refractive; stylet robust, 18.3–27 μm long; post anal intestinal sac absent; tail elongate conical, dorsally convex, with 24 (19–28) annuli in ventral side, ending to a smooth terminus and males common; spicules 24.5–31 μm long. The phylogenetic analyses were carried out using molecular data from nuclear ribosomal DNA (rDNA) genes viz. D2–D3 expansion segments of the large ribosomal subunit (28S rRNA), partial small ribosomal subunit (18S rRNA), and internal transcribed spacer (ITS). The molecular variability of D2–D3 expansion segments of the 28S rRNA and partial 18S rRNA was low in this family in comparison to the ITS region, which could be a more helpful molecular marker in species and genus identification.
Methanol intoxication is a public health problem in developing countries and can be ingested accidentally or with suicidal intent, leading to intoxication in isolated or collective forms. Methanol is used as a substitute for ethyl alcohol in several adulterated alcoholic beverages such as “eau de vie”, which is a drink distilled from dried fruits, such as dates, grapes and figs. Inside the body, it is metabolised into formic acid which, if left untreated, affects brain tissue, leads to blindness and can also cause death.
Objectives
The objective of this retrospective study of a series of cases was to describe the epidemiological characteristics of methanol “eau de vie” poisoning cases collected by the Anti-Poison and Pharmacovigilance Centre of Morocco between 2013 and 2020 and to explain these results.
Methods
This is a descriptive and retrospective cross-sectional study over a period of 7 years from 1 January 2013 to 31 December 2020, which concerned 16 cases of intoxication by methanol “eau de vie” reported to the Anti-Poison and Pharmacovigilance Centre of Morocco, the study population concerned the entire Moroccan population throughout the territory of Morocco. The analysis concerned the frequency, the distribution in time, the distribution in space, the characteristics of the intoxicated, the type and circumstances of the intoxication and its evolution.
Results
The CAPM recorded, during the study period, 16 cases of intoxication by methanol “Eau de vie” in Morocco. These cases were reported by telephone in 93.75% of the cases and collected by studies on hospital registers in 6.25% of the cases. Men were more affected than women. The most affected age group was adults, accounting for 50%. Adolescents accounted for 37% of cases and children for 13%. Drug addiction was the most frequent circumstance, followed by accidental intoxication and voluntary intoxication. The most frequently encountered signs were gastrointestinal signs followed by central and peripheral nervous system signs and heart rate and rhythm disorders. The outcome was favourable in 62% of cases, 6% with blindness after-effects and death occurred in 19% of cases.
Conclusions
Methanol poisoning can result from the consumption of illegal products containing methanol such as brandy, hence the importance of raising public awareness of this danger. It is also necessary to make health professionals aware of the clinical signs of methanol poisoning and what to do in the event of intoxication.
Post-traumatic stress disorder (PTSD) is characterized by intense, unpleasant, and dysfunctional reactions that appear after an overwhelming traumatic event. A life-threatening or serious injury event can cause lasting and intense suffering.
Hospitalization without consent, the use of isolation techniques, restraint or the obligation to take treatment are situations that can be perceived as traumatic.
Objectives
Our goal is: The search for the existence of psycho-pathological links and vulnerabilities between the state of post-traumatic stress and physical restraint. Consideration of the traumatic event in the development of appropriate care strategies.
Our goal is:The search for the existence of psycho-pathological links and vulnerabilities between the state of post-traumatic stress and physical restraint.Consideration of the traumatic event in the development of appropriate care strategies.
Methods
To meet this objective, we carried out a descriptive study which identified 200 cases collected in the psychiatric emergency department of the Arrazi Hospital in Salé from 2017 to 2021. An exploitation sheet was drawn up and the study was carried out using Meta-chart and Visuel-chart software.
Results
At the end of this work we found: The average age is 35 years +/- the sex ratio is equal to 1.42. 80% are single while 10% are divorced. Regarding professional activity, 70% are unemployed. 10% of patients have a level of education above the baccalaureate.
As for the history, 60% of the cases studied have a personal psycho-addictive history. 34.6% of the cases studied have a medical-surgical history.
