Objective
To identify the most common locations of cluster headache pain from an international, non–clinic‐based survey of participants with cluster headache, and to compare these locations to other ...cluster headache features as well as to somatotopic maps of peripheral, brainstem, thalamic, and cortical areas.
Background
Official criteria for cluster headache state pain in the orbital, supraorbital, and/or temporal areas, yet studies have noted pain extending beyond these locations, and the occipital nerve appears relevant, given the effectiveness of suboccipital corticosteroid injections and occipital nerve stimulation. Furthermore, cranial autonomic features vary between patients, and it is not clear if the trigeminovascular reflex is dermatome specific (e.g., do patients with maxillary or V2 division pain have more rhinorrhea?). Finally, functional imaging studies show early activation of the posterior hypothalamus in a cluster headache attack. However, the first somatosensory area to be sensitized is unclear; the first area can be hypothesized based on the complete map of pain locations.
Methods
The International Cluster Headache Questionnaire was an internet‐based cross‐sectional survey that included a clickable pain map of the face. These data were compared to several other datasets: (1) a meta‐analysis of 22 previous publications of pain location in cluster headache (consisting of 6074 patients); (2) four cephalic dermatome maps; (3) participants’ survey responses for demographics, autonomic features, and effective medications; and (4) previously published somatotopic maps of the brainstem, thalamus, primary somatosensory cortex, and higher order somatosensory cortex.
Results
One thousand five hundred eighty‐nine participants completed the pain map portion of the survey, and the primary locations of pain across all respondents was the orbital, periorbital, and temporal areas with a secondary location in the lower occiput; these primary and secondary locations were consistent with our meta‐analysis of 22 previous publications. Of the four cephalic dermatomes (V1, V2, V3, and a combination of C2‐3), our study found that most respondents had pain in two or more dermatomes (range 85.7% to 88.7%, or 1361–1410 of 1589 respondents, across the four dermatome maps). Dermatomes did not correlate with their respective autonomic features or with medication effectiveness. The first area to be sensitized in the canonical somatosensory pathway is either a subcortical (brainstem or thalamus) or higher order somatosensory area (parietal ventral or secondary somatosensory cortices) because the primary somatosensory cortex (area 3b) and somatosensory area 1 have discontinuous face and occipital regions.
Conclusions
The primary pain locations in cluster headache are the orbital, supraorbital, and temporal areas, consistent with the official International Classification of Headache Disorders criteria. However, activation of the occiput in many participants suggests a role for the occipital nerve, and the pain locations suggest that somatosensory sensitization does not start in the primary somatosensory cortex.
Plain Language Summary
Cluster headache (CH) pain is often thought to be located in or around the eye; however, multiple studies have documented pain elsewhere, and procedures that target nerves in the back of the head can help CH. In this large survey (1604 respondents) with a clickable pain map of the face, we found that (1) most respondents had pain extending beyond the area of the eye, and (2) the pain location did not correlate with autonomic symptoms, medication effectiveness, or other CH features. Cluster headache pain beyond the eye is common, and based on the pattern of areas activated, we hypothesized which parts of the brain's somatosensory system may be activated first in cluster attacks.
The innovation process, and its application to tourism, has been gradually gaining ground in the academic community as a field of study. Similarly, in recent decades, tourism has received greater ...attention from researchers in various sciences, varying only by the different emphases considered: economic, social, cultural and environmental. This increased attention must be welcomed, as innovation research represents a meaningful and valuable way of understanding the economic dynamics of the tourism industry, and deeper insights will be helpful for the industry and policy makers alike. The purpose of this article is to identify literature on special interest tourism innovation, in particular from the perspective of wine tourism. In order to structure the sometimes unclear use of the innovation process (in tourism research), the article will present closely to primary classical innovation and entrepreneurship issues. This is a conceptual perspective that brings together the major components of innovation process and its implications in special interest tourism perspective We also consider some of the implications for management, as well as suggestions for future lines of research. This article concludes by drawing attention to the challenging research needs.
