Magnitude, impact, and stability of primary headache subtypes: 30 year prospective Swiss cohort study

Objective To determine the prevalence, impact, and stability of different subtypes of headache in a 30 year prospective follow-up study of a general population sample

Insights into the biodegradation of PHA/wood composites: micro- and macroscopic changes

This study presents a comprehensive analysis of the microscopic and macroscopic changes during the biodegradation of composites of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and wood flour (WF) in soil, to provide insights into the biodegradability of this emerging material. Composite samples with different wood contents (0, 20 and 50 wt%) were buried in soil at a field trial site in a subtropical region of Australia, alongside polylactic acid (PLA) and polyethylene (PE) based wood composites as reference. The degradation rate of the PHBV/WF composites increased with wood content, with weight loss after 12 months being five times greater for PHBV/50 wt% WF than for neat PHBV plaques under identical conditions. The mechanical properties of neat PHBV were retained after 12 months of soil burial. However, PHBV/50 wt% WF lost its mechanical integrity after 12 months, despite only a 13% loss in weight. PLA and PE composites by contrast showed only slight decreases in mechanical properties, which could be associated with moisture induced degradation at the surface only. It is proposed, with evidence from optical microscopy, that for the PHBV-based samples, localised stress loosened the interface, allowing channels for the bacteria and fungi to access PHBV in the bulk of the matrix for local enzymatic biodegradation. With this network of interconnecting pores and cracks, crack propagation and mechanical failure would readily result from an applied stress. Overall, although the erosion rate for the exposed PHBV surfaces in the different samples could be similar, the accessible surface area in PHBV/50 wt% WF composites is significantly larger following local biodegradation and subsequent void formation than for neat PHBV and thus delivers a higher biodegradation rate

Insights into the biodegradation of PHA/wood composites: micro- and macroscopic changes

This study presents a comprehensive analysis of the microscopic and macroscopic changes during the biodegradation of composites of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and wood flour (WF) in soil, to provide insights into the biodegradability of this emerging material. Composite samples with different wood contents (0, 20 and 50 wt%) were buried in soil at a field trial site in a subtropical region of Australia, alongside polylactic acid (PLA) and polyethylene (PE) based wood composites as reference. The degradation rate of the PHBV/WF composites increased with wood content, with weight loss after 12 months being five times greater for PHBV/50 wt% WF than for neat PHBV plaques under identical conditions. The mechanical properties of neat PHBV were retained after 12 months of soil burial. However, PHBV/50 wt% WF lost its mechanical integrity after 12 months, despite only a 13% loss in weight. PLA and PE composites by contrast showed only slight decreases in mechanical properties, which could be associated with moisture induced degradation at the surface only. It is proposed, with evidence from optical microscopy, that for the PHBV-based samples, localised stress loosened the interface, allowing channels for the bacteria and fungi to access PHBV in the bulk of the matrix for local enzymatic biodegradation. With this network of interconnecting pores and cracks, crack propagation and mechanical failure would readily result from an applied stress. Overall, although the erosion rate for the exposed PHBV surfaces in the different samples could be similar, the accessible surface area in PHBV/50 wt% WF composites is significantly larger following local biodegradation and subsequent void formation than for neat PHBV and thus delivers a higher biodegradation rate

Biological sources and sinks of nitrous oxide and strategies to mitigate emissions

Nitrous oxide (N 2 O) is a powerful atmospheric greenhouse gas and cause of ozone layer depletion. Global emissions continue to rise. More than two-thirds of these emissions arise from bacterial and fungal denitrification and nitrification processes in soils, largely as a result of the application of nitrogenous fertilizers. This article summarizes the outcomes of an interdisciplinary meeting, ‘Nitrous oxide (N 2 O) the forgotten greenhouse gas’, held at the Kavli Royal Society International Centre, from 23 to 24 May 2011. It provides an introduction and background to the nature of the problem, and summarizes the conclusions reached regarding the biological sources and sinks of N 2 O in oceans, soils and wastewaters, and discusses the genetic regulation and molecular details of the enzymes responsible. Techniques for providing global and local N 2 O budgets are discussed. The findings of the meeting are drawn together in a review of strategies for mitigating N 2 O emissions, under three headings, namely: (i) managing soil chemistry and microbiology, (ii) engineering crop plants to fix nitrogen, and (iii) sustainable agricultural intensification. </jats:p

