Friday, 30 November 2018

Intersecting Worlds: The Interplay of Cultures and Technology Published on 29 November 2018 From January 14th to 18th the workshop Intersecting Worlds: The Interplay of Cultures and Technology is organized by Corinne Hofman (Leiden University, Distinguished Lorentz Fellow), Christopher DeCorse (Syracuse University), and Ian Lilley (University of Queensland) in collaboration with the Lorentz Center. Aim and Description European expansion into the non-western world at the end of the fifteenth century represents a landmark in global history, transforming indigenous societies permanently that at present often remain marginalized in colonial and post-colonial historiographies of conquest and hegemony. The workshop “Intersecting Worlds: the interplay of cultures and technologies” that is taking place on January 14-18, 2019 in Leiden, aims to use the archaeological record to provide completely novel insights into these infamous histories by uncovering the indigenous perspectives currently biased by still dominant Eurocentric viewpoints. With the Portuguese exploration of the West African coast in the fifteenth century, specifically in Cabo Verde, the European expansion began. On 1460 they established the first plantations and lay the groundwork for the transformation of the African societies as a consequence of the commerce and slave trading. In the Americas, the Caribbean indigenous where the first to experience the European contact and colonization. At the beginning of the 16th century, they also experience the influx of African slaves, contributing to the formation of present-day, multi-ethnic Caribbean society. In Asia and the Pacific Rim, Australia and New Zealand the Europeans encounters represented equally varied contacts and cultural intersections. Been the principal cause of widespread social, political and economic change, causing catastrophic demographic collapse as a result of the introduction of exotic diseases to which Europeans were tolerant but to which local populations had no resistance. This workshop aims to explore, in a comparative way, the transformations and responses of indigenous societies around the world to changing cultural, social, economic and political environments triggered by European contact and colonialism. Archaeological data forms the backbone; the indigenous perspective is the hallmark. The two key questions addressed are 1) What were the immediate, and the lasting, effects of colonial encounters on indigenous cultures and societies across the world, and what were the intercultural dynamics that took place during these infamous colonization processes? 2) How can the study of indigenous histories contribute to a more sophisticated awareness in the present, and how can it speak to multiple and perhaps competing stakeholders at local, regional, pan-regional, and global scales? Organized by the distinguished academics as, Prof. Corinne Hofman, Caribbean Archaeology, Leiden University; Prof. Ian Lilley, Archaeological Heritage Management, University of Queensland, and Prof. Christopher DeCorse, African Archaeology and History, Syracuse University. It brings together 35 researchers from around the world with expertise on the Caribbean, West Africa, Pacific, on state-of-the-art method and technique development in relevant fields and local stakeholders. The Lorentz Center financed this workshop as part of the Distinguished Lorentz Fellowship (DLF) awarded to Prof. Corinne Hofman in 2018. If you are interested to join this workshop, please register through this link.

Press Release New Hope Fertility Clinic Now Offers Ovarian Rejuvenation NEW YORK - November 30, 2018 - ( Ovarian rejuvenation, a newly pioneered infertility treatment, is offering women suffering from Premature Ovarian Insufficiency (POI) a chance to finally conceive a child and have the family they’ve always wanted. New Hope Fertility Center, a leading research and treatment clinic, has now established their own system of ovarian rejuvenation through a minimally invasive procedure. Helmed by internationally recognized Dr. Zaher Merhi, this novel procedure is redefining the age at which woman may become pregnant and challenging what most fertility specialists held to be the “window of fertility.” Research has shown that as women age, their ovarian wall becomes rigid and stiff. This puts pressure on the follicle, ultimately preventing normal egg development and reducing a woman’s overall chance of achieving pregnancy. However, through New Hope’s Modified Ovarian Rejuvenation treatment, specialists puncture the ovary itself, relieving pressure on the eggs lying dormant inside. By alleviating that stress, egg development stands a much better chance of transpiring properly, and the punctures will facilitate greater blood flow into the ovary, delivering much-needed growth factors. Two other forms of ovarian rejuvenation are under development at New Hope as well. PRP (platelet rich plasma) injections, which have successfully been used in sports medicine, may be injected into the ovarian artery. The flood of plasma has been shown to potentially revitalize the ovarian tissue. Similarly, stem cells may be used in the same way by creating a culture from fat cells, which are processed and injected back into the ovaries. Both techniques are experimental. New Hope’s various ovarian rejuvenations are groundbreaking developments that carry some tremendous implications. Foremost, women suffering from ovarian disease can seek this out as a premature ovarian failure treatment. Thousands of women under the age of 40 experience a failure in their reproductive system and ovarian rejuvenation gives them a chance to conceive. Pregnancy after menopause may even be achievable, though ideal candidates should be under the age of 40. Other primary patients include women who suffer from low levels of Anti-Mullerian hormone (AMH) and those with early perimenopause. Once the procedure is completed, patients must return for weekly tests over the next month. Blood samples will be taken to measure levels of Follicle Stimulating Hormone (FSH), Estradiol (E2) and AMH. Vaginal ultrasounds will also be taken so specialists can monitor the number of follicles present within the ovary. Currently, New Hope specialists are ready to provide consultations for all three types of ovarian rejuvenation. With nearly 8,000 successful babies conceived through New Hope’s program, their excellence speaks for itself. With the addition of this new procedure, there’s no more asking if it is possible to get pregnant during menopause or when suffering from ovarian failure. For anyone considering fertility treatment, contact them today and book a consultation. New Hope also hosts monthly seminars and egg-freezing events to further delineate information about infertility and the ways to overcome it.

Christopher Wylie: 'The fashion industry was crucial to the election of Donald Trump'

Fashion The Cambridge Analytica whistleblower reveals how certain brands were weaponised during the US election campaign Morwenna Ferrier Thu 29 Nov 2018 17.50 GMT Last modified on Fri 30 Nov 2018 05.02 GMT Christopher Wylie at The Business of Fashion conference in Oxfordshire. Photograph: Samir Hussein/Getty Christopher Wylie, the whistleblower who exposed the widespread misuse of data by his former employer, Cambridge Analytica, has revealed how the company “weaponised” the fashion industry in the run up to the 2016 US election, which he claims helped Donald Trump get elected. Speaking at the annual BoF Voices festival in Oxfordshire, Wylie revealed for the first time a matrix based on data collected by the firm which he claims can show how users’ preferences for particular brands on social media platforms – Facebook, in particular – were then used to help target these same users with pro-Trump messaging. He compared the misuse of fashion-based data as one of the campaign’s lesser reported “weapons of mass destruction”. Exposing Cambridge Analytica: 'It's been exhausting, exhilarating, and slightly terrifying' “They [Cambridge Analytica] looked at actual people. How they engaged with certain brands was put into a funnel and helped build the algorithms,” Wylie explained. “When you look at personality traits, music and fashion are the most informative [tools] for predicting someone’s personality.” A user’s predilection for a particular label gives, he said, a very clear indication of what reports often call “populist political signalling”. Wylie on stage. Wylie on stage. Photograph: John Phillips/Getty Cambridge Analytica, which was shut down earlier this year following an investigation by the Observer, was the political marketing firm headed by Trump’s former key adviser, Steve Bannon, and owned by hedge-fund billionaire Robert Mercer. It also used user information obtained without authorisation in early 2014 – including cultural preferences such as fashion and music – to create a system that could single out voters in order to expose them to specific political advertising. Prior to the company’s role on Trump’s election campaign, Wylie had been its director of research. Recalling his first meeting with Bannon, he explained how fashion was one of the many things they examined, along with “Judith Butler, Foucault and nature of our fractured self”. He said the pair discussed the difference between Crocs and Chanel’s little black dress as analogous for the fashion spectrum – which would become a blueprint for how the firm used fashion preferences later on. Wylie went onto to criticise the fashion industry for creating a “pre-existing cultural foundation which allowed the alt-right to grow over that time period”. He conceded that while Cambridge Analytica “exploited the cultural narratives that the fashion and culture industry put out”, the fashion industry was responsible for creating those cultural narratives in the first place. He added: “We need new narratives in culture, and to do a better job of showing more diversity” in order to direct politics along a different route. According to the data obtained (the majority of which came from US users), certain fans of American denim brands such as Wrangler, Hollister and Lee Jeans could be more closely linked to low levels of openness and mistrust – and therefore more likely to engage with pro-Trump messaging. This data also showed more esoteric fashion labels such as Kenzo or Alexander McQueen tended towards a more open and imaginative fanbase, which Wylie said leant more towards typical democratic voters. Peter Cvjetanovic (right) at the Unite the Right rally in Charlottesville ‘When we think about fascist movements, the first thing they do is develop an aesthetic ... ’ Peter Cvjetanovic (right) at the Unite the Right rally in Charlottesville Photograph: Anadolu Agency/Getty Images Wylie went on to explain that this data was particularly used to target the alt-right: “When we think about fascist movements, the first thing they do is develop an aesthetic,” he said, illustrating his point with the uniforms of the Nazi party and, more recently, alt-right supremacists who, in August 2017 marched through Charlottesville in a uniform of chinos and white polo shirts. The link between fashion and psychology is nothing new, but this is the first time that it has been exploited in order to influence political thinking, says Wylie. “We [Bannon and I, during that time] said, if we indulge in light stereotyping, [if we look] at culture as a distribution of attributions that plays out in the wider world, we can work out where it goes … ” Fashion is part of the so-called culture wars. “The thing with Crocs and the Chanel dress, one is quick, fast and regrettable, the other is enduring and iconic … it is up to you if Trump or Brexit [are] the Crocs or the Chanel of our political age.”