During COVID-19 pandemic, healthcare workers (HCWs) have had high workload and have been exposed to multiple psychosocial stressors. The aim of this study was to evaluate HCWs in terms of the ...relative contributions of socio-demographic and mental health variables on three burnout dimensions: personal, work-related, and client-related burnout.
A cross-sectional study was performed using an online questionnaire spread via social networks. A snowball technique supported by health care institutions and professional organizations was applied.
A total of 2008 subjects completed the survey. Gender, parental status, marriage status, and salary reduction were found to be significant factors for personal burnout. Health problems and direct contact with infected people were significantly associated with more susceptibility to high personal and work-related burnout. Frontline working positions were associated with all three dimensions. Higher levels of stress and depression in HCWs were significantly associated with increased levels of all burnout dimensions. Higher levels of satisfaction with life and resilience were significantly associated with lower levels of all burnout dimensions.
All three burnout dimensions were associated with a specific set of covariates. Consideration of these three dimensions is important when designing future burnout prevention programs for HCWs.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Breastfeeding and neurodevelopmental outcomes Horta, Bernardo L; de Sousa, Bruno A; de Mola, Christian L
Current opinion in clinical nutrition and metabolic care
21, Številka:
3
Journal Article
Recenzirano
PURPOSE OF REVIEWBreastfeeding has clear short-term benefits for child survival. Concerning its long-term consequences, it has been reported that subjects who had been breastfed would have a better ...performance in intelligence tests. In this review, we perused the recently published studies on the association of breastfeeding with developmental outcomes.
RECENT FINDINGSA meta-analysis published in 2015 reported that intelligence quotient (IQ) was 3.44 points (95% confidence interval2.30; 4.58) higher among subjects who had been breastfed, and this association was observed even among those studies that controlled for maternal IQ. In the present review, we identified two studies that reported that duration of breastfeeding was positively associated with IQ in childhood, whereas another study reported that cognitive score at 67.9 years of age was higher among those subjects who had been breastfed for at least 6 months. Furthermore, two studies reported that the small gain in IQ was associated with higher school achievement and income in adulthood. Concerning the possible mechanisms for the effect of breastfeeding on development, children who had been breastfed showed greater gray matter volume in the left and right parietal and left temporal lobes and more activation in the right frontal and temporal lobes for perception tasks, whereas for the language task, the activation was higher in the left temporal lobe. Moreover, it has been reported that subcortical gray matter volume mediated the association between breastfeeding and IQ.
SUMMARYThe new studies identified in the review reinforce the evidence that breastfeeding has long-term consequences on performance in intelligence tests. In addition, this association between breastfeeding and development has long-term consequences on human capital, increasing earning ability.
Abstract
Background
This work aims to study the spatio-temporal evolution of a woman’s age at menarche in the central region of Portugal. One of the concerns of the study is early or late menarches; ...thus, we consider percentile regression to build the respective curves as opposed to the more traditional mean regression approach.
Methods
We analysed the data from
$$N=452\,348$$
N
=
452
348
women born in the period 1920–1973 who attended a free breast cancer screening program between 1990 and 2019. Distributional regression models inside the package GAMLSS in R were considered. These methods allowed us not only to model the location (mean) of the specific probability distribution of the age at menarche, but also allowed for the scale (variance) parameter of this distribution to depend on covariates. Additionally, a spatial random-effect was considered in order to capture the correlation at the regional level. The obtained clustered spatial effects were analysed to assess geographical differences among the percentiles of the age at menarche by year of birth.
Results
A decreasing trend in the age at menarche (about 1.5 years in 5 decades) and regional differences for all the considered percentiles were found. Women living in the north-central areas of the central region of Portugal tend to have menarche at older ages.
Conclusion
We obtained percentile estimates for the age at menarche by year of birth and region of residence and demonstrated that these two explanatory variables have an impact on the explanation about the decreasing trend in age at a woman’s first menstruation.