The psychiatric pathologies that were found are: 10% suffer from depressive disorder, 80% have psychosis, 10% have attempted suicide.
Conclusions
During an acute episode, patients may be exposed to coercive treatments. Hospitalization without consent, the use of isolation techniques, restraint or the obligation to take treatment are all factors that can be perceived as traumatic. For example, patients recently exposed to a first psychotic episode confirmed the traumatic character of the psychotic episode itself, of the treatment or of both.
This study aimed to determine the effect of psychological first-aid (PFA) E-learning on the competence and empathy of nurses in disasters.
Methods:
In a randomized controlled trial, 50 nurses were randomly assigned to 2 intervention and control groups, and psychological first-aid training sessions were implemented for the intervention group. The data were collected using the personal information form, a researcher-made questionnaire to measure competence, and the Davis Empathy Questionnaire.
Results:
Two groups were homogeneous in terms of competency (P = 0.691) and empathy (P = 0.363) in the preintervention phase. The intervention group had more competence in the next stage than before the intervention (P < 0.0001). In the post-intervention phase, the intervention group had more competence compared with the control group (P < 0.0001). The overall effect size of PFA E-learning training on the nurses’ competency was 1.9. Regarding empathy, in the post-intervention phase, the subscale of personal distress (P = 0.014) was significantly lower in the intervention group and the perspective-taking subscale was higher than in the control group (P < 0.0001). However, there was no significant difference between the groups in terms of all scores of empathy and the subscale of empathic concern (P > 0.05). The overall effect size of PFA E-learning training on the nurses’ empathy was 0.44.
Conclusions:
It is suggested to provide training, including a PFA E-learning model, for nurses and other therapists in disaster situations.
Spermatogonial stem cells (SSCs) are the basis of male spermatogenesis and fertility. SSCs are distinguished by their ability to self-renew and differentiate into spermatozoa throughout the male reproductive life and pass genetic information to the next generation. Immunohistochemistry (IHC), immunocytochemistry (ICC) and Fluidigm reverse transcriptase-polymerase chain reaction (RT-PCR) were used to analyze the expression of PLZF and VASA in mice testis tissue. In this experimental study, whereas undifferentiated spermatogonial cells sharply expressed PLZF, other types of germ cells located in the seminiferous tubule were negative for this marker. Conversely, the germ cells near the basal membrane of the seminiferous tubule showed VASA expression, whereas the undifferentiated germ cells located on the basal membrane were negative. The ICC analysis indicated higher expression of PLZF in the isolated undifferentiated cells compared with differentiated germ cells. Fluidigm real-time RT-PCR results demonstrated a significant expression (P < 0.05) of VASA in the SSCs compared with differentiated cells and also showed expression of PLZF in undifferentiated spermatogonia. These results clearly proved the role of PLZF as a specific marker for SSCs, and can be beneficial for advanced research on in vitro differentiation of SSCs to functional sperms.
Underwater archaeological research has been developed less aggressively in Malaysia than in other ASEAN partner countries, such as Indonesia, Thailand, Vietnam, and the Philippines. In past decades, financial constraints have limited the development of underwater archaeology, and the field has been dominated by commercial salvage experts. Malaysia has not addressed many issues or fundamental problems related to future development. The discovery of the Bidong Shipwreck in 2013 has raised hopes that underwater archaeological research in Malaysia will develop more dynamically. The successful excavation of this shipwreck site proves that local experts can conduct scientific excavations. This article presents and discusses the discovery and process of excavating artifacts from the Bidong Shipwreck. The project outcomes provide a guide for stakeholders and agencies involved in future underwater excavations in Malaysian waters.
It is currently debated whether vitamin D requirements during pregnancy differ from those during non-gravid states. In current analyses, we aimed to determine the best model for the association between PTH and serum 25-hydroxyvitamin D (25(OH)D) and the threshold for circulating 25(OH)D at which serum parathyroid hormone (PTH) is suppressed. This multicenter prospective cross-sectional study was conducted on 227 Iranian pregnant women aged 15–45 years in their third trimester of pregnancy. The locally weighted smoothing scatter plot (LOWESS) was used to determine the curvilinear shape of the 25(OH)D/PTH relationship. Linear and non-linear methods were employed to determine the best fit and cut-point for serum 25(OH)D concentration. The median serum 25(OH)D and corresponding serum PTH concentration were 17⋅26 (13⋅44–23⋅08) ng/ml and 19⋅46 (15⋅08–25⋅04) pg/ml in our study population, respectively. The LOWESS curve suggested a non-linear and monotonic with a negative slope relation between PTH (pg/ml) and serum 25(OH)D (ng/ml). The optimal model for the association between PTH and serum 25(OH)D was a one-term fractional polynomial (FP1) (AIC = 1640⋅463). The FP1 analysis identified the 25(OH)D threshold of 12⋅48 ng/ml at which serum PTH rapidly rose. The expected degree of PTH stimulation seems to have a linear trend as 25(OH)D falls below 40 ng/ml. 25(OH)D (ng/ml) and PTH (pg/ml) had a non-linear and monotonic relationship with a negative slope. Our data suggest that a 25(OH)D threshold of 12⋅48 ng/ml is sufficient for parathyroid hormone suppression, which could be used to screen for deficient individuals.
Thrombolite reefs with archaeocyaths are common in the subtidal limestones of the lower Cambrian in the western Anti-Atlas of Morocco. The Igoudine Formation of the Tata Group recorded the first replacement of the microbial consortium (stromatolite-dominated) by thrombolite reefs with archaeocyaths and shelly metazoans. In order to better understand the role of the microbial community in the formation of thrombolite reefs with archaeocyaths across this critical transition, the macro-, micro- and ultra-fabric of thrombolites have been studied in detail. Three major components are identified within the first thrombolytic reef: archaeocyaths, calcimicrobes and micritic matrix. The studied thrombolites are typically dominated by the calcimicrobe Renalcis with subordinate Epiphyton and Girvanella. Scanning electron microscopy of the dark micrite of the Renalcis chambers showed amorphous translucent sheet-like structures interpreted as extracellular polymeric substances, closely associated with organominerals including nanoglobules and polyhedrons. Exceptionally well-preserved Renalcis chambers contain bacterial fossils similar to those described in modern microbialites, including microspherical coccoid fossils and filamentous bacteria that are either spaced or in close associations forming colonies. These organomineralization-related features suggest a bacterial origin for the Renalcis calcimicrobe. The matrices between the Renalcis chambers consist predominantly of clotted peloidal micrite. Mineralization of Renalcis microframes may involve two major biomineralization processes: (1) replacement of organic matter by organominerals resulting from anaerobic degradation of extracellular polymeric substances and bacterial sheaths and (2) encrustation of bacterial sheaths and extracellular polymeric substances due to increasing alkalinity of the microenvironment. These mechanisms played a crucial role in the early diagenetic cementation and preservation of the studied reefs.
In neurological clinical practice, Parkinson’s disease (PD) is commonly associated with a variety of dermatological disorders, such as seborrheic dermatitis, rosacea, bullous pemphigoid, skin cancer and melanoma, as well as sweating dysfunction. The recognition, diagnosis, and therapeutic approaches of these characteristic skin disorders affecting PD patients are important for the clinician and may even be life-saving, considering the relatively higher incidence of malignant skin tumors in PD patients.
Many contend that U.S. state parties are increasingly polarized and nationalized, meaning that they have adopted divergent positions matching their national counterparts’ positions. Such trends reflect a transformation of America's historically decentralized party system. Yet, the precise timing of these related trends—as well as the mechanisms underpinning them—remain unclear. We assess these dynamics using a novel data set of 1,783 state party platforms between 1918 and 2017. Applying tools from automated and manual content analysis, we document a dramatic divergence in the topics emphasized by Democrats and Republicans starting in the mid-1990s, just as congressional speech became polarized. During this period, cross-state differences in each party's agenda decreased and regional/sectoral issues became less prominent, suggesting tight connections between polarization, nationalization, and state agendas. We also find that innovative phrases increasingly debut in state (not national) platforms. Overall, the evidence undercuts claims of top-down polarization emanating from national party leaders in Washington, DC. Polarization at the state and federal levels coincided with the development of an integrated network of activists spanning multiple levels of the polity.