Thursday, 29 November 2018

Mary Daly’s Gyn/Ecology: Mysticism, Difference, and Feminist History

Volume 44, Number 2 | Winter 2019 Clare Monagle Department of Modern History, Politics, and International Relations Macquarie University Abstract Full Text PDF Abstract The object of this article is to contextualize Mary Daly’s mixed reception within feminist scholarship in order to read her status within the larger project(s) of feminist thought in recent history. Daly is a polarizing figure who inspires enmity, devotion, and trenchant criticism. I track these responses, arguing that they offer an important source for the intellectual history of feminist thought. Daly’s work is mystical and polemical, proudly separatist and essentialist. As such, she has enjoyed the devotion of those who embrace her Wiccan-inspired manifestos. However, over the course of the 1980s and 1990s, Daly’s work received two core critiques. The first came in 1980 in the form of excoriating public criticism from Audre Lorde, who charged Daly with racism. While Lorde shared Daly’s desire to recuperate a goddess tradition for the purposes of feminist devotions, she was perturbed that Daly drew only from the Western tradition in her construction of a new pantheon, neglecting long histories of goddess worship in Africa. As the eighties wore on, Daly also became synonymous with the reductive excesses of what Alice Echols and Linda Alcoff call “cultural feminism,” so named because it calls for a countercultural feminine and feminist project devoted to an ideology of reverence for the female nature. This politics, as Alcoff describes it, argues that “Feminist theory, the explanation of sexism, and the justification of feminist demands can all be grounded securely and unambiguously on the concept of the essential female.” As a result of these critiques, Daly has been designated as standing for both racism and essentialism. As exhibit A for these perceived sins, Daly’s work has been a site of continual correction in feminist scholarship. This article offers an intellectual history of Daly’s correction, attempting to isolate the stakes at play in each of those moments. The object of this article is not to recuperate Daly’s thought per se but to historicize her reception within a larger story of the making of feminist orthodoxies

The Polluted Child and Maternal Responsibility in the US Environmental Health Movement Norah MacKendrick Department of Sociology Rutgers University, New Brunswick Kate Cairns Department of Childhood Studies Rutgers University, Camden Abstract Full Text PDF Abstract Early exposure to environmental chemicals is associated with multiple health problems, including neurological and reproductive disorders. In response to this problem, the environmental health movement has emerged as a leading authority on strategies of self-protection, or what we call “precautionary consumption.” In this essay, we use discourse analysis to examine two decades of environmental health reports and advice from a key organization in the United States: the Environmental Working Group (EWG). During this period, the discourse of environmental health used by this organization presents babies as contaminated before birth and mothers as vectors of chemical risk. This discourse locates risk within three primary sources: first, inadequate regulation of environmental chemicals; second, maternal environments of the body and home; and finally, maternal desires for food and beauty. We argue that EWG strategically mobilizes existing medical and scientific discourses surrounding maternal bodies to build greater support for chemical regulation. Key to this discursive construction is a differential attribution of blame and responsibility, where blame for pollution is assigned to regulatory failure, yet responsibility for mediating children’s exposure is assigned to individual mothers. This social construction of pollution as a mother’s problem is not only gendered but also classed and racialized and warrants greater attention in feminist research. Our analysis also contributes to scholarship on the maternal-fetal conflict by tracing the ambiguous place of maternal self-care within constructions of child well-being, and it advances research on the regulation of women’s bodies and actions throughout their reproductive lives.

Re: Clinical Trial Reports that Cinnamon Reduces Insulin Resistance in Women with Polycystic Ovary Syndrome

Cinnamon (Cinnamomum verum, Lauraceae) Polycystic Ovary Syndrome Insulin Resistance Date: 11-15-2018 HC# 101831-604 Hajimonfarednejad M, Nimrouzi M, Heydari M, Zarshenas MM, Raee MJ, Jahromi BN. Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double-blind placebo controlled clinical trial. Phytother Res. February 2018;32(2):276-283. doi: 10.1002/ptr.5970. Polycystic ovary syndrome (PCOS), caused by a hormonal imbalance, is diagnosed when a woman has two of the following conditions without other medical explanation: hyperandrogenism, intermittent or absent menstrual cycles, and polycystic ovary indicated by ultrasound. Although its etiology is uncertain, PCOS appears to result from a combination of genetic and environmental factors. Insulin resistance is common in women with PCOS, may play a causal role in its development, and can contribute to the development of obesity, diabetes, and cardiovascular problems. Pharmaceutical treatments for PCOS are limited by contraindications, poor efficacy, and adverse effects. Cinnamon (Cinnamomum verum, Lauraceae) bark is used traditionally to regulate menstrual cycles in patients with PCOS and has been shown to lower blood glucose and reduce the homeostatic model assessment of insulin resistance (HOMA-IR) index in patients with diabetes. These authors conducted a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy of cinnamon in patients with PCOS. The study was conducted at Shiraz University of Medical Sciences in Shiraz, Iran. Fresh cinnamon bark, purchased from a local Shiraz market, was washed, dried, and ground into a powder, which was used to fill 500 mg capsules. Placebo capsules contained 450 mg of starch (heated until it turned brown) and 50 mg of cinnamon powder (used to produce similar taste and odor). Patients at the University's Shaheed Motahari Outpatient Clinic who were aged 18 to 45 years, met the Rotterdam Criteria for PCOS, and had a body mass index (BMI) ≥18 kg/m2 were eligible for the study. Exclusion criteria included diabetes, hypertension, hyperprolactinemia, or thyroid problems, pregnancy or lactation, treatment for infertility, or use of hormones or any drug that affects insulin sensitivity. Enrollment took place between January 2016 and July 2016. Of 80 women screened, 66 were enrolled in the trial. For 12 weeks, 33 of those patients were instructed to take one cinnamon capsule three times daily after meals, for a total daily dose of 1500 mg. The remaining 33 patients were to take one placebo capsule three times daily. All patients also took a standard treatment of 10 mg daily of medroxyprogesterone for 10 days per month starting from day 15 of each menstrual cycle. The primary outcome of the study was insulin resistance, as measured by the HOMA-IR index. Secondary outcomes were patients' anthropometric profiles (weight, BMI, and waist circumference); biochemical parameters including fasting blood sugar (FBS), two-hour postprandial blood glucose, and lipid profile; and androgenic hormone assays to measure serum total testosterone and dehydroepiandrosterone sulphate levels. Three patients in the cinnamon group and two in the placebo group were not included in the final analyses because they missed follow-up visits. One patient in the cinnamon group discontinued the treatment because of a rash and itching, and one patient in the placebo group withdrew from the study because of travel plans. Four others, one in the cinnamon group and three in the placebo group, were noncompliant (more than three doses missed) but were included in intention-to-treat analyses. The final analyses included 29 patients in the cinnamon group and 30 patients in the placebo group. Compared with the placebo group, the cinnamon group had significantly greater reductions in fasting insulin (P=0.024), HOMA-IR index (P=0.014), and low-density lipoprotein cholesterol levels (P=0.049). Fasting insulin and HOMA-IR declined substantially over the course of the study in both groups, though significantly more so in the cinnamon group. Improvements were observed in the cinnamon group in body weight, BMI, waist circumference, FBS, two-hour postprandial blood glucose, total cholesterol, triglycerides, and serum androgenic hormone levels. However, the changes were mostly small and final figures were not significantly different from those in the placebo group. Testosterone significantly decreased in the cinnamon group from 0.82 ± 0.82ng/mL at baseline to 0.55 ± 0.28 ng/mL at the conclusion of the study (P=0.001); there was also a smaller significant decrease (P=0.041) in the placebo group. The rash and itching reported by one patient in the cinnamon group disappeared after the treatment was discontinued. No other serious adverse effects were reported. The use of progesterone therapy as standard treatment along with the study intervention in both groups is a limitation of this study, as the authors could not evaluate the effects of cinnamon on the patients' menstrual cycles. The therapy was used, however, because it was considered unethical to deprive any patient of standard medical treatment. Although the first evaluation of androgen was conducted during the follicular phase of all patients, final blood samples were drawn at the end of the study at 12 weeks, when some patients may have been in different phases of their menstrual cycle. According to the authors, this should be considered when interpreting the results of the androgenic hormone assays. Other limitations of this study include the lack of an ultrasound of the patients' ovaries at the end of the study, the small number of study patients, and the short duration. The fact that the placebo contained a small dose of cinnamon might have reduced differences between groups. The authors concluded that "cinnamon supplementation with the daily dose of 1.5 g for 12 weeks in combination with progesterone therapy was well tolerated and significantly improved insulin sensitivity and decreased insulin and LDL level in women with PCOS." The authors declared that they have no conflicts of interest. —Shari Henson

