San Francisco Predictable Scheduling and Fair Treatment for Formula Retail Employees Ordinance

Economic and labor force changes since the Great Recession of 2007 have changed the way many American workers support themselves and their families. Today, Americans who would prefer full-time stable work are more likely to work in part-time jobs, and have little control over their work schedules. As employers seek new ways to maximize scheduling efficiency and profit, worker advocate groups have raised concerns about the implications of these scheduling practices on the lives of employees. This issue brief highlights some of the research on the growth of unstable work schedules, and describes the provisions of recently introduced legislation in San Francisco that seeks to increase predictable scheduling among certain retail and food service workers. San Francisco's is the first such legislation to be introduced at the local level in the natio

Effects of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20536 people with cerebrovascular disease or other high-risk conditions.

BACKGROUND: Lower blood cholesterol concentrations have consistently been found to be strongly associated with lower risks of coronary disease but not with lower risks of stroke. Despite this observation, previous randomised trials had indicated that cholesterol-lowering statin therapy reduces the risk of stroke, but large-scale prospective confirmation has been needed. METHODS: 3280 adults with cerebrovascular disease, and an additional 17256 with other occlusive arterial disease or diabetes, were randomly allocated 40 mg simvastatin daily or matching placebo. Subgroup analyses were prespecified of first "major vascular event" (ie, non-fatal myocardial infarction or coronary death, stroke of any type, or any revascularisation procedure) in prior disease subcategories. Subsidiary outcomes included any stroke, and stroke sub-type. Comparisons are of all simvastatin-allocated versus all placebo-allocated participants (ie, "intention-to-treat"), which yielded an average difference in LDL cholesterol of 1.0 mmol/L (39 mg/dL) during the 5-year treatment period. FINDINGS: Overall, there was a highly significant 25% (95% CI 15-34) proportional reduction in the first event rate for stroke (444 [4.3%] simvastatin vs 585 [5.7%] placebo; p<0.0001), reflecting a definite 28% (19-37) reduction in presumed ischaemic strokes (p<0.0001) and no apparent difference in strokes attributed to haemorrhage (51 [0.5%] vs 53 [0.5%]; rate ratio 0.95 [0.65-1.40]; p=0.8). In addition, simvastatin reduced the numbers having transient cerebral ischaemic attacks alone (2.0% vs 2.4%; p=0.02) or requiring carotid endarterectomy or angioplasty (0.4% vs 0.8%; p=0.0003). The reduction in stroke was not significant during the first year, but was already significant (p=0.0004) by the end of the second year. Among patients with pre-existing cerebrovascular disease there was no apparent reduction in the stroke rate, but there was a highly significant 20% (8-29) reduction in the rate of any major vascular event (406 [24.7%] vs 488 [29.8%]; p=0.001). The proportional reductions in stroke were about one-quarter in each of the other subcategories of participant studied, including: those with coronary disease or diabetes; those aged under or over 70 years at entry; and those presenting with different levels of blood pressure or lipids (even when the pretreatment LDL cholesterol was below 3.0 mmol/L [116 mg/dL]). INTERPRETATION: Much larger numbers of people in the present study suffered a stroke than in any previous cholesterol-lowering trial. The results demonstrate that statin therapy rapidly reduces the incidence not only of coronary events but also of ischaemic strokes, with no apparent effect on cerebral haemorrhage, even among individuals who do not have high cholesterol concentrations. Allocation to 40 mg simvastatin daily reduced the rate of ischaemic strokes by about one-quarter and so, after making allowance for non-compliance in the trial, actual use of this regimen would probably reduce the stroke rate by about a third. HPS also provides definitive evidence that statin therapy is beneficial for people with pre-existing cerebrovascular disease, even if they do not already have manifest coronary disease

Bibliography of Secondary Sources on the History of Dermatology II. Obituaries and Biographies in English Supplemented through 2015

Introduction A bibliographic record on the history of dermatology has been a project that started over 4 decades ago. It is a collection of all forms of history, ranging from dermatologic conditions, to famous dermatologists and physicians who have advanced the field of both dermatology and medicine, to the different countries that promoted the development of scientists, researchers and physicians alike. It was decided that the bibliographic record would encompass journals, books and a compilation of obituaries. A pertinent question is whether a manually created bibliographic project is still warranted in the 21st century. In short, yes. While Index Medicus has expanded the number of journals that are indexed, the number of dermatology publications currently included by Index Medicus exceeds 164; however, not all are in English or easily accessible. Although most of the papers of dermatologic interest are included in these journals, some contributions are also located in non-indexed publications. In addition, many documents of an historical interest or of a biographical nature are not necessarily selected for indexing in Index Medicus. The amalgamation of these historical publications from 2010-2015 will be divided into 3 separate contributions: journals, obituaries and books, with only those in English being recorded. Not only will this bibliographic record serve as a formal collection on the history of dermatology, it will also provide a reference to those wishing to enrich their knowledge on the expansion of the different fields of dermatology over time. It will also serve as a reminder of the achievements of our dermatology forefathers, from whom we have still so much to learn

