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Dietary restriction of carbohydrate has been demonstrated to be beneficial for nervous system dysfunction in animal models and may be beneficial for human chronic pain. The purpose of this review is to assess the impact of a low-carbohydrate/ketogenic diet on the adult nervous system function and inflammatory biomarkers to inform nutritional research for chronic pain. An electronic database search was carried out in May 2021. Publications were screened for prospective research with dietary carbohydrate intake <130 g per day and duration of ≥2 weeks. Studies were categorised into those reporting adult neurological outcomes to be extracted for analysis and those reporting other adult research outcomes. Both groups were screened again for reported inflammatory biomarkers. From 1548 studies, there were 847 studies included. Sixty-four reported neurological outcomes with 83% showing improvement. Five hundred and twenty-three studies had a different research focus (metabolic n = 394, sport/performance n = 51, cancer n = 33, general n = 30, neurological with non-neuro outcomes n = 12, or gastrointestinal n = 4). The second screen identified sixty-three studies reporting on inflammatory biomarkers, with 71% reporting a reduction in inflammation. The overall results suggest a favourable outcome on the nervous system and inflammatory biomarkers from a reduction in dietary carbohydrates. Both nervous system sensitisation and inflammation occur in chronic pain, and the results from this review indicate it may be improved by low-carbohydrate nutritional therapy. More clinical trials within this population are required to build on the few human trials that have been done.
For human dental cementum research, sample preparation protocol is now widely tested, validated, and standardized, thanks to the low variability in teeth morphology. For non-human mammals, posterior teeth are typically preferred. However, the taxa diversity implies a significant variation in morphology or specific characteristics for certain species (equids, suids), leading to multiple unstandardized protocols. This work aims to improve protocols for producing a thin section by optimizing the parameters, minimizing the risk of errors, and offering an easily reproducible quality of thin-sections. The result of 26 experiments and 124 analyses during stages of consolidation (embedding), cutting, gluing, and finishing (grinding) allowed the co-authors' combined experience from multiple laboratories to propose standardized humans and ungulates (large teeth) protocols for the systematic analysis of dental research collections.
In modern humans, counts of tooth cementum annulations (TCA) have been widely used to determine adult age at death using classical histology. This destructive technique requires physically thin sectioning the teeth which may not be an option for valuable fossil and subfossil specimens. For over a decade, propagation phase contrast synchrotron X-ray microtomography (SRμCT) at the European Synchrotron Radiation Facility has paved the way to non-destructively visualize dental microstructures that remain otherwise invisible to conventional X-ray absorption-based μCT. Here we extend the use of SRμCT to the non-destructive visualization of TCAs in known age archeological modern human teeth, for adult age at death estimation. Our results show that virtual sections are able to elucidate true cementum annulations even if their visibility is often close to the resolution limit of our setup. This is a promising first step in non-destructive adult age at death estimation which future technical fine-tuning will undoubtedly improve further
Uterus transplantation involves a vascularised composite allograft for women with absolute uterine factor infertility, and is considered research. It requires a large medical and surgical multidisciplinary team, requires adequate psychological support and risks premature birth in the offspring. We compare it with the alternative of surrogacy, with the pros and cons regarding the prospective parents and offspring, the parental project collaborators, whether dead or live uterine donor or the gestating surrogate, and society at large. The possible aspects of cross-border reproductive care are also considered before concluding that it is still ‘a step too far’.
Chapter 1 examines war’s place in a universal paradigm of order and chaos, balance and imbalance; explores war’s origins and relationship to human nature; and concludes by formally defining war. After relating Aristotle’s “four causes” model (material, formal, efficient, and final) to war as an organizing concept, the chapter articulates war’s alignment within a universal theme of balance and characterizes war as an amalgam of twenty “dialectics,” including order-chaos and creation-destruction. It highlights how political imbalances can spark war and how dialectical disparities undermine war theory and strategy. Next, the chapter marshals multidisciplinary evidence to argue that evolutionary processes have imbued humanity with warlike and peaceful attributes and that war ultimately reflects human choices arising from various motives including Thucydides’s fear, honor, and interest. Finally, the chapter concludes by defining war as the nexus of a new trinity – humanity, politics, and combat – evaluating the boundaries between war and peace, and taking a first look at the question of war’s inevitability as a human activity.