Re: Echinacea Mouthwash More Effective than Chlorhexidine in Decreasing Oral Microbial Load in Intubated Patients

Echinacea (Echinacea spp., Asteraceae) Chlorhexidine Antimicrobial Mouthwash Oral Microbial Load Date: 11-15-2018 HC# 041833-604 Safarabadi M, Ghaznavi-Rad E, Pakniyat A, Rezaie K, Jadidi A. Comparing the effect of echinacea and chlorhexidine mouthwash on the microbial flora of intubated patients admitted to the intensive care unit. Iran J Nurs Midwifery Res. November-December 2017;22(6):481-485. doi: 10.4103/ijnmr.IJNMR_92_16. Ventilator-associated pneumonia (VAP) is a common bacterial infection among patients in intensive care units (ICUs). For patients placed on a ventilator, the risk for nosocomial pneumonia and mortality is higher than for other patients. The use of anti-bacterial mouthwashes is recommended to prevent the occurrence of VAP. Among the available mouthwashes, chlorhexidine is highly effective in reducing dental plaque and pathogenic microorganisms; however, studies investigating the efficacy of chlorhexidine for the prevention of VAP have yielded conflicting results. Extracts of echinacea (Echinacea spp., Asteraceae) aerial parts have immuno-stimulant, anti-inflammatory, and mild antimicrobial properties. This double-blind, randomized, controlled clinical trial compared the effects of echinacea and chlorhexidine mouthwashes on the oral microbial load in ICU patients who underwent tracheal intubation. The study included 70 patients admitted to the ICUs in three hospitals in Arak, Iran, between April 2014 and October 2014 who underwent intubation. The patients were randomly assigned to either the intervention group (n=35) or the control group (n=35). Exclusion criteria were not reported. Baseline demographic data, patient history, cause of hospitalization, and medications were recorded. All patients received the normal care protocol which included saline rinses and suctioning of secretions every two to three hours. All areas of each patient's mouth were brushed twice daily with a toothbrush. Before and after brushing each section of the mouth, 15 mL of either 0.01% echinacea or 0.2% chlorhexidine mouthwash was applied and then suctioned in less than 30 seconds. To prepare the echinacea mouthwash, dried herb was soaked in water for 60 hours. The solution was filtered and then maintained at 104-111.2° F (40-44° C) for solvent evaporation. The authors report that the final solution (solvent not specified) contained 95 g dried herb per mL; however, this is likely a reporting error. The authors cite a previous study regarding the preparation method which appears to have used a final solution containing 95 mg/mL. Elsewhere, the authors also mention preparation of a 1% solution and using a 0.01% solution. Based on this poor reporting, it is unclear what was actually prepared and used. The species of echinacea used in this study also was not specified. The source of the echinacea was not reported. Before and after each mouthwash application, 50 μL samples of aspirated secretions were collected from the back of the mouth. Normal saline was added to the sample to reach a volume of 1 mL; 10 μL of that solution was incubated overnight on blood agar plates. The number of colony-forming units (CFU) was counted, and the results were expressed as the base 10 logarithm of the concentration (log CFU/mL). Secretion samples were collected ≤ 12 hours after admission and then every 12 hours during the intervention. Post-test samples were collected four days after the last intervention. Most (67.1%) of the patients were male, with an average age of 44.9 years. For 52.8% of the patients, trauma was the cause of hospitalization. Before the intervention, no significant between-group differences were observed for age, sex, smoking history, admitting hospital, blood pressure, respiratory and heart rates, or number of teeth. Before the intervention, the mean (standard deviation) oral microbial counts were 6.21 (0.75) in the intervention group and 6.43 (0.47) in the control group (P=0.1). Four days after admission, the oral microbial counts were 4.75 (0.96) in the intervention group and 5.26 (0.80) in the control group (P=0.01). The authors conclude that compared with the chlorhexidine solution, "the echinacea solution was more effective in decreasing the oral microbial flora of patients in the intensive care unit." The authors report no conflicts of interest. —Shari Henson

Stella McCartney to launch UN charter for sustainable fashion Designer aiming to make business case for why brands should tackle climate change Jess Cartner-Morley @JessC_M Thu 29 Nov 2018 06.00 GMT Stella McCartney: ‘We really don’t have long now, to change things.’ Photograph: Lauren Maccabee Stella McCartney is to announce a United Nations fashion industry charter for climate action, which will be launched at next month’s climate talks in Poland. The designer hopes the charter will “ring some alarm bells” while making a business case for sustainable fashion, setting out a path for collective action to enable low-carbon production methods to be scaled up, improving economic viability. Other signatories to the charter, which will be launched in Katowice on 10 December, have yet to be announced but are known to include several major fast fashion brands. The charter has been initiated by the UN climate change secretariat. Waste, pollution, deforestation, toxicity in manufacture and carbon-fuelled supply chains combine to make fashion one of the most environmentally damaging industries, and reform is essential if the goals agreed in the Paris climate agreement are to be met. There are signs consumers are driving a move towards responsible consumption. A report by the fashion search website Lyst, which tracked more than 100m searches over the past year, shows a 47% rise in searches that combine style and ethics, such as “vegan leather” and “organic cotton”. “We really don’t have long now, to change things. But I honestly believe it’s doable – I couldn’t do what I do if I didn’t believe that,” said McCartney. “There is so much guilt and fear attached to talking about sustainability and that’s not helpful. What is essential is for the big players in the industry to come along with me, because that changes the price point.” Cheap fashion sales threaten the planet. Could online influencers be our saviours? Read more Support for the charter has so far come largely from high street brands. “Fast fashion is responsible for the lion’s share of environmental impact, so they are the most important element in effecting real change,” said McCartney. But Thursday’s announcement doubles as a recruitment drive for the luxury industry. Between 30 and 40 chief executives of international high fashion brands will be in the audience when McCartney unveils the charter at Voices, an annual fashion industry conference staged by Imran Amed’s Business of Fashion website. “It’s a captive audience of industry leaders,” said Amed. “And that presents an opportunity to convince them to come onboard.” Convincing industry decision-makers to prioritise sustainability is “not about peer pressure, it’s about making them excited”, said McCartney. “Who wants to talk about this season’s colour or the next It bag? The sustainability conversation is really the only one that I am interested in having. Prospects for lab-grown alternatives to leather are the kind of topics I find sexy now.” Cotton being harvested in Egypt Facebook Twitter Pinterest Cotton being harvested in Egypt. Mass production of the crop is causing huge damage to soil biodiversity around the world. Photograph: Bloomberg via Getty Images Facing a trend from younger consumers to spend money on experiences rather than clothes, the fashion industry has been resistant to regulations that would make fabric production more expensive. An ethically produced velvet that McCartney hopes to use for next season’s party dresses is priced at £100 a metre because a lack of demand means it is produced in tiny quantities. “There is a reason the fashion industry clings to old-fashioned ways of doing things – it is cheaper and it is easier,” said McCartney. “We can only fix this mess if we work together.” Sign up for the Fashion Statement email Read more Sustainability is not immune to trends, and the buzzword in environmental fashion is soil. “We know about the rainforest and about the ocean, but we also need to talk about soil and regenerative agriculture,” said McCartney. Mass production of cotton, the most widely produced fabric on earth, is inflicting huge damage on soil biodiversity. McCartney will be preceded on stage at the conference by the keynote speaker, Christopher Wylie. The Cambridge Analytica whistleblower will address the growing power of big technology companies, and how the fashion industry interacts with them. Wylie, who studied for a PhD in fashion trend forecasting at the London School of Economics, told the Observer he drew an analogy between fashion and politics for Steve Bannon, telling him: “Trump is like a pair of Uggs, or Crocs, basically. So how do you get from people thinking ‘Ugh. Totally ugly’, to the moment when everyone is wearing them?” On Friday, David Pemsel, the chief executive of Guardian Media Group, and John Ridding, the chief executive of the Financial Times, will address digital disruption and new media audiences.