Bibliography of Secondary Sources on the History of Dermatology

Introduction A bibliographic record on the history of dermatology has been a project that started over 4 decades ago. It is a collection of all forms of history, ranging from dermatologic conditions, to famous dermatologists and physicians who have advanced the field of both dermatology and medicine, to the different countries that promoted the development of scientists, researchers and physicians alike. It was decided that the bibliographic record would encompass journals, books and a compilation of obituaries. A pertinent question is whether a manually created bibliographic project is still warranted in the 21st century. In short, yes. While Index Medicus has expanded the number of journals that are indexed, the number of dermatology publications currently included by Index Medicus exceeds 164; however, not all are in English or easily accessible. Although most of the papers of dermatologic interest are included in these journals, some contributions are also located in non-indexed publications. In addition, many documents of an historical interest or of a biographical nature are not necessarily selected for indexing in Index Medicus. The amalgamation of these historical publications from 2010-2015 will be divided into 3 separate contributions: journals, obituaries and books, with only those in English being recorded. Not only will this bibliographic record serve as a formal collection on the history of dermatology, it will also provide a reference to those wishing to enrich their knowledge on the expansion of the different fields of dermatology over time. It will also serve as a reminder of the achievements of our dermatology forefathers, from whom we have still so much to learn

A comprehensive analysis of APOE genotype effects on human brain structure in the UK Biobank

Alzheimer’s disease (AD) risk is increased in carriers of the apolipoprotein E (APOE) ε4 allele and decreased in ε2 allele carriers compared with the ε3ε3 genotype. The aim of this study was to determine whether: the APOE genotype affects brain grey (GM) or white matter (WM) structure; and if differences exist, the age when they become apparent and whether there are differential effects by sex. We used cross-sectional magnetic resonance imaging data from ~43,000 (28,494 after pre-processing) white British cognitively healthy participants (7,446 APOE ε4 carriers) aged 45–80 years from the UK Biobank cohort and investigated image-derived phenotypes (IDPs). We observed no statistically significant effects of APOE genotype on GM structure volumes or median T2* in subcortical structures, a measure related to iron content. The volume of white matter hyperintensities differed significantly between APOE genotype groups with higher volumes in APOE ε4ε4 (effect size 0.14 standard deviations [SD]) and ε3ε4 carriers (effect size 0.04 SD) but no differences in ε2 carriers compared with ε3ε3 carriers. WM integrity measures in the dorsal (mean diffusivity [MD]) and ventral cingulum (MD and intracellular volume fraction), posterior thalamic radiation (MD and isotropic volume fraction) and sagittal stratum (MD) indicated lower integrity in APOE ε4ε4 carriers (effect sizes around 0.2–0.3 SD) and ε3ε4 (effect sizes around 0.05 SD) carriers but no differences in ε2 carriers compared with the APOE ε3ε3 genotype. Effects did not differ between men and women. APOE ε4 homozygotes had lower WM integrity specifically at older ages with a steeper decline of WM integrity from the age of 60 that corresponds to around 5 years greater “brain age”. APOE genotype affects various white matters measures, which might be indicative of preclinical AD processes. This hypothesis can be assessed in future when clinical outcomes become available

ASCEND-Eye: effects of aspirin on diabetic retinopathy

Purpose: Preclinical studies support a protective role for aspirin in early diabetic retinopathy (DR), but the findings from randomized trials are limited. We present randomized evidence for the efficacy and safety of aspirin on DR outcomes. Design: A sub-study of the ASCEND (A Study of Cardiovascular Events iN Diabetes) double-blind, randomized, placebo-controlled trial of 100mg aspirin daily for the primary prevention of serious cardiovascular events in people with diabetes. Participants: 15,480 UK adults at least 40 years of age with diabetes. Methods: Linkage to electronic NHS Diabetic Eye Screening Programme records in England and Wales, and confirmation of participant-reported eye events via medical record review. Logrank methods were used for intention-to-treat analyses of time until the first primary efficacy and safety outcomes. Main Outcome Measures: The primary efficacy endpoint was the first post-randomization record of referable disease, a composite of referable retinopathy (R2 or R3a/s) or referable maculopathy (M1) based on the grading criteria defined by the UK National Screening Committee. The primary safety outcome was the first sight-threatening eye bleed, defined as clinically significant bleeding in the eye that resulted in unresolved visual loss or required an urgent intervention such as laser photocoagulation, vitreoretinal surgery, intraocular injection, or both. Results: Linkage data were obtained for 7360 participants (48% of those randomized in ASCEND). During their mean follow-up of 6.5 years, 539 [14.6%] had a referable disease event in the aspirin group, compared to 522 [14.2%] in the placebo group (rate ratio 1.03; 95% confidence interval (CI): 0.91-1.16; P = 0.64). There was no statistically significant between-group difference in the proportions of sight-threatening eye bleed events (57 [0.7%] and 64 [0.8%] participants, respectively; rate ratio 0.89; 95% CI: 0.62-1.27). Discussion: These data exclude any clinically-meaningful benefits of aspirin for diabetic retinopathy but give reassurance regarding the ophthalmological safety of aspirin

ASCEND-Eye: effects of omega-3 fatty acids on diabetic retinopathy

Purpose: Preclinical studies support a protective role for omega-3 fatty acids (FAs) on diabetic retinopathy (DR), but these observations have not been confirmed in randomized trials. We present randomized evidence for the effects of omega-3 FAs on DR outcomes. Design and Participants: A sub-study of the ASCEND (A Study of Cardiovascular Events iN Diabetes) double-blind, randomized, placebo-controlled trial of 1g omega-3 fatty acids (containing 460mg eicosapentaenoic acid and 380mg docosahexaenoic acid) daily for the primary prevention of serious cardiovascular events, in 15,480 UK adults at least 40 years of age, with diabetes. Methods: Linkage to electronic NHS Diabetic Eye Screening Programme records in England and Wales, and confirmation of participant-reported eye events via medical record review. Logrank and stratified logrank methods were used for intention-to-treat analyses of time until the main outcomes of interest. Main Outcome Measures: The primary efficacy endpoint was time to the first postrandomization recording of referable disease, a composite of referable retinopathy (R2 or R3a/ s) or referable maculopathy (M1) based on the grading criteria defined by the UK National Screening Committee. Secondary and tertiary outcomes included the referable disease outcome stratified by the severity of DR at baseline, any progression in retinopathy grade, and incident diabetic maculopathy. Results: Linkage data were obtained for 7360 participants (48% of those who were randomized in ASCEND). During their mean follow-up of 6.5 years, 548 [14.8%] had a referable disease event in the omega-3 FAs group, compared to 513 [13.9%] in the placebo group (rate ratio 1.07; 95% confidence interval: 0.95-1.20; P = 0.29). There were no statistically significant between-group differences in the proportion of events for either of the secondary or tertiary outcomes. Discussion: Representing the first large-scale, prospective test of its kind, these data exclude any clinically meaningful benefits of 1g daily omega-3 FAs on DR

Bibliography of Secondary Sources on the History of Dermatology III. Books, Monographs, and Chapters in English Supplemented through 2015

Introduction A bibliographic record on the history of dermatology has been a project that started over 4 decades ago. It is a collection of all forms of history, ranging from dermatologic conditions, to famous dermatologists and physicians who have advanced the field of both dermatology and medicine, to the different countries that promoted the development of scientists, researchers and physicians alike. It was decided that the bibliographic record would encompass journals, books and a compilation of obituaries. A pertinent question is whether a manually created bibliographic project is still warranted in the 21st century. In short, yes. While Index Medicus has expanded the number of journals that are indexed, the number of dermatology publications currently included by Index Medicus exceeds 164; however, not all are in English or easily accessible. Although most of the papers of dermatologic interest are included in these journals, some contributions are also located in non-indexed publications. In addition, many documents of an historical interest or of a biographical nature are not necessarily selected for indexing in Index Medicus. The amalgamation of these historical publications from 2010-2015 will be divided into 3 separate contributions: journals, obituaries and books, with only those in English being recorded. Not only will this bibliographic record serve as a formal collection on the history of dermatology, it will also provide a reference to those wishing to enrich their knowledge on the expansion of the different fields of dermatology over time. It will also serve as a reminder of the achievements of our dermatology forefathers, from whom we have still so much to learn

Thromboxane biosynthesis and future events in diabetes: the ASCEND trial

Background and Aims Thromboxane (TX) A2, released by activated platelets, plays an important role in atherothrombosis. Urinary 11-dehydro-TXB2 (U-TXM), a stable metabolite reflecting the whole-body TXA2 biosynthesis, is reduced by ∼70% by daily low-dose aspirin. The U-TXM represents a non-invasive biomarker of in vivo platelet activation and is enhanced in patients with diabetes. This study assessed whether U-TXM is associated with the risk of future serious vascular events or revascularizations (SVE-R), major bleeding, or cancer in patients with diabetes. Methods The U-TXM was measured pre-randomization to aspirin or placebo in 5948 people with type 1 or 2 diabetes and no cardiovascular disease, in the ASCEND trial. Associations between log U-TXM and SVE-R (n = 618), major bleed (n = 206), and cancer (n = 700) during 6.6 years of follow-up were investigated by Cox regression; comparisons of these associations with the effects of randomization to aspirin were made. Results Higher U-TXM was associated with older age, female sex, current smoking, type 2 diabetes, higher body size, urinary albumin/creatinine ratio of ≥3 mg/mmol, and higher estimated glomerular filtration rate. After adjustment for these, U-TXM was marginally statistically significantly associated with SVE-R and major bleed but not cancer [hazard ratios per 1 SD higher log U-TXM (95% confidence interval): 1.09 (1.00–1.18), 1.16 (1.01–1.34), and 1.06 (0.98–1.14)]. The hazard ratio was similar to that implied by the clinical effects of randomization to aspirin for SVE-R but not for major bleed. Conclusions The U-TXM was log-linearly independently associated with SVE-R in diabetes. This is consistent with the involvement of platelet TXA2 in diabetic atherothrombosis