Customer-to-customer interaction constraints are key points in services management. The topic has been studied in the tourism field, but remains under-researched in a pilgrimage context. This paper ...discusses conflicts in pilgrim-to-pilgrim interaction along the path to sacred places, and in the connected tourist and hospitality services, that emerge from the heterogeneity of motivations to go on pilgrimage. An ethnographic research on the Way of Saint James was conducted. The researchers walked alongside with pilgrims driven by different motivations and experienced situations of interaction among them. This study suggests that interactions of purist with non-purist pilgrims may result in conflicts, discomfort and judgement due to differences in experiencing the pilgrimage. This paper discusses the challenges faced and provides recommendations for hospitality managers operating in pilgrimage areas to address different needs and expectations and thus minimise conflict-prone interactions.
•Pilgrim-to-pilgrim interaction may result in conflicts, due to the different motivations behind pilgrimage.•The study identifies conflicts between “purist” and “non-purist” pilgrims.•The sense of communitas with similar motivations may prevent conflicts within the pilgrimage groups.
Animal studies and the scarce clinical trials available that have been conducted suggest that bioactive surfaces on dental implants could improve the osseointegration of such implants. The purpose of ...this systematic review was to compare the effectiveness of osseointegration of titanium (Ti) dental implants using bioactive surfaces with that of Ti implants using conventional surfaces such as sandblasted large-grit acid-etched (SLA) or similar surfaces. Applying the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, the MEDLINE, PubMed Central and Web of Science databases were searched for scientific articles in April 2020. The keywords used were “dental implants”, “bioactive surfaces”, “biofunctionalized surfaces”, and “osseointegration”, according to the question: “Do bioactive dental implant surfaces have greater osseointegration capacity compared with conventional implant surfaces?” Risk of bias was assessed using the Cochrane Collaboration tool. 128 studies were identified, of which only 30 met the inclusion criteria: 3 clinical trials and 27 animal studies. The average STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) and ARRIVE (Animal Research: Reporting of In Vivo Experiments) scores were 15.13 ± 2.08 and 17.7±1.4, respectively. Implant stability quotient (ISQ) was reported in 3 studies; removal torque test (RTT)—in 1 study; intraoral periapical X-ray and microcomputed tomography radiological evaluation (RE)—in 4 studies; shear force (SF)—in 1 study; bone-to-implant contact (BIC)—in 12 studies; and BIC and bone area (BA) jointly—in 5 studies. All animal studies reported better bone-to-implant contact surface for bioactive surfaces as compared to control implants with a statistical significance of p < 0.05. Regarding the bioactive surfaces investigated, the best results were yielded by the one where mechanical and chemical treatment methods of the Ti surfaces were combined. Hydroxyapatite (HA) and calcium–phosphate (Ca–Ph) were the most frequently used bioactive surfaces. According to the results of this systematic review, certain bioactive surfaces have a positive effect on osseointegration, although certain coating biomolecules seem to influence early peri-implant bone formation. Further and more in-depth research in this field is required to reduce the time needed for osseointegration of dental implants.
Aim
Disentangling historical and ecological effects on different components of species diversity is key to understanding the assembly and maintenance of communities over space and time. Historical ...factors may be stronger predictors of the community composition at regional scales, while ecological factors may be more important predictors at local scales. Here, we evaluate multiple biodiversity dimensions to investigate riverine barrier and aridity effects on the assembly and structure of lizard assemblages.
Location
Semi‐arid region of northeastern Brazil.
Taxon
Lacertilia (lizards).
Methods
We used data describing 63 lizard assemblages from Caatinga habitats to investigate the effects of a riverine barrier and eight environmental gradients on estimates of taxonomic, phylogenetic and functional diversity. At the regional scale, we compared communities between the banks of the SFr, assuming that differences could emerge from regionally interrupted dispersal in some of the sampled species. At local scales, we evaluated the patterns of phylogenetic and functional structure of the lizard assemblages from Caatinga, and investigated the influence of aridity‐related gradients on species richness, taxonomic, phylogenetic and functional diversity.