Wednesday, 28 November 2018

Science and Religion: Conversations Across Boundaries

My name is Anthony Nairn from the IHPST at the University of Toronto. I am emailing you to ask that you distribute the following call for abstracts for a session I am putting together for the 2019 conference of the Canadian Society for the History and Philosophy of Science taking place at the University of British Columbia from June 1-3, 2019. Below is my session title and description: Science and Religion: Conversations Across Boundaries Science and religion, in the popular mind, is seemingly incompatible. This has been the source of rising tensions and vocal activism ascending from both sides. The conflict thesis, which began in the late 19th century by Draper and White, has had a powerful and lasting effect on the understanding of the interaction between these two powerful enterprises, even though historians and philosophers of science and religion agree that the conflict thesis is inadequate in explanatory power. The aim of this session is to spark critical discourse on the relationship between science and religion from a variety of investigatory lenses (history, philosophy, integrated, STS, etc.) and different objects of inquiry (Islam, knowledge, Christianity, media, knowledge, etc.) to better carve out a deeper theoretical and applied space for working and learning scholars to operate within. With the theme of this year’s Congress as “circles of conversation,” the time seems necessary for bringing forth novel ways to better understand how science and religion can be better understood from different disciplinary and specialist backgrounds. Any faculty, researchers, or graduate students who are doing work on related topics in the field of science and religion can email me ( their abstracts following these instructions: ◦ In order to preserve the anonymity of authors, it is important that contact information and other identifying information be excluded from the file containing the abstract. The author’s name and contact information, and a list of keywords should be placed in the email, not in the abstract document. ◦ Individual paper submissions should include a file with a title and a brief abstract (150-250 words). Thank you very much and I look forward to hearing from some of you soon! Sincerely, Anthony

Challenges and Changes in Gendered Poverty: The Feminization, De-Feminization, and Re-Feminization of Poverty in Latin America

Articles Sarah Bradshaw, Sylvia Chant & Brian Linneker Published online: 23 Oct 2018 Download citation ABSTRACT Despite reductions in poverty generally, recent trends in Latin American countries show processes of both de-feminization and re-feminization of poverty. A rise in the numbers of women to men living in income-poor households has occurred despite feminized anti-poverty programs, most notably conditional cash transfers (CCTs), which target resources to women. This paper shows that methodological differences in what, how, and who is the focus of measurement may influence patterns of poverty “feminization.” It also suggests that feminized policy interventions might in themselves be playing a role in the re-feminization of poverty, not least because of data and definitional limitations in the way female-headed households and, relatedly, women’s poverty are understood. The somewhat paradoxical interactions between the feminization of household headship, the feminization of poverty, and the feminization of anti-poverty programs present interesting challenges for redressing gender gaps in poverty within the 2030 Agenda for Sustainable Development. KEYWORDS: Latin America, gender, feminization of poverty, conditional cash transfers, female-headed households JEL Codes: I32, B54, D1 Additional information Author information Sarah Bradshaw Sarah Bradshaw has worked on gender issues for over twenty years including research around gendered rights, poverty and poverty alleviation, and household decision making. She has undertaken work with various development agencies, including the United Nations Development Programme (UNDP) and Department for International Development (DFID). In 2013, she was commissioned to write the gender background paper for the High-Level Panel on the Post-2015 Development Agenda. In 2014, she was awarded the Gender Evidence Synthesis Research Award for the ESRC/DFID Joint Poverty Alleviation Fund Scheme to review all grants awarded under the scheme for their contribution to gendered understandings of poverty. Sylvia Chant Sylvia Chant has undertaken research in Mexico, Costa Rica, the Philippines, and The Gambia, and consulted for a wide range of development organizations including UNDP, ILO, UN-HABITAT, World Bank, and ECLAC. She is a member of the Expert Advisory Group for UN Women’s Progress of the World’s Women 2018. In 2015, Chant was appointed as a Fellow of the Academy of Social Sciences, which described her as a “world-leading figure in international social science, helping to stake out the field of gender and development.” She has published extensively, including editing the 2010 International Handbook of Gender and Poverty, comprising over 100 chapters from 125 authors. Brian Linneker Brian Linneker is an independent scholar and freelance senior researcher in economic geography. He holds a PhD and MSc from the London School of Economics and Political Science. He has worked for over twenty-five years in the general area of poverty, vulnerability, and social exclusion for UK government departments, UK international and Latin American national NGOs and civil society organizations, and within various academic institutions including the LSE, Kings College, Birkbeck College, Queen Mary University of London, and Middlesex University. He has published over 100 articles, reports, book chapters, and working papers on London, the UK, and Latin America.

Cumin (Cuminum cyminum L.) is a safe approach for management of lipid parameters: A systematic review and meta-analysis of randomized controlled trials.

Phytother Res. 2018 Nov;32(11):2146-2154. doi: 10.1002/ptr.6162. Epub 2018 Aug 8. Hadi A1, Mohammadi H2, Hadi Z3, Roshanravan N4, Kafeshani M1. Author information 1 School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. 2 Department of Clinical Nutrition, School of Nutrition & Food Science, Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran. 3 Shohadaye Lenjan Hospital, Zarrin shahr, Isfahan, Iran. 4 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Abstract We performed a meta-analysis to evaluate the efficacy of cumin supplementation on plasma lipid concentration in adult population. The search included PubMed, Scopus, ISI Web of Science, Google Scholar, and the Cochrane library (up to January 2018) to identify randomized controlled trials (RCTs) investigating the effects of cumin supplementation on serum lipid parameters. Mean difference (MD) was pooled using a random-effects model. Meta-analysis of data from six eligible RCTs with 376 participants showed a significant reduction in plasma concentration of total cholesterol (MD [95% CI] -10.90 [-21.39, -0.42] mg/dl, p = 0.042) and low-density lipoprotein cholesterol (MD [95% CI] -6.94 [-11.53, -2.35] mg/dl, p = 0.003) after supplementation with cumin compared with control treatment, and plasma concentration of high-density lipoprotein cholesterol (MD [95% CI] 3.35 [1.58, 5.12] mg/dl, p˂0.001) were found to be increased. Although our analysis indicated that cumin supplementation cannot change triglyceride (TG) concentration (MD [95% CI] -20.48 [-41.23, -0.26] mg/dl, p = 0.053), but after stratified the RCTs based on the primary level of TG (hypertriglyceridemia versus nonhypertriglyceridemia subjects), there was a significant decrease in nonhypertriglyceridemia subset. This systematic review and meta-analysis suggested the efficacy of cumin supplementation on lipid parameters. KEYWORDS: cumin; lipids; meta-analysis; randomized controlled trials PMID: 30088304 DOI: 10.1002/ptr.6162 [Indexed for MEDLINE]

Lead in Spices, Herbal Remedies, and Ceremonial Powders Sampled from Home Investigations for Children with Elevated Blood Lead Levels - North Carolina, 2011-2018.