This chapter examines the reception of two Platonic texts, the Protagoras and the Statesman, in Diogenes Laertius’ Lives of the Eminent Philosophers and Plutarch’s Gryllus. It argues that part of the reason for the success of this reception lies in the way that Plato’s texts are embedded in insolvable problems such as what constitutes nudity and how one distinguishes between animal and human. Embedding a text in a wicked problem is an effective way to ensure it afterlife. In the case of Plato, the difficulty of this problem is exacerbated by his decision to ground his distinction between animal and human in the presence or absence of body-hair. Diogenes Laertius and Plutarch, in different ways, draw attention to the simultaneous complexity, instability, and capaciousness of body-hair as a signifier. They are attracted to explore its potential, but are ultimately forced to reject it and the systems of thought that it supports as unsatisfactory.
Influenza vaccination remains the most effective primary prevention strategy for seasonal influenza. This research explores the percentage of emergency medical services (EMS) clinicians who received the seasonal flu vaccine in a given year, along with their reasons for vaccine acceptance and potential barriers.
A survey was distributed to all EMS clinicians in Virginia during the 2018-2019 influenza season. The primary outcome was vaccination status. Secondary outcomes were attitudes and perceptions toward influenza vaccination, along with patient care behaviors when treating an influenza patient.
Ultimately, 2796 EMS clinicians throughout Virginia completed the survey sufficiently for analysis. Participants were mean 43.5 y old, 60.7% male, and included the full range of certifications. Overall, 79.4% of surveyed EMS clinicians received a seasonal flu vaccine, 74% had previously had the flu, and 18% subjectively reported previous side effects from the flu vaccine. Overall, 54% of respondents believed their agency has influenza or respiratory specific plans or procedures.
In a large, state-wide survey of EMS clinicians, overall influenza vaccination coverage was 79.4%. Understanding the underlying beliefs of EMS clinicians remains a critical priority for protecting these frontline clinicians. Agencies should consider practical policies, such as on-duty vaccination, to increase uptake.
We present the comparative characterisation of 195 non-aureus staphylococci (NAS) isolates obtained from sheep (n = 125) and humans (n = 70) in Sardinia, Italy, identified at the species level by gap gene polymerase chain reaction (PCR) followed by restriction fragment length polymorphism analysis with AluI. Isolates were tested phenotypically with a disc diffusion method and genotypically by PCR, for resistance to 11 antimicrobial agents including cationic antiseptic agents. Among the ovine isolates, Staphylococcus epidermidis (n = 57), S. chromogenes (n = 29), S. haemolyticus (n = 17), S. simulans (n = 8) and S. caprae (n = 6) were the most prevalent species, while among human isolates, S. haemolyticus (n = 28) and S. epidermidis (n = 26) were predominant, followed by S. lugdunensis and S. hominis (n = 4). Of the 125 ovine isolates, 79 (63.2%) did not carry any of the resistance genes tested, while the remainder carried resistance genes for at least one antibiotic. The highest resistance rates among ovine isolates were recorded against tetracycline (20.8%), and penicillin (15.2%); none was resistant to methicillin and two exhibited multidrug resistance (MDR); one of which was positive for the antiseptic resistance smr gene. By contrast, most human isolates (59/70, 84.3%) were resistant to ⩾1 antimicrobials, and 41 (58.6%) were MDR. All 52 (74.3%) penicillin-resistant isolates possessed the blaZ gene, and 33 of 70 (47.1%) harboured the mec gene; of these, seven were characterised by the Staphylococcal Chromosomal Cassette (SCCmec) type IV, 6 the type V, 5 of type III and one representative each of type I and type II. The majority (57.1%) was erythromycin-resistant and 17 isolates carried only the efflux msrA gene, 11 the methylase ermC gene and an equal number harboured both of the latter genes. Moreover, 23 (32.8%) were tetracycline-resistant and all but one possessed only the efflux tetK gene. qacA/B and smr genes were detected in 27 (38.6%) and 18 (25.7%) human NAS, respectively. These results underline a marked difference in species distribution and antimicrobial resistance between ovine and human-derived NAS.
Motifs featuring trios of figures have been discovered at a newly documented rock art site in the Swaga Swaga Game Reserve in Tanzania. These images find parallels in paintings from rockshelters at the nearby Kolo site, and raise the possibility that they represent anthropomorphic figures with stylised buffalo heads.