Results
Lizard assemblages were regionally structured by the SFr acting as a barrier to 47% of the species sampled. We detected phylogenetic signal in 88% of the functional traits. Lizard assemblages were phylogenetic and functionally overdispersed. Moreover, we detected evidence of aridity gradients intensifying the overdispersion of phylogenies and functional traits.
Main conclusions
Lizard assemblages showed high variation at both regional and local scales. Riverine barriers played a stronger role as a historical factor structuring assemblages on a regional scale. The interaction of historical constraints with competition enhanced by aridity on a local scale may play a role in structuring lizard assemblages across multiple scales.
In animals, changes in colour pigmentation in an intraspecific context are usually described as a polymorphism adaptive to environmental factors. According to the thermal melanism hypothesis (TMH), ...melanic individuals are more active because they may attain higher temperature and then benefit from higher size, foraging time and reproduction. The polymorphic seed‐beetle Acanthoscelides quadridentatus (Coleoptera: Chrysomelidae) naturally attacks the seeds of two plant varieties, Mimosa setosa var. paludosa and M. setosa var. setosa, in the Brazilian savanna.
The authors tested TMH in this system, predicting that melanic beetles would be larger, and infringe worst germination rate and higher seed mortality. Additionally, they tested whether seed weight plays a role in germination.
The authors found two beetle morphs: a melanic/1.1‐fold larger and another lighter/smaller. Seeds of M. setosa var. setosa are 1.9‐fold heavier and its intact seeds germinate faster and with a higher amount than the seeds of M. setosa var. paludosa. There is no difference in the attack rate by beetle morphs. The attacked seeds of both plant varieties did not germinate.
The authors evidence phenotypic plasticity in A. quadridentatus, highlighting that TMH is confirmed for the relationship between melanism and larger sizes, although there was no difference in foraging of melanic individuals. This study shed light on the importance of plant varieties in driving the morphology of seed‐beetles.
We tested TMH in this system, predicting that melanic beetles would be larger, and infringe worst germination rate and higher seed mortality. Additionally, we tested whether seed weight plays a role in germination. We found two beetle morphs: a melanic/1.1‐fold larger and another lighter/smaller. Seeds of M. setosa var. setosa are 1.9‐fold heavier and its intact seeds germinate faster and with a higher amount than the seeds of M. setosa var. paludosa. There is no difference in the attack rate by beetle morphs. The attacked seeds of both plant varieties did not germinate. We evidence phenotypic plasticity in A. quadridentatus, highlighting that TMH is confirmed for the relationship between melanism and larger sizes. Our study shed light on the importance of plant varieties in driving the morphology of seed‐beetles.
Agricultural soil degradation is occurring at unprecedented rates, not only as an indirect effect of climate change (CC) but also due to intensified agricultural practices which affect soil ...properties and biodiversity. Therefore, understanding the impacts of CC and soil degradation on plant physiology is crucial for the sustainable development of mitigation strategies to prevent crop productivity losses. The amino acid proline has long been recognized for playing distinct roles in plant cells undergoing osmotic stress. Due to its osmoprotectant and redox-buffering ability, a positive correlation between proline accumulation and plants' tolerance to abiotic stress has been pointed out in numerous reviews. Indeed, proline quantification is used systematically by plant physiologists as an indicator of the degree of tolerance and a measurement of the antioxidant potential in plants under stressful conditions. Moreover, the exogenous application of proline has been shown to increase resilience to several stress factors, including those related to soil degradation such as salinity and exposure to metals and xenobiotics. However, recent data from several studies often refer to proline accumulation as a signal of stress sensitivity with no clear correlation with improved antioxidant activity or higher stress tolerance, including when proline is used exogenously as a stress reliever. Nevertheless, endogenous proline levels are strongly modified by these stresses, proving its involvement in plant responses. Hence, one main question arises-is proline augmentation always a sign of improved stress resilience? From this perspective, the present review aims to provide a more comprehensive understanding of the implications of proline accumulation in plants under abiotic stress induced by soil degradation factors, reinforcing the idea that proline quantification should not be employed as a sole indicator of stress sensitivity or resilience but rather complemented with further biochemical and physiological endpoints.
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