MMWR Morb Mortal Wkly Rep. 2018 Nov 23;67(46):1290-1294. doi: 10.15585/mmwr.mm6746a2. Angelon-Gaetz KA, Klaus C, Chaudhry EA, Bean DK. Abstract The number of pediatric cases of elevated blood lead levels (BLLs) are decreasing in North Carolina. However, one county reported an increase in the number of children with confirmed BLLs ≥5 μg/dL (CDC reference value,, from 27 in 2013 to 44 in 2017. Many children with elevated BLLs in this county lived in new housing, but samples of spices, herbal remedies, and ceremonial powders from their homes contained high levels of lead. Children with chronic lead exposure might suffer developmental delays and behavioral problems ( In 1978, lead was banned from house paint in the United States (1); however, children might consume spices and herbal remedies daily. To describe the problem of lead in spices, herbal remedies, and ceremonial powders, the North Carolina Childhood Lead Poisoning Prevention Program (NCCLPPP) retrospectively examined properties where spices, herbal remedies, and ceremonial powders were sampled that were investigated during January 2011-January 2018, in response to confirmed elevated BLLs among children. NCCLPPP identified 59 properties (6.0% of all 983 properties where home lead investigations had been conducted) that were investigated in response to elevated BLLs in 61 children. More than one fourth (28.8%) of the spices, herbal remedies, and ceremonial powders sampled from these homes contained ≥1 mg/kg lead. NCCLPPP developed a survey to measure child-specific consumption of these products and record product details for reporting to the Food and Drug Administration (FDA). Lead contamination of spices, herbal remedies, and ceremonial powders might represent an important route of childhood lead exposure, highlighting the need to increase product safety. Setting a national maximum allowable limit for lead in spices and herbal remedies might further reduce the risk for lead exposure from these substances. PMID: 30462630 DOI: 10.15585/mmwr.mm6746a2 [Indexed for MEDLINE] Free full text

Demographic histories and genetic diversity across pinnipeds are shaped by human exploitation, ecology and life-history.

Nat Commun. 2018 Nov 16;9(1):4836. doi: 10.1038/s41467-018-06695-z. Stoffel MA1,2, Humble E1,3, Paijmans AJ1, Acevedo-Whitehouse K4, Chilvers BL5, Dickerson B6, Galimberti F7, Gemmell NJ8, Goldsworthy SD9, Nichols HJ2,10,11, Krüger O1, Negro S12,13, Osborne A14, Pastor T15, Robertson BC16, Sanvito S7, Schultz JK17, Shafer ABA18, Wolf JBW19,20, Hoffman JI21,22. Author information 1 Department of Animal Behaviour, Bielefeld University, Postfach 100131, 33501, Bielefeld, Germany. 2 School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, L3 3AF, UK. 3 British Antarctic Survey, High Cross, Madingley Road, Cambridge, CB3 OET, UK. 4 Unit for Basic and Applied Microbiology, School of Natural Sciences, Autonomous University of Queretaro, Avenida de las Ciencias S/N, Queretaro, 76230, Mexico. 5 Wildbase, Institute of Veterinary, Animal and Biomedical Science, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand. 6 National Marine Mammal Laboratory, Alaska Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration, Seattle, 98115, WA, USA. 7 Elephant Seal Research Group, Sea Lion Island, FIQQ 1ZZ, Falkland Islands. 8 Department of Anatomy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. 9 South Australian Research and Development Institute, West Beach, SA, 5024, Australia. 10 Department of Animal Behaviour Bielefeld University, Postfach 100131 33501, Bielefeld, Germany. 11 Department of Biosciences, Swansea University, Swansea, SA2 8PP, UK. 12 UMR de Génétique Quantitative et Évolution - Le Moulon, INRA, Université Paris-Sud, CNRS, AgroParisTech, Université Paris-Saclay, Gif-sur-Yvette, 91190, France. 13 GIGA-R, Medical Genomics - BIO3, Université of Liège, Liège, 4000, Belgium. 14 School of Biological Sciences, University of Canterbury, Private Bag 4800, Christchurch, New Zealand, 8140. 15 EUROPARC Federation, Carretera de l'Església, 92, 08017, Barcelona, Spain. 16 Department of Zoology, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. 17 National Marine Fisheries Service, National Oceanic and Atmospheric Administration, 1315 East West Highway, Silver Spring, MD, 20910, USA. 18 Forensic Science & Environmental Life Sciences, Trent University, Peterborough, ON, Canada, K9J 7B8. 19 Division of Evolutionary Biology, Faculty of Biology, LMU Munich, Planegg-Martinstried, Munich, 82152, Germany. 20 Science of Life Laboratory and Department of Evolutionary Biology, Uppsala University, Uppsala, 752 36, Sweden. 21 Department of Animal Behaviour, Bielefeld University, Postfach 100131, 33501, Bielefeld, Germany. 22 British Antarctic Survey, High Cross, Madingley Road, Cambridge, CB3 OET, UK. Abstract A central paradigm in conservation biology is that population bottlenecks reduce genetic diversity and population viability. In an era of biodiversity loss and climate change, understanding the determinants and consequences of bottlenecks is therefore an important challenge. However, as most studies focus on single species, the multitude of potential drivers and the consequences of bottlenecks remain elusive. Here, we combined genetic data from over 11,000 individuals of 30 pinniped species with demographic, ecological and life history data to evaluate the consequences of commercial exploitation by 18th and 19th century sealers. We show that around one third of these species exhibit strong signatures of recent population declines. Bottleneck strength is associated with breeding habitat and mating system variation, and together with global abundance explains much of the variation in genetic diversity across species. Overall, bottleneck intensity is unrelated to IUCN status, although the three most heavily bottlenecked species are endangered. Our study reveals an unforeseen interplay between human exploitation, animal biology, demographic declines and genetic diversity. PMID: 30446730 PMCID: PMC6240053 DOI: 10.1038/s41467-018-06695-z Free PMC Article Share on FacebookShare on TwitterShare on Google+

Effects of Probiotics on Necrotizing Enterocolitis, Sepsis, Intraventricular Hemorrhage, Mortality, Length of Hospital Stay, and Weight Gain in Very Preterm Infants: A Meta-Analysis.