Impacts on Men’s Health/Mental Health

Publisher Copyright: Copyright © 2022 de Sousa, Moreira, da Silva Santana, Araújo, Borges, Almeida, das Mercês, da Silva, Teixeira, Lourenção, Gomes, de Santana Carvalho, de Sousa, de Almeida, Viana and Pereira.Objective: This study aims to analyze sociohistorically how the normative patterns of hegemonic masculinity produced impacts on men’s health/mental health in the context of the COVID-19 pandemic. Methods: A qualitative study from a socio-historical perspective was conducted with 50 men based on an online survey. A semistructured form was applied. The data were analyzed by the Collective Subject Discourse method, interpreted in the light of the context of epidemic disease and hegemonic masculinity. Results: The experience of the pandemic exposed the normative patterns of masculinities from the consummation of acts representative of the pandemic context, which incited men to deny the existence of COVID-19 disease and to delay the understanding and adoption of measures to protect and control COVID-19. As a repercussion, men presented conflicts in the regulation of emotions; presented emotional suppression; were more reactive; felt threatened regarding the loss of the role of family provider, virility; and revealed a sense of invulnerability, added to the weakening of self-care. Conclusion: The discourse revealed that the men’s behaviors are consistent with the characteristics of hegemonic masculinity, but express signs of recognition that this behavior causes harm to themselves and their health.publishersversionpublishe

Psychological Distress in Men during the COVID-19 Pandemic in Brazil: The Role of the Sociodemographic Variables, Uncertainty, and Social Support

Objective: To analyze the relationships between sociodemographic variables, intolerance to uncertainty (INT), social support, and psychological distress (i.e., indicators of Common Mental Disorders (CMDs) and perceived stress (PS)) in Brazilian men during the COVID-19 pandemic. Methods: A cross-sectional study with national coverage, of the web survey type, and conducted with 1006 Brazilian men during the period of social circulation restriction imposed by the health authorities in Brazil for suppression of the coronavirus and control of the pandemic. Structural equation modeling analysis was performed. Results: Statistically significant direct effects of race/skin color ( = 0.268; p-value < 0.001), socioeconomic status (SES) ( = 0.306; p-value < 0.001), household composition( = 0.281; p-value < 0.001), PS ( = 0.513; p-value < 0.001), and INT ( = 0.421; p-value < 0.001) were evidenced in the occurrence of CMDs. Black-skinned men with higher SES, living alone, and with higher PS and INT levels presented higher prevalence values of CMDs. Conclusions: High levels of PS and INT were the factors that presented the strongest associations with the occurrence of CMDs among the men. It is necessary to implement actions to reduce the stress-generating sources as well as to promote an increase in resilience and the development of intrinsic reinforcements to deal with uncertain threats.info:eu-repo/semantics/publishedVersio

Sociotechnical Systems and Ethics in the Large

Advances in AI techniques and computing platforms have triggered a lively and expanding discourse on ethical decision-making by autonomous agents. Much recent work in AI concentrates on the challenges of moral decision making from a decision-theoretic perspective, and especially the representation of various ethical dilemmas. Such approaches may be useful but in general are not productive because moral decision making is as context-driven as other forms of decision making, if not more. In contrast, we consider ethics not from the standpoint of an individual agent but of the wider sociotechnical systems (STS) in which the agent operates. Our contribution in this paper is the conception of ethical STS founded on governance that takes into account stakeholder values, normative constraints on agents, and outcomes (states of the STS) that obtain due to actions taken by agents. An important element of our conception is accountability, which is necessary for adequate consideration of outcomes that prima facie appear ethical or unethical. Focusing on STSs avoids the difficult problems of ethics as the norms of the STS give an operational basis for agent decision making

Identifying perinatal depression with case-finding instruments : a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy)

