Characterizing healthcare utilization patterns in a Danish population with headache: results from the nationwide headache in Denmark (HINDER) panel

INTRODUCTION: Worldwide, far from all of those who would benefit make use of headache services, largely because of clinical, social, and political barriers to access. Identifying the factors contributing to low healthcare utilization can generate evidence to guide health policy. Our purpose here is better to characterize healthcare utilization patterns in Denmark. METHODS: The Headache in Denmark (HINDER) study is a nationwide cross-sectional survey of people with headache, conducted using SurveyXact (Rambøll Group A/S, Copenhagen). Healthcare utilization was assessed in a study sample generated by population screening and recruitment. Data collection occurred over two weeks, from September 23rd until October 4th, 2021. The questions enquired into disease characteristics, management, burden, medication intake and healthcare utilization. RESULTS: The number of participants included in the HINDER panel was 4,431, with 2,990 (67.5%: 2,522 [84.3%] female, 468 [15.7%] male; mean age 40.9 ± 11.6 years) completing the survey. One quarter of participants (27.7%) disagreed or strongly disagreed that they were able to manage their headache attacks. Most participants (81.7%) agreed or strongly agreed that their headache was a burden in their everyday lives. The most reported acute medications, by 87.2% of participants, were simple analgesics; of note, 8.6% reported using opioids for their headache. One quarter of participants (24.4%) had never consulted a medical doctor for their headache; one in six (16.5%: more than two thirds of the 24.4%) had never done so despite agreeing or strongly agreeing that their headache was a burden in their everyday lives. Two thirds (65.3%) of participants overall, and almost three quarters (72.4%) of those with weekly headache, had tried one or more complementary or alternative therapies outside conventional medical care. CONCLUSIONS: Our findings are indicative of inadequate delivery of headache care in a country that provides free and universal coverage for all its residents. The implications are twofold. First, it is not sufficient merely to make services available: public education and increased awareness are necessary to encourage uptake by those who would benefit. Second, educational interventions in both pre- and postgraduate settings are necessary, but a prerequisite for these is a resetting of policy priorities, properly to reflect the very high population ill-health burden of headache

The relationship between cellular and calcium responses of Aspergillus awamori to external influences

The cellular and Ca2+ responses to physiological stimuli of different nature were studied in the experiments with the strain Aspergillus awamori 66A containing recombinant aequorin, a Ca2+-dependent photosensitive protein. The relationship between the cellular response registered by changes in the development of the mycelial fungus (colony growth, hyphal branching, and the rate of spore formation) and the level and duration of calcium flares in the cytosol was assessed. The physical or chemical stimuli (mechanical effect, osmotic shock) inducing short-time calcium flares in the cytosol did not influence significantly the development of A. awamori grown in liquid or on solid nutrient media. The action on the 24-h A. awamori culture of the Ca2+-selective ionophore (A23187) inducing long-term changes in calcium homeostasis caused disorders in the fungus development and morphology (hyperbranching of mycelial hyphae, formation of spherical cells, and inhibition of colony growth and spore formation). Thus, it was established that the development of cellular response in the micromycete correlated with the duration of the calcium flare in the cytosol. © 2010 Pleiades Publishing, Ltd

Effect of the RNase from bacillus intermedius on growth and physiological characteristics of Escherichia coli

The effect of the RNase from Bacillus intermedius on the growth of Escherichia coli was investigated. RNase added to growth medium enhanced the synthesis of DNA, RNA, and protein and stimulated cell division; the degree of stimulation depended on the enzyme concentration. A necessary condition for stimulation was the adsorption of the enzyme on the cell surface and its interaction with the cytoplasmic membrane, as demonstrated immunocytochemically. The adsorption of the enzyme was accompanied by a 43% decrease in the surface charge density. Other effects of RNase involved a 25% increase in the growth rate, a 38% biomass gain, and generation time shortening by 10 min. The stimulation of bacterial growth correlated with the stimulation of the cellular respiration rate. © 1999 MAHK "Hayka/Interperiodica"

Effect of a chemical analogue of autoinducers of microbial anabiosis on the Ca2+ response of mycelial fungi

The microbial alkylhydroxybenzenes (AHB), autoinducers of anabiosis, or d1 factors, participate in stress response of mycelial fungi, as determined from changes in intracellular Ca2+ concentration. By using the genetically modified strain Aspergillus awamori 66A, which produces a recombinant Ca2+-dependent protein aequorin, the dynamics of Ca 2+ was studied in the cytosol of cells exposed to mechanical shock in the presence of the protective doses (0.001-0.01% w/vol) of a chemical AHB analogue, 4-n-hexylresorcinol. Like under stressful conditions, Ca2+ concentration increases in the cell cytosol in response to enhanced AHB level in a growing fungal culture; thus, AHB is perceived by cells as a stress signal. The level of cell response, which was determined from the amplitude of luminescence dependent on the Ca2+ concentration in cytosol was related to the physiological age of the cells and AHB concentration. Micromycete preincubation with AHB was found to protect cells from subsequent stress; this was reflected in the Ca2+ response. The protective AHB effect was manifested as (1) a significant decrease in the amplitude of luminescence and, thus, in Ca2+ accumulation in the cytosol during subsequent mechanical stress (as compared to the control-mechanical stress only); (2) development of the secondary Ca2+ response, which was not observed in the control; (3) a high level of Ca2+ retained in the cytosol for a long time in the presence of AHB (as compared to the control without preincubation with AHB). The mechanisms underlying the AHB effect on the Ca 2+ transport systems are discussed

Effect of the RNase from bacillus intermedium on growth and physiological characteristics of escherichia coli

The effect of the RNase from Bacillus intermedium on the growth of Escherichia coli was investigated. RNase added to growth medium enhanced the synthesis of DNA, RNA, and protein and stimulated cell division; the degree of stimulation depended on the enzyme concentration. A necessary condition for stimulation was the adsorption of the enzyme on the cell surface and its interaction with the cytoplasmic membrane, as demonstrated immunocytochemically. The adsorption of the enzyme was accompanied by a 43% decrease in the surface charge density. Other effects of RNase involved a 25% increase in the growth rate, a 38% biomass gain, and generation time shortening by 10 min. The stimulation of bacterial growth correlated with the stimulation of cellular respiration rate

Effect of a chemical analogue of autoinducers of microbial anabiosis on the Ca2+ response of mycelial fungi

The microbial alkylhydroxybenzenes (AHB), which are anabiosis autoinducers also termed d1 factors, participate in the stress response of mycelial fungi, as determined from changes in intracellular Ca2+ concentration. By using the genetically modified strain Aspergillus awamori 66A, which produces the recombinant Ca2+ -dependent protein aequorin, the dynamics of Ca2+ was studied in the cytosol of cells exposed to mechanical shock in the presence of protective doses (0.001-0.01% w/vol) of a chemical AHB analogue, 4-n-hexylre-sorcinol. As under stressful conditions, Ca2+ concentration increases in the cell cytosol in response to an enhanced AHB level in a growing fungal culture; thus, AHB is perceived by cells as a stress signal. The level of cell response, which was determined from the amplitude of luminescence dependent on the Ca2+ concentration in the cytosol, was related to the physiological age of the cells and the AHB concentration. Micromycete preincubation with AHB was found to protect cells from subsequent stress; this was reflected in the Ca2+ response. The protective AHB effect was manifested as (1) a significant decrease in the amplitude of luminescence and, thus, in Ca2+ accumulation in the cytosol during subsequent mechanical stress (as compared to the control-mechanical stress only); (2) development of a secondary Ca2+ response, which was not observed in the control; and (3) a high level of Ca 2+ retained in the cytosol for a long time in the presence of AHB (as compared to the control without preincubation with AHB). The mechanisms underlying the AHB effect on Ca2+ transport systems are discussed. © 2004 MAIK "Nauka/Interperiodica"

A Multi-model Analysis of Post-2020 Mitigation Efforts of Five Major Economies

This paper looks into the regional mitigation strategies of five major economies (China, EU, India, Japan and USA) in the context of the 2 degrees C target, using a multi-model comparison. In order to stay in line with the 2 degrees C target, a tripling or quadrupling of mitigation ambitions is required in all regions by 2050, employing vigorous decarbonization of the energy supply system and achieving negative emissions during the second half of the century. In all regions looked at, decarbonization of energy supply (and in particular power generation) is more important than reducing energy demand. Some differences in abatement strategies across the regions are projected: In India and the USA the emphasis is on prolonging fossil fuel use by coupling conventional technologies with carbon storage, whereas the other main strategy depicts a shift to carbon-neutral technologies with mostly renewables (China, EU) or nuclear power (Japan). Regions with access to large amounts of biomass, such as the USA, China and the EU, can make a trade-off between energy related emissions and land related emissions, as the use of bioenergy can lead to a net increase in land use emissions. After supply-side changes, the most important abatement strategy focuses on enduse efficiency improvements, leading to considerable emission reductions in both the industry and transport sectors across all regions. Abatement strategies for non-CO2 emissions and land use emissions are found to have a smaller potential. Inherent model, as well as collective, biases have been observed affecting the regional response strategy or the available reduction potential in specific (end-use) sectors

Analysis of the Ca2+ response of mycelial fungi to external effects by the recombinant aequorin method

Using the mutant strain Aspergillus awamori 66A producing a recombinant Ca2+-dependent photosensitive protein aequorin, the dynamics of Ca2+ was studied for the first time in the cytosol of the micromycetes exposed to stressful factors, such as an increase in extracellular Ca2+ to 50 mM, hypoosmotic shock, and mechanical shock. Cell response to stress proved to involve an increase in the Ca2+ concentration in the cytosol, which was determined from the amplitude of aequorin luminescence and the time of the amplitude enhancement and relaxation. The level of Ca 2+ response depended on the physiological stimulus. Inhibitory analysis with various agents that block Ca2+ channels and with agonists that specifically enhance the activity of the channels suggested that (1) the level of Ca2+ in the cytosol of micromycetes increases in response to stress because of the ion influx from both the growth medium and intracellular reservoirs and (2) the potential-dependent transport systems play the major role in the Ca2+ influx into the cytosol of the micromycete cells

CO2 emission mitigation and fossil fuel markets: Dynamic and international aspects of climate policies

This paper explores a multi-model scenario ensemble to assess the impacts of idealized and non-idealized climate change stabilization policies on fossil fuel markets. Under idealized conditions climate policies significantly reduce coal use in the short- and long-term. Reductions in oil and gas use are much smaller, particularly until 2030, but revenues decrease much more because oil and gas prices are higher than coal prices. A first deviation from optimal transition pathways is delayed action that relaxes global emission targets until 2030 in accordance with the Copenhagen pledges. Fossil fuel markets revert back to the no-policy case: though coal use increases strongest, revenue gains are higher for oil and gas. To balance the carbon budget over the 21st century, the long-term reallocation of fossil fuels is significantly larger -- twice and more -- than the short-term distortion. This amplifying effect results from coal lock-in and inter-fuel substitution effects to balance the full-century carbon budget. The second deviation from the optimal transition pathway relaxes the global participation assumption. The result here is less clear-cut across models, as we find carbon leakage effects ranging from positive to negative because trade and substitution patterns of coal, oil, and gas differ across models. In summary, distortions of fossil fuel markets resulting from relaxed short-term global emission targets are more important and less uncertain than the issue of carbon leakage from early mover action