Adv Nutr. 2017 Sep 15;8(5):749-763. doi: 10.3945/an.116.014605. Print 2017 Sep. Sun J1,2, Marwah G1, Westgarth M1, Buys N2, Ellwood D1,2,3, Gray PH4,5. Author information 1 School of Medicine, Griffith University, Gold Coast, Queensland, Australia. 2 Menzies Health Institute, Gold Coast, Queensland, Australia. 3 Gold Coast University Hospital, Gold Coast, Queensland, Australia. 4 Mater Mothers' Hospital, Brisbane, Queensland, Australia. 5 Mater Research Institute-University of Queensland, Brisbane, Queensland, Australia. Abstract Probiotics are increasingly used as a supplement to prevent adverse health outcomes in preterm infants. We conducted a systematic review, meta-analysis, and subgroup analysis of findings from randomized controlled trials (RCTs) to assess the magnitude of the effect of the probiotics on health outcomes among very-low-birth-weight (VLBW) infants. Relevant articles from January 2003 to June 2017 were selected from a broad range of databases, including Medline, PubMed, Scopus, and Embase. Studies were included if they used an RCT design, involved a VLBW infant (birthweight <1500 g or gestational age <32 wk) population, included a probiotic intervention group, measured necrotizing enterocolitis (NEC) as a primary outcome, and measured sepsis, mortality, length of hospital stay, weight gain, and intraventricular hemorrhage (IVH) as additional outcomes. The initial database search yielded 132 potentially relevant articles and 32 (n = 8998 infants) RCTs were included in the final meta-analysis. Subgroup analysis was used to evaluate the effects of the moderators on the outcome variables. In the probiotics group, it was found that NEC was reduced by 37% (95% CI: 0.51%, 0.78%), sepsis by 37% (95% CI: 0.72%, 0.97%), mortality by 20% (95% CI: 0.67%, 0.95%), and length of hospital stay by 3.77 d (95% CI: -5.94, -1.60 d). These findings were all significant when compared with the control group. There was inconsistent use of strain types among some of the studies. The results indicate that probiotic consumption can significantly reduce the risk of developing medical complications associated with NEC and sepsis, reduce mortality and length of hospital stay, and promote weight gain in VLBW infants. Probiotics are more effective when taken in breast milk and formula form, consumed for <6 wk, administered with a dosage of <109 CFU/d, and include multiple strains. Probiotics are not effective in reducing the incidence of IVH in VLBW infants. KEYWORDS: hospital admission; mortality; necrotizing enterocolitis; probiotics; sepsis; very preterm infants PMID: 28916575 PMCID: PMC5593111 DOI: 10.3945/an.116.014605 [Indexed for MEDLINE] Free PMC Article

Blackmore Foundation's record $10m gift to Southern Cross University Marcus Blackmore AM, together with his wife, Caroline, has made a record $10 million personal donation to Southern Cross University to help establish the National Centre for Naturopathic Medicine. One of Australia’s leading figures in naturopathic medicine, Marcus Blackmore AM, together with his wife, Caroline, has made a record $10 million personal donation to Southern Cross University. It is both the largest, single donation ever given to the University and the largest personal gift to a university from The Blackmore Foundation. For Mr Blackmore the significance lies in the final wish of his father, the late Maurice Blackmore, that Naturopathy be properly recognised and respected as a profession. “We have a responsibility to respond to the growing health care needs of Australia and evidence-based natural medicine will play an increasingly active role in that regard.” Vice Chancellor Professor Adam Shoemaker said the gift would be used to establish a National Centre for Naturopathic Medicine at Southern Cross University to engage in naturopathic medicine higher education, research, and engagement with the profession. “We aim to establish an internationally-recognised centre of excellence in naturopathic medicine education and associated research. We are proud to be the first Australian university to offer higher education qualifications in Naturopathy. This will enable Southern Cross to provide distinctive career pathways and ongoing development for the profession, as well as increased research capability,” said Professor Shoemaker. Mr Blackmore added, “This is a very special day for Caroline and myself, both in helping to achieve my father’s legacy, and my own passion to see the continued advancement of Naturopathic education and critical health research in this country." VC Prof Adam Shoemaker said the @Blackmores Foundation gift would create a National Centre for #NaturopathicMedicine “We have a responsibility to respond to the growing health care needs of Australia and evidence-based natural medicine will play an increasingly active role in that regard.” Natural medicine and nutrition-led treatment are already used extensively to address a range of contemporary health issues ranging from obesity through to the demands of an ageing population. Southern Cross has been a leader in complementary medicine tertiary education since the university was founded 25 years ago. Mr Blackmore has had a long association with the university, receiving an honorary doctorate in 2006 and serving on the Southern Cross University Foundation board. The commitment to Southern Cross University is in keeping with the principles of the late Maurice Blackmore, who founded the Blackmores company that grew from a tiny dispensary in Queensland to become Australia’s leading brand in vitamin and dietary supplements. As a Naturopath, Maurice believed in a more natural approach to health, based on applied expertise in vitamins, minerals, herbs and nutrients. A belief shared by Marcus. Professor Shoemaker said the combination of Marcus Blackmore’s passion and belief along with the University’s evidence-based research rigour would be formidable. “We are excited by the possibilities that the Blackmores’ vision will open up and we thank Marcus and Caroline for their generosity.” Work begins immediately on the new centre with a planned opening in 2019.

Is cupping therapy effective in patients with neck pain? A systematic review and meta-analysis

Complementary medicine Research Seoyoun Kim1,2, Sook-Hyun Lee1, Me-Riong Kim3, Eun-Jung Kim4, Deok-Sang Hwang5, Jinho Lee6, Joon-Shik Shin6, In-Hyuk Ha3, Yoon Jae Lee1 Author affiliations Abstract Objectives Neck pain is a significant condition that is second only to depression as a cause of years lived with disability worldwide. Thus, identifying and understanding effective treatment modalities for neck pain is of heightened importance. This systematic review aimed to investigate the effects of cupping on neck pain from the current literature. Design Systematic review and meta-analysis of randomised controlled trials (RCTs). Setting Nine databases, including Chinese, Korean and Japanese databases, were searched for data up to January 2018 with no restrictions on publication language. Participants Patients with neck pain. Interventions Cupping therapy as the sole or add-on intervention compared with no treatment or active controls. Primary and secondary outcome measures Pain severity, functional disability and quality of life. Results Eighteen RCTs were selected. Compared with the no intervention group, the cupping group exhibited significant reduction in pain (mean difference (MD) −2.42(95% CI −3.98 to −0.86)) and improvement in function (MD −4.34(95% CI −6.77 to −1.19)). Compared with the active control, the cupping group reported significant reduction in pain (p=0.0009) and significantly improved quality of life (p=0.001). The group that received control treatment with cupping therapy (add-on group) displayed significant pain reduction compared with the active control group (p=0.001). Of the 18 studies, only 8 reported occurrence of adverse events, which were mostly mild and temporary. Conclusions Cupping was found to reduce neck pain in patients compared with no intervention or active control groups, or as an add-on treatment. Depending on the type of control group, cupping was also associated with significant improvement in terms of function and quality of life; however, due to the low quality of evidence of the included studies, definitive conclusions could not be drawn from this review. Future well-designed studies are needed to substantiate the effectiveness of cupping on neck pain. PROSPERO registration number CRD42016047218. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: Statistics from Article has an altmetric score of 17 See more details Tweeted by 20 On 1 Facebook pages Mentioned in 3 Google+ posts Request Permissions Strengths and limitations of this study This systematic review investigated the effectiveness of cupping in treating pain, and placed no restrictions on publication language. This study employed stringent inclusion and exclusion criteria, and nine databases were accordingly searched for randomised controlled trials. The analysis addressed functional improvement, quality of life and safety of cupping, and risk of bias and levels of evidence. The results of data synthesis may be limited due to the heterogeneity and low quality of evidence of selected studies. Introduction A recent WHO study of the 20 major causes of years lived with disability (YLD) from 2000 to 2012 worldwide reported that neck pain is the second leading cause of YLD.1 One study of patients in the Netherlands showed that neck pain was associated with 1% of total medical expenditure and 0.1% of gross domestic product, 77% of which comprised indirect medical expenses associated with absence from work or disability expenses.2 Prevalence of neck pain is directly associated with escalated medical costs and negative impact on productivity, potentially increasing long-term absences from work. The lifelong prevalence of neck pain in adults ranges from 14.2% to 71%, although this rate varies greatly across studies.3 Neck pain can easily progress to chronic conditions, with approximately 25% to 60% of patients developing chronic back or neck pain within the first year.4 Additionally, neck pain is reported to be most prevalent in high activity age groups, particularly individuals aged 35 to 49 years,5 and is also more common in women.3 Standard first-line therapy for neck pain can be largely divided into pharmacological and non-pharmacological therapies. Pharmacological treatment frequently involves use of acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). However, acetaminophen and NSAIDs are known to increase risk of reduced liver function, liver failure and haemorrhagic gastritis,6 and side effects may be more common when these drugs are used long-term for chronic neck pain. For these reasons, many studies have investigated the clinical effectiveness of complementary medicine therapies, including acupuncture for chronic pain conditions.7 One type of complementary therapy that can be used for neck pain is cupping. Cupping is a physical treatment, typically used by acupuncturists and other complementary medicine therapists, that uses glass or plastic cups placed on the skin over a painful area or acupuncture point to create negative pressure through suction. The rationale for use of cupping is not yet fully understood; it is described as a detoxification process by which waste matter and toxins are removed, and as a harmonisation process for the imbalance of Qi, a traditional Chinese medicine term for ‘vital energy’.8 Cupping has been used globally for several thousand years, particularly in countries such as Egypt and China.8 Today, cupping is widely used as a holistic treatment in Europe for inpatient care and the prevention and treatment of various disorders, as well as for promotion of general health.9 In South Korea, cupping is a popular treatment, and is covered by national health insurance; in 2013 alone, insurance claims for cupping reached a total 215 billion Korean won.10 There are two types of cupping: dry and wet. Dry cupping is a technique in which cups are applied to the skin to create a vacuum for suction without drawing blood, whereas in wet cupping, blood is drawn with scarification before applying the cups for blood-letting. Cupping therapy is used for poststroke rehabilitation and hypertension, and has been reported to be effective for treating pain and musculoskeletal disorders.11 12 A systematic literature review published by Yuan et al in 2015 reviewed the effects of cupping on neck pain, reporting that cupping is effective for reducing pain and improving function.13 However, only articles published up to 2013 were included in that review, and as new clinical trials investigating cupping for neck pain have since been published, an updated systematic review on the topic is needed. Moreover, Yuan et al 13 restricted the publication language to include only English and Chinese language articles. Therefore, the aim of this study was to assess current evidence of cupping for neck pain and better understand its effects on pain, function, quality of life (QoL) and safety through the review of randomised controlled trials (RCTs). To conduct a more extensive review, no restrictions were placed on publication language, and studies in English, Korean, Japanese and Chinese were included. Methods The protocol of this systematic literature review was registered in the PROSPERO international prospective register of systematic reviews (CRD42016047218). This review was performed and reported in adherence with the Preferred Reporting Items for Systematic Reviews and Meta Analyses.14 Literature search Studies that used cupping as an intervention for neck pain were searched in the Ovid-Medline (1946 to January 2018), Ovid-EMBASE (1980 to January 2018), Ovid-Allied and Complementary Medicine (AMED) (1985 to December 2017) and the Cochrane Central Register of Controlled Trials up to 9 January 2018. The Chinese database China National Knowledge Infrastructure, Korean databases Oriental Medicine Advanced Searching Integrated System and National Discovery for Science Leaders and Japanese databases J-stage and ISHUSHI were also used. Search terms included a combination of Medical Subject Headings (MeSH) terms such as neck pain (eg, neck pain, cervical spondylosis, cervical radiculopathy, cervical disc herniation and myofascial pain syndrome) and cupping. Details of the search strategy are presented in online supplementary appendix 1. The publication language of study articles was not restricted. Supplementary data [bmjopen-2017-021070-SP1.pdf] Study inclusion and exclusion Two or more investigators (YJL, SK and/or SHL) independently selected articles for analysis from the searched articles. After excluding duplicate publications, titles and abstracts were reviewed to primarily screen for articles according to the inclusion and exclusion criteria. The full texts of these articles were then reviewed for secondary screening of articles per inclusion and exclusion criteria. Only RCTs were considered. Any disagreement in the study selection process was resolved by discussion, and when an agreement was not reached, a third investigator intervened to reach consensus. Study subjects included adult patients with neck pain, including neck pain with neuropathy, and the authors did not discriminate between acute and chronic phases of neck pain. However, post-traumatic pain caused by whiplash or sports injuries was excluded as the natural history of neck pain may differ in such cases. Furthermore, patients with myelopathy or cervical headache/vertigo without neck pain were also excluded. All types of cupping therapies were included without restriction regarding dry or wet cupping, and the type of cupping device was not limited. Control groups included patients who underwent usual care for neck pain, such as physical therapy, NSAIDs, heat pack therapy and acupuncture,15–17 as well as inactive controls, such as waiting lists or no intervention groups. The outcome variables assessing the effectiveness of cupping included pain intensity, neck disability indexes and QoL. Pain intensity was measured using the visual analogue scale (VAS), the McGill Pain Questionnaire and the Northwick Park Neck Pain Questionnaire (NPQ). The Neck Disability Index (NDI) was generally used to evaluate neck function disability. QoL was assessed using the 36-item Short-form (SF-36) and EuroQol-5 Dimension (EQ-5D) questionnaires. However, studies that did not use objective instruments and reported outcomes in terms of improvement rates without standards, and investigations that used instruments without confirmation of reliability and validity were excluded. Risk of bias evaluation and data extraction Risk of bias in the RCTs was assessed by seven categories according to the Cochrane Risk of Bias. Studies that used appropriate methods for each item and specified the methods in the text were considered to have low risk of bias; studies that did not perform the relevant item or used inappropriate methods were considered to have high risk of bias; and studies that did not mention specific methods or used ambiguous expressions to describe the methods for each item were considered to have an unclear risk of bias. Two or more investigators independently assessed all research data, and disagreements were resolved through discussion. When an agreement could not be reached, a third investigator intervened to reach consensus. Two reviewers independently read the full text of all articles and extracted data according to a predetermined format. Any disagreements were resolved by discussion between the two reviewers. Data analysis A meta-analysis was performed using quantitative data from each study to assess the effectiveness of cupping. The mean difference (MD) and 95% CIs were calculated using the Cochrane Collaboration software (Review Manager (RevMan) V.5.3, Copenhagen: The Nordic Cochrane Centre) for Windows (Microsoft Corporation, Redmond, Washington, USA). Heterogeneity across studies was assessed using the χ2 test with a significance level of p<0.10 and I2 statistics. When heterogeneity was statistically significant, the cause of heterogeneity was analysed through subgroup analysis. Sensitivity analyses were also conducted to test the robustness of results by determining the impact of a single study on overall results. If statistical heterogeneity was found, sensitivity analyses (by eliminating one study at a time) were performed to explore possible reasons for the heterogeneity. A random effects model was applied, and publication bias was not assessed when the number of studies in the group was <10. Quality of evidence The quality of evidence for each outcome was assessed in accordance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Quality of evidence was classified into high, moderate, low and very low. To determine the quality of evidence, the following domains were assessed according to the standards suggested by the GRADE group: risk of bias, imprecision, inconsistency, indirectness, publication bias, large magnitude of effect, dose–response and confounding.18 Patient and public involvement Patients and public were not involved in the development of the research question and outcome measures or design of this study, or recruitment to and conduct of the study as a systematic review and meta-analysis. There are no plans for the results to be disseminated directly to study participants. Results Search results A total of 541 articles were retrieved, including 86 from Ovid-Medline, 137 from Ovid-EMBASE, 19 from Ovid-AMED, 43 from the Cochrane Library, 193 from a Chinese database, 47 from Korean databases and 16 from Japanese databases. Following the first and second rounds of screening, a total of 18 articles were selected for review. The search results are shown in figure 1. Figure 1 Download figure Open in new tab Download powerpoint Figure 1 PRISMA flow diagram of the literature search. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta Analyses. Features of the included studies A total of 18 studies were analysed in two separate analyses19–36: direct comparison of the cupping (sole) and control groups; and an add-on analysis comparing the control with cupping group with the control only group. Two studies used three groups; 15 studies were included in the sole analysis while five studies were included in the add-on analysis. Seven19 21 23 26–28 34 of the 18 studies used wet cupping while 11 studies used dry cupping. The frequency of cupping therapy varied greatly. Two studies performed only one round of therapy, and four conducted two to four rounds. The majority of studies conducted >10 rounds of therapy because most patients who were treated had neck pain with radiculopathy or chronic neck pain. The region of administration was typically the upper shoulder and neck area, and cupping was primarily administered to Ashi or other proximal acupoints. As these studies mainly treated pain, most presented pain scores in the form of VAS scores; disability was presented in NDI scores, while QoL was mostly reflected in responses to the EQ-5D and SF-36 questionnaires. The features of each study are presented in table 1. VIEW INLINE VIEW POPUP Table 1 Characteristics of the included studies Risk of bias assessment Random sequence Seven of the 18 studies20 22–25 27 28 were assessed to have low risk of bias as they randomly allocated the subjects using a table of random numbers. One study did not specify the randomisation method, and the group sizes notably varied, that is, 68, 56 and 59; this study was thus assessed to have high risk of bias.26 The remaining 10 studies, however, only mentioned randomly assigning subjects without specifying the method used for randomisation; thus, these studies were assessed to have an unclear risk of bias. The results are shown in figure 2. Figure 2 Download figure Open in new tab Download powerpoint Figure 2 Risk of bias in the included studies, as assessed using the Cochrane Collaboration’s risk of bias tool. +, high risk of bias; ?, unclear risk of bias; -, low risk of bias. Allocation concealment Nine20 22 24–26 28–31 studies concealed allocation using a sealed envelope, and thus were considered to have low risk of bias. The remaining studies were determined to be unclear as they did not describe the method of allocation concealment used. Blinding Control groups were either waiting list controls or active controls. Although efforts have been made to develop a sham version of cupping,37 blinding is difficult given that sham cupping is not often used. Chi et al 29 described single blinding; however, it was difficult to assess whether blinding was actually implemented. Hence, all studies were considered to not have blinded their investigators and participants. With regard to the blinding of participants and medical personnel, all studies were considered to have high risk of bias. Similarly, blinding of outcome assessors could not be performed in most studies as many used VAS for pain measurement and patient-reported outcomes. Blinding of outcome assessors would have been made feasible if the studies had used physician-reported outcomes or other outcome variables measured by the examiner; however, such studies were found lacking. Therefore, all studies were considered to have high risk of bias. Incomplete outcome data Seven20 22 24 25 27 30 31 studies reported the number of excluded and withdrawn participants, and the number of participants included for final analysis. It was decided that the number of withdrawn participants and the reasons for withdrawal were not a cause of bias; therefore, these studies were considered to have low risk of bias. One study was regarded to possess a high risk of bias as 33 participants from the intervention group and 27 from the control group dropped out after only one session of treatment.26 The remaining studies were determined to be unclear for not mentioning the number of participants who withdrew or were excluded. Selective reporting Ten20 22 24 25 27 29–31 of the 18 studies were determined to have unclear risk of bias regarding selective reporting as they did not describe adverse events (AEs) nor did they register the trial protocols. The remaining eight studies were found to have reported all outcome variables initially planned to be investigated, and thus were determined to have low risk of bias. Other biases All studies were assessed to have low risk of other biases. Analysis Cupping versus no treatment Pain Five studies were included in the meta-analysis.20 29–32 Compared with the no intervention group, the cupping group reported significant reduction in pain with an MD of −2.42 (95% CI −3.98 to −0.86). Considerable heterogeneity was observed (I2=93%; p<0.00001 (χ2 test)); however, the study by Chi et al 29 showed a statistically outlying effect size; a sensitivity analysis was conducted with the study omitted, and resulted in an MD of −1.48 (95% CI −1.86 to −1.10; I2=0%; p=0.57) with the heterogeneity resolved. Disability Three studies were included in the analysis.20 30 31 Results revealed that the cupping group reported significant functional improvement compared with the no intervention group with an MD of −4.34 (95% CI −6.77 to −1.91; I2=6%; p=0.35). Quality of life Three studies were included in the analysis,20 30 31 and results showed that the cupping group indicated significant improvement in the mental component summary of SF-36, with an MD of 5.32 (95% CI 0.83 to 9.80; I2=32%; p=0.23). No statistical significance was found in terms of the physical component summary of SF-36 with an MD of 2.46 (95% CI −0.36 to 5.29) (figure 3). Figure 3 Download figure Open in new tab Download powerpoint Figure 3 Forest plots demonstrating the effect of cupping as the sole intervention versus no treatment on neck pain. Cupping versus active control Pain Ten studies were included in the analysis.21–28 34 35 Of these 10 studies, 9 reported the outcome in VAS, while one study reported NPQ scores.21 In analysis of the nine studies, the cupping group exhibited significant reduction in pain with an MD of −0.89 (95% CI −1.42 to −0.37; p=0.0009) compared with the control group. The χ2 test, however, revealed some heterogeneity (p<0.00001; I2=88%). In order to resolve the heterogeneity, studies were analysed separately depending on the type of cupping: either wet (with scarification) or dry. Meta-analysis of three studies conducted with dry cupping indicated an MD of −1.50 (95% CI −2.28 to −0.72; I2=28%; p=0.25). On the other hand, analysis of studies with wet cupping showed an MD of −0.70 (95% CI −1.32 to −0.07; I2=92%; p<0.00001) with unresolved heterogeneity. Omission of the study by Zhou28—which had a notably large effect size—resulted in an MD of −0.49 (95% CI −0.78 to −0.20) with I2=-35%, p=0.19, implying that the heterogeneity was considerably resolved. The single study that reported outcomes with NPQ indicated an MD of 3.59 (95% CI 2.02 to 5.16), suggesting that cupping significantly decreased pain compared with the control. Disability Four studies were included in the analysis.22 24–26 Compared with the control, the cupping group demonstrated functional improvement, with an MD of −4.36 (95% CI −8.67 to −0.04; p=0.05), but not to a statistically significant degree, and substantial heterogeneity was identified (I2=62%; p=0.05). Quality of life Two studies were included in this analysis.22 25 Compared with the control, the cupping group reported significant improvement in the physical component summary of SF-36, with an MD of 5.44 (95% CI 2.09 to 8.78; p=0.001). However, statistically significant differences were not found for the mental component summary of SF-36 with an MD of 0.44 (95% CI −4.05 to 4.93) (figure 4). The study by Kim et al reported EQ-5D outcomes as median values, and therefore inclusion for meta-analysis was not feasible. In this study, the cupping group and control reported identical median values of 0.91, suggesting no statistical difference. Figure 4 Download figure Open in new tab Download powerpoint Figure 4 Forest plots demonstrating the effect of cupping as the sole intervention versus active control on neck pain. Cupping with active control versus active control (add-on) Pain Five studies were included in the analysis.19 26 33 35 36 Adding cupping therapy to the treatment administered in the control group led to significant reduction in pain, with an MD of −0.87 (95% CI −1.14 to −0.61; p<0.00001). Disability Only one study reported a disability-related outcome,26 and the effect on disability was not significant, with an MD of 3.61 (95% CI −3.93 to 11.15; p=0.35). Heterogeneity was not identified (I2=19%; p=0.29) (figure 5). Figure 5 Download figure Open in new tab Download powerpoint Figure 5 Forest plots demonstrating the effect of cupping as an add-on intervention on neck pain. Safety of cupping Ten of the 18 studies included in the final analysis did not address safety, while eight studies did. First, Kim et al 24 reported skin laceration (n=1), whole body itching (n=1), pain at the cupping sites (n=1) and generalised body ache (n=1) in four patients in the cupping group; however, the study reported that the symptoms were mild and resolved within a few days. Lauche et al 31 reported one case of pain during the procedure itself in addition to tension headache, migraine, tinnitus and wound healing itches; however, all side effects were mild and temporary. Chi et al 29 reported two cases of mild low back pain due to the seated position in the cupping group. Lauche et al 25 reported muscular tension (n=1), increased pain (n=1) and prolapsed intervertebral disc (n=1). While prolapsed intervertebral disc should be regarded as a severe event, the original authors stated that a causal relationship was unlikely. Lauche et al 30 reported tingling sensation in the hands and arms (n=1), strain/pain at the treated area (n=2), strain/pain in the general neck region (n=1), slight headache (n=1), tiredness (n=1), shivering attack (n=1) and blurred vision (n=1). Lauche et al 30 reported that all symptoms subsided within 4 hours, and that the causal relationship with cupping was unclear. Yin et al 27 reported one case of delayed wound healing due to wet cupping. Cramer et al 22 reported muscle soreness (n=2), minor haematoma (n=1) and increased neck pain for 1 hour to 5 hours (n=2). In the study by Saha et al,20 two participants complained of headache that resolved within 1 hour. One participant suffered upper back pain, which subsided within days, and one participant reported slight dizziness. Although one case of lipoma was identified during the trial, it did not have any causal relationship with cupping, as reported by the authors. Levels of