Here, I examine the link between intelligence and life. Unlike a skeleton, which is a requisite for any large organism, intelligence is less crucial for survival. It is much more thinly spread in the animal kingdom than are skeletons, and is absent entirely from the plant kingdom. After considering how intelligence might be defined, I consider the question of where it is found in the animal tree of life. I then focus on four examples – tool use by octopuses and crows, mirror self-recognition in certain mammals, and space travel by apes (both humans and chimps). I finish by considering the link between intelligence and Darwinian fitness. Over the course of animal evolution, some groups have prospered without having brains, others have evolved small brains, and others still – notably humans – large ones. Strangest of all, perhaps, is the case of the starfish group (echinoderms), where all current species are brainless, in contrast to their ancestors, which possessed brains, albeit small ones. This combination of evolutionary trajectories in brain size shows that the link between intelligence and fitness is complex.
Domestic ruminants (cattle, goats and sheep) are considered to be the main reservoirs for human Coxiella burnetii infection. However, there is still a need to assess the specific contribution of cattle. Indeed, most seroprevalence studies in humans were carried out in areas comprising both cattle and small ruminants, the latter being systematically implicated in human Q fever outbreaks. Therefore, we conducted a cross-sectional study in areas where C. burnetii infection in cattle was endemic, where the density of cattle and small ruminant farms were respectively high and very low. The aim was to estimate the seroprevalence rates among two occupational (cattle farmers and livestock veterinarians), and one non-occupational (general adult population) risk groups. Sera were collected in 176 cattle farmers, 45 veterinarians and 347 blood donors, and tested for phase I and II antibodies using immunofluorescence assay. Seroprevalence rates were 56.3% among cattle farmers, 88.9% among veterinarians and 12.7% among blood donors. This suggests that a specific risk for acquiring C. burnetii infection from cattle in endemically infected areas exists, mainly for occupational risk groups, but also for the general population. Further research is needed to identify risk factors for C. burnetii infection in humans in such areas.
Onchocerca lupi is a parasitic filarioid and the causative agent of canine ocular onchocercosis, a zoonotic disease of domestic dogs with sporadic reports in humans. A 13-year-old dog with no travel history outside of Israel was presented to an ophthalmology veterinary clinic in Israel with severe right ocular and periocular disease. After surgical exploration, thin helminths were removed from the dorsal sclera of the eye and identified as Onchocerca lupi by polymerase chain reaction according to the cytochrome c oxidase subunit I (cox1), reduced nicotinamide adenine dinucleotide dehydrogenase subunit 5 (nad5) and 12S rRNA genes. Phylogenetic trees and haplotype networks of the cox1 and nad5 genes confirmed the circulation of two genotypes: genotype 1 with worms from dogs, cats and humans from both the Old and New Worlds, and genotype 2 with specimens from Portugal and Spain. The Israeli sequences clustered in genotype 1 and were identical to O. lupi from the USA. Evidence of two genotypes separated geographically sheds light on the phylogeography and evolution of this zoonotic pathogen, and suggests a diverse pathology observed in different regions of the world.
The number of transnational corporations - including parent companies and subsidiaries - has exploded over the last forty years, which has led to a correlating rise of corporate violations of international human rights and environmental laws, either directly or in conjunction with government security forces, local police, state-run businesses, or other businesses. In this work, Gwynne Skinner details the harms of business-related human rights violations on local communities and describes the barriers, both functional and institutional, that victims face in seeking remedies. She concludes by offering solutions to these barriers, with a focus on measures designed to improve judicial remedies, which are the heart of international human rights law but often fail to deliver justice to victims. This work should be read by anyone concerned with the role of corporations in our increasingly globalized society.
The number of transnational corporations (TNCs) – including parent companies and subsidiaries – has exploded over the last forty years. In 1970, there were approximately 7,000 TNCs in the world; today, there are more than 100,000 with over 900,000 foreign affiliates.1 TNCs are now so complex and amorphous in their structure – even compared to ten years ago – that it is difficult for even the most sophisticated legal systems to adequately hold TNCs accountable for the harms they create in countries where they operate, even as the TNCs make enormous profits at the expense of often vulnerable communities. The truth is, certain legal doctrines, often devised nearly a century ago or longer, are too outdated to sufficiently assure that TNCs are held accountable for harms they create in today’s world, where TNCs operate globally, and often have structures that transcend a single country or jurisdiction.
While TNCs stand to benefit greatly from their work in less developed or developing countries, it is frequently the local, most vulnerable populations and communities – often nonconsenting to the development – who absorb most of the costs associated with this economic activity in the form of lower labor and regulatory costs, environmental damages, and civil and human rights violations.1 Although many TNCs are responding to human rights violations by acting responsibly, engaging in due diligence,2 and otherwise establishing mechanisms to assist in the prevention of human rights violations, when violations do occur, victims often do not have any remedy available to them.
