Immunoblot analysis of the seroreactivity to recombinant Borrelia burgdorferi sensu lato antigens, including VlsE, in the long-term course of treated patients with Erythema migrans

Objective: We evaluated whether immunoblotting is capable of substantiating the posttreatment clinical assessment of patients with erythema migrans ( EM), the hallmark of early Lyme borreliosis. Methods: In 50 patients, seroreactivity to different antigens of Borrelia burgdorferi sensu lato was analyzed by a recombinant immunoblot test (IB) in consecutive serum samples from a minimum follow-up period of 1 year. Antigens in the IgG test were decorin- binding protein A, internal fragment of p41 (p41i), outer surface protein C (OspC), p39, variable major protein-like sequence expressed (VlsE), p58 and p100; those in the IgM test were p41i, OspC and p39. Immune responses were correlated with clinical and treatment-related parameters. Results: Positive IB results were found in 50% before, in 57% directly after therapy and in 44% by the end of the follow-up for the IgG class, and in 36, 43 and 12% for the IgM class. In acute and convalescence phase sera, VlsE was most immunogenic on IgG testing 60 and 70%), and p41i (46 and 57%) and OspC (40 and 57%) for the IgM class. By the end of the follow-up, only the anti-p41i lgM response was significantly decreased to 24%. Conclusions: No correlation was found between IB results and treatment-related parameters. Thus, immunoblotting does not add to the clinical assessment of EM patients after treatment. Copyright (c) 2008 S. Karger AG, Basel

Fine Feathers Make Fine Birds? Wealth Effects and the Choice between Major and Minor Corporate Name Changes

This study is the first to investigate the causes and effects of corporate name changes in Continental Europe using a sample of German firms in the period 1997-2009. We report a positive and significant stock market reaction to announcements of corporate name changes considerably different for major and minor name changes. Regression results show that prior firm performance positively affects the observed stock returns. Short-term effects turn out to be transitory as firms significantly underperform the German CDAX in the year after the name change was announced. As the first study, we examine the impact of performance and corporate governance on the probability of corporate name changes and show that managers react to poor firm performance by implementing more expensive major name changes. This can be interpreted as an attempt to cloud poor past performance of both the firm and the management. Accordingly, we document a positive relation between management influence, available cash, and the probability of major name changes

Indigenous Peoples’ food systems, nutrition and gender:Conceptual and methodological considerations

Indigenous Peoples, especially women and children, are affected disproportionately by malnutrition and diet-related health problems. Addressing this requires an investigation of the structural conditions that underlie unequal access to resources and loss of traditional lifestyles, and necessitates inclusive approaches that shed light onto these issues and provide strategies to leverage change. Indigenous Peoples’ food systems are inextricably connected to land, which in turn is interwoven with issues of self-determination, livelihoods, health, cultural and spiritual heritage, and gender. Ongoing loss of land and the dominant agri-food model further threaten Indigenous Peoples’ food systems. Continuing gender-based discrimination undermines the self-determination and rights of women, and negatively impacts on their health, nutritional status, and overall wellbeing, as well as on the wellbeing of households and communities. We suggest that feminist political ecology and modern matriarchal studies provide holistic interlinking frameworks for investigating underlying issues of power and inequality. We further argue that a focus on the principles of respect, responsibility, and relationships, and an openness to different worldviews, can facilitate a bridging of Indigenous and Western approaches in research and community action conducted in partnership with Indigenous Peoples. This can contribute to creating new ways of knowing regarding Indigenous Peoples’ food systems, equally valuing both knowledge systems. Indigenous Peoples’ rights, right to food, and food sovereignty are frames that, despite some tensions, have the common goal of self-determination. Through their ability to inform, empower, and mobilize, they provide tools for social movements and communities to challenge existing structural inequalities and leverage social change. Publisher Statement: This is the peer reviewed version of the following article: Lemke, S & Delormier, T 2018, 'Indigenous Peoples’ food systems, nutrition and gender: Conceptual and methodological considerations' Maternal & Child Nutrition, vol 13, no. S3, e12499, which has been published in final form at https://dx.doi.org/10.1111/mcn.12499. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving

Non-invasive diagnostic tests for Helicobacter pylori infection

BACKGROUND: Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H & E) stain or special stains such as Giemsa stain and Warthin-Starry stain. Special stains are more accurate than H & E stain. There is significant uncertainty about the diagnostic accuracy of non-invasive tests for diagnosis of H pylori. OBJECTIVES: To compare the diagnostic accuracy of urea breath test, serology, and stool antigen test, used alone or in combination, for diagnosis of H pylori infection in symptomatic and asymptomatic people, so that eradication therapy for H pylori can be started. SEARCH METHODS: We searched MEDLINE, Embase, the Science Citation Index and the National Institute for Health Research Health Technology Assessment Database on 4 March 2016. We screened references in the included studies to identify additional studies. We also conducted citation searches of relevant studies, most recently on 4 December 2016. We did not restrict studies by language or publication status, or whether data were collected prospectively or retrospectively. SELECTION CRITERIA: We included diagnostic accuracy studies that evaluated at least one of the index tests (urea breath test using isotopes such as13C or14C, serology and stool antigen test) against the reference standard (histopathological examination using H & E stain, special stains or immunohistochemical stain) in people suspected of having H pylori infection. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the references to identify relevant studies and independently extracted data. We assessed the methodological quality of studies using the QUADAS-2 tool. We performed meta-analysis by using the hierarchical summary receiver operating characteristic (HSROC) model to estimate and compare SROC curves. Where appropriate, we used bivariate or univariate logistic regression models to estimate summary sensitivities and specificities. MAIN RESULTS: We included 101 studies involving 11,003 participants, of which 5839 participants (53.1%) had H pylori infection. The prevalence of H pylori infection in the studies ranged from 15.2% to 94.7%, with a median prevalence of 53.7% (interquartile range 42.0% to 66.5%). Most of the studies (57%) included participants with dyspepsia and 53 studies excluded participants who recently had proton pump inhibitors or antibiotics.There was at least an unclear risk of bias or unclear applicability concern for each study.Of the 101 studies, 15 compared the accuracy of two index tests and two studies compared the accuracy of three index tests. Thirty-four studies (4242 participants) evaluated serology; 29 studies (2988 participants) evaluated stool antigen test; 34 studies (3139 participants) evaluated urea breath test-13C; 21 studies (1810 participants) evaluated urea breath test-14C; and two studies (127 participants) evaluated urea breath test but did not report the isotope used. The thresholds used to define test positivity and the staining techniques used for histopathological examination (reference standard) varied between studies. Due to sparse data for each threshold reported, it was not possible to identify the best threshold for each test.Using data from 99 studies in an indirect test comparison, there was statistical evidence of a difference in diagnostic accuracy between urea breath test-13C, urea breath test-14C, serology and stool antigen test (P = 0.024). The diagnostic odds ratios for urea breath test-13C, urea breath test-14C, serology, and stool antigen test were 153 (95% confidence interval (CI) 73.7 to 316), 105 (95% CI 74.0 to 150), 47.4 (95% CI 25.5 to 88.1) and 45.1 (95% CI 24.2 to 84.1). The sensitivity (95% CI) estimated at a fixed specificity of 0.90 (median from studies across the four tests), was 0.94 (95% CI 0.89 to 0.97) for urea breath test-13C, 0.92 (95% CI 0.89 to 0.94) for urea breath test-14C, 0.84 (95% CI 0.74 to 0.91) for serology, and 0.83 (95% CI 0.73 to 0.90) for stool antigen test. This implies that on average, given a specificity of 0.90 and prevalence of 53.7% (median specificity and prevalence in the studies), out of 1000 people tested for H pylori infection, there will be 46 false positives (people without H pylori infection who will be diagnosed as having H pylori infection). In this hypothetical cohort, urea breath test-13C, urea breath test-14C, serology, and stool antigen test will give 30 (95% CI 15 to 58), 42 (95% CI 30 to 58), 86 (95% CI 50 to 140), and 89 (95% CI 52 to 146) false negatives respectively (people with H pylori infection for whom the diagnosis of H pylori will be missed).Direct comparisons were based on few head-to-head studies. The ratios of diagnostic odds ratios (DORs) were 0.68 (95% CI 0.12 to 3.70; P = 0.56) for urea breath test-13C versus serology (seven studies), and 0.88 (95% CI 0.14 to 5.56; P = 0.84) for urea breath test-13C versus stool antigen test (seven studies). The 95% CIs of these estimates overlap with those of the ratios of DORs from the indirect comparison. Data were limited or unavailable for meta-analysis of other direct comparisons. AUTHORS' CONCLUSIONS: In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions

Matriarchal Studies

Evidence of matriarchy had always existed in Western chronicles, albeit scattered or hidden amid other ethnographic tidbits, all of them filtered heavily through the androcentric lens of Christian missionaries or European travelers. Most of these old European sources were either puzzled or horrified by women-led cultures, having had nothing to attach them to but scary stories from Herodotus about the ferocious Amazons as “men-slayers” or the Christian theological depictions of sinful Eve, resulting in the “burning times” (witch hunts). Moving out from Europe in the 15th and 16th centuries, especially into Africa and the Americas, home to many matriarchal cultures, was very unsettling to the patriarchal paradigm of Europe. Until quite recently, this culture shock combined with colonialism to ensure that scholarship on matriarchy was crafted exclusively by elite, Western scholars, nearly all of them male and coming from nothing remotely resembling a matriarchal culture. Scholars in the 19th century were all infiltrated by the unilinear, universal evolution theory, as a part of European American colonialism, sporting racist and sexist roots. These disabilities distorted comprehension of the matriarchal form of society, allowing Western scholars either to dismiss it outright as a fantasy or to portray it crudely, as a wicked, Amazonian domination of men. This background left enduring marks on the scholarship around matriarchy until new interest was piqued among German and American scholars in the 19th century, moving thought from the Amazonian conception to the definition of matriarchy as a “mother right.” These scholars remained mired, however, in the racist and sexist premises of European colonialism, well into the 20th century. As colonial Eurocentrism lifted in the mid- to late 20th century, scholars from non-Western, matriarchal cultures worldwide began chiming in on the conversation, in order to revamp old ideas together with Western female scholars. The “maternal values” in matriarchal studies do not indicate Western sentimentalism, but principles formulated by Indigenous, matriarchal societies themselves, in their sayings (e.g., Minangkabau) and in their social rules (e.g., Iroquois), based on the prototype of Mother Nature, as conceptualized in mythology, proverbs, songs, etc. Collating all the evidence of non-Western and Western 21st-century scholarship, matriarchy is here defined as mother-centered societies, based on maternal values: equality, consensus finding, gift giving, and peace building by negotiations. Gift economies, defined by modern matriarchal studies as a transitive relation in closed communities, is a core concept of all matriarchies. The result is a gender-egalitarian society, in which each gender has its own sphere of power and action. All these societies are characterized by matrilinearity, matrilocality, and women as keepers of the land and distributors of food, based on a structured gift economy. As derived from inductive studies of singular matriarchal societies and in collaboration with Indigenous scholars writing on their own communities, the current definition of matriarchy is a mother-centered, gender-egalitarian society that practices the gift economy. Modern matriarchal studies primarily assesses the patterns of those cultures, past and present, in their unique displays of gender egalitarianism and generally social egalitarianism.</p