Background: Perinatal depression is well recognised as a mental health condition but < 50% of cases are identified in routine practice. A case-finding strategy using the Whooley questions is currently recommended by the National Institute for Health and Care Excellence. Objectives: To determine the diagnostic accuracy, acceptability and cost-effectiveness of the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to identify perinatal depression. Design: A prospective diagnostic accuracy cohort study, with concurrent qualitative and economic evaluations. Setting: Maternity services in England. Participants: A total of 391 pregnant women. Main outcome measures: Women completed the Whooley questions, EPDS and a diagnostic reference standard (Clinical Interview Schedule – Revised) during pregnancy (20 weeks) and postnatally (3–4 months). Qualitative interviews were conducted with health professionals (HPs) and a subsample of women. Results: Diagnostic accuracy results: depression prevalence rates were 10.3% during pregnancy and 10.5% postnatally. The Whooley questions and EPDS (cut-off point of ≥ 10) performed reasonably well, with comparable sensitivity [pregnancy: Whooley questions 85.0%, 95% confidence interval (CI) 70.2% to 94.3%; EPDS 82.5%, 95% CI 67.2% to 92.7%; postnatally: Whooley questions 85.7%, 95% CI 69.7% to 95.2%; EPDS 82.9%, 95% CI 66.4% to 93.4%] and specificity (pregnancy: Whooley questions 83.7%, 95% CI 79.4% to 87.4%; EPDS 86.6%, 95% CI 82.5% to 90.0%; postnatally: Whooley questions 80.6%, 95% CI 75.7% to 84.9%; EPDS 87.6%, 95% CI 83.3% to 91.1%). Diagnostic accuracy of the EPDS (cut-off point of ≥ 13) was poor at both time points (pregnancy: sensitivity 45%, 95% CI 29.3% to 61.5%, and specificity 95.7%, 95% CI 93.0% to 97.6%; postnatally: sensitivity 62.9%, 95% CI 44.9% to 78.5%, and specificity 95.7%, 95% CI 92.7% to 97.7%). Qualitative evaluation: women and HPs were supportive of screening/case-finding for perinatal depression. The EPDS was preferred to the Whooley questions by women and HPs, mainly because of its ‘softer’ wording. Whooley question 1 was thought to be less acceptable, largely because of the terms ‘depressed’ and ‘hopeless’, leading to women not revealing their depressive symptoms. HPs identified a ‘patient-centred’ environment that focused on the mother and baby to promote discussion about mental health. Cost-effectiveness results: screening/case-finding using the Whooley questions or the EPDS alone was not the most cost-effective strategy. A two-stage strategy, ‘Whooley questions followed by the Patient Health Questionnaire’ (a measure assessing depression symptomatology), was the most cost-effective strategy in the range between £20,000 and £30,000 per quality-adjusted life-year in both the prenatal and postnatal decision models. Limitations: Perinatal depression diagnosis was not cross-referenced with women’s medical records so the proportion of new cases identified is unknown. The clinical effectiveness and cost-effectiveness of screening/case-finding strategies was not assessed as part of a randomised controlled trial. Conclusions: The Whooley questions and EPDS had acceptable sensitivity and specificity, but their use in practice might be limited by low predictive value and variation in their acceptability. A two-stage strategy was more cost-effective than single-stage strategies. Neither case-finding instrument met National Screening Committee criteria. Future work: The yield of screening/case-finding should be established with reference to health-care records. The clinical effectiveness and cost-effectiveness of screening/case-finding for perinatal depression needs to be tested in a randomised controlled trial. Funding: The National Institute for Health Research Health Services and Delivery Research programme

Phenotypic Characterization of EIF2AK4 Mutation Carriers in a Large Cohort of Patients Diagnosed Clinically With Pulmonary Arterial Hypertension.

BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare disease with an emerging genetic basis. Heterozygous mutations in the gene encoding the bone morphogenetic protein receptor type 2 (BMPR2) are the commonest genetic cause of PAH, whereas biallelic mutations in the eukaryotic translation initiation factor 2 alpha kinase 4 gene (EIF2AK4) are described in pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis. Here, we determine the frequency of these mutations and define the genotype-phenotype characteristics in a large cohort of patients diagnosed clinically with PAH. METHODS: Whole-genome sequencing was performed on DNA from patients with idiopathic and heritable PAH and with pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis recruited to the National Institute of Health Research BioResource-Rare Diseases study. Heterozygous variants in BMPR2 and biallelic EIF2AK4 variants with a minor allele frequency of <1:10 000 in control data sets and predicted to be deleterious (by combined annotation-dependent depletion, PolyPhen-2, and sorting intolerant from tolerant predictions) were identified as potentially causal. Phenotype data from the time of diagnosis were also captured. RESULTS: Eight hundred sixty-four patients with idiopathic or heritable PAH and 16 with pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis were recruited. Mutations in BMPR2 were identified in 130 patients (14.8%). Biallelic mutations in EIF2AK4 were identified in 5 patients with a clinical diagnosis of pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis. Furthermore, 9 patients with a clinical diagnosis of PAH carried biallelic EIF2AK4 mutations. These patients had a reduced transfer coefficient for carbon monoxide (Kco; 33% [interquartile range, 30%-35%] predicted) and younger age at diagnosis (29 years; interquartile range, 23-38 years) and more interlobular septal thickening and mediastinal lymphadenopathy on computed tomography of the chest compared with patients with PAH without EIF2AK4 mutations. However, radiological assessment alone could not accurately identify biallelic EIF2AK4 mutation carriers. Patients with PAH with biallelic EIF2AK4 mutations had a shorter survival. CONCLUSIONS: Biallelic EIF2AK4 mutations are found in patients classified clinically as having idiopathic and heritable PAH. These patients cannot be identified reliably by computed tomography, but a low Kco and a young age at diagnosis suggests the underlying molecular diagnosis. Genetic testing can identify these misclassified patients, allowing appropriate management and early referral for lung transplantation