This chapter explores the pervasive ways in which Gothic forces and affiliations appear in Dickens’s writings. The word ‘Gothic’ is rare in his work but an awareness of Gothic tropes, plottings and conventions is vital to understanding it. Gothic is used in highly innovative ways: to explore asymmetrical power relations of many sorts; to limit-test the idea of the ‘human’; and as radical social critique. The diabolical and uncanny are particularly powerful modes, and Dickens is pioneering both in his use of ‘virtual’ Gothic in A Christmas Carol and in the creation of ‘paranoid Gothic’ in the violent same-sex eroticism of Our Mutual Friend and theMystery of Edwin Drood. Gothic is also an essential component of such scenes as Miss Havisham’s resemblance to ‘waxwork and skeleton’ in Great Expectations and Fagin’s and Monks’s appearance at the sleeping Oliver Twist’s window. The chapter discusses a wide range of Gothic presences in these and other works, concluding with a discussion of Dicken’s remarkable late essay ‘Nurse’s Stories’ (1863), a complex ‘meta-Gothic’ reflection on uncanny repetition and its simultaneously comic and diabolical power in subjective experience and narration.
In the aftermath of World War I, some politicians, scholars, and lawyers argued that individuals ought to be subjects of international law and bear rights within the international order. With the collapse of the Russian Empire and the onset of revolution, hundreds of thousands of Russians found themselves effectively stateless. Without a state to protect them, these Russians had no identity documents and no effective nationality. The League of Nations and the International Labor Organization worked with various states to create the first refugee passport system. However, unlike today’s system that is based upon someone’s “well-founded fear” of persecution, eligibility for refugee status in the interwar period was based, in part, on one’s former nationality. Even refugees couldn’t escape the tyranny of nationality as the fundamental classification of the individual in the international realm.
To evaluate the effect of cosmetic surgery and the stability of body dysmorphic disorder (BDD) diagnosis in patients with a minimal defect in appearance, with and without BDD, 5 years after their request for plastic surgery.
Subjects and methods
Thirty patients requesting cosmetic surgery with minimal defect in appearance, of whom 12 had BDD and 18 did not, were re-evaluated 5 years later by telephone interview regarding their cosmetic surgery interventions, satisfaction with the intervention, BDD diagnosis, handicap, and psychiatric comorbidity.
Of the 30 patients, we were able to re-evaluate 24 subjects (80%), 10 with BDD and 14 non-BDD. Seven BDD subjects had undergone cosmetic surgery vs 8 non-BDD. Patient satisfaction with the intervention was high in both groups. Nevertheless at follow-up, 6 of the 7 operated BDD patients still had a BDD diagnosis and exhibited higher levels of handicap and psychiatric comorbidity compared to their non-BDD counterparts. Moreover, 3 non-BDD patients had developed a BDD at follow-up.
This prospective study confirms that cosmetic surgery is not efficient on BDD despite declared patient satisfaction. Cosmetic surgery had no significant effects on BDD diagnosis, handicap or psychiatric comorbidity in BDD patients at 5-year follow-up. Furthermore, BDD appeared at follow-up in some initially non-BDD diagnosed subjects. Patients' declared satisfaction with surgery may contribute to explain why some plastic surgeons may not fully adhere to the contraindication of cosmetic surgery in BDD.
Body dysmorphic disorder (B.D.D.) consists of a preoccupation with an imagined or slight physical defect. This study is the first European report on prevalence and several clinical and functional characteristics of patients with B.D.D. in a cosmetic surgery setting. Comparisons with defect- and severity-matched subjects without B.D.D. were also performed.
From 1971 to 2012, in New York State, years with human Eastern equine encephalitis (EEE) were more strongly associated with the presence of Aedes canadensis, Coquillettidia perturbans and Culiseta melanura mosquitoes infected with the EEE virus (Fisher's exact test, one-sided P = 0.005, 0.03, 0.03) than with Culiseta morsitans, Aedes vexans, Culex pipiens-restuans, Anopheles quadrimaculatus or Anopheles punctipennis (P = 0.05, 0.40, 0.33, 1.00, 1.00). The estimated relative risk of a case in a year in which the virus was detected vs. not detected was 14.67 for Ae. canadensis, 6.38 for Cq. perturbans and 5.50 for Cs. morsitans. In all 5 years with a case, Cs. melanura with the virus was detected. In no year was there a case in the absence of Cs. melanura with the virus. There were 18 years with no case in the presence of Cs. melanura with the virus. Such observations may identify the time of increased risk, and when the methods may be used to prevent or reduce exposure to vector mosquito species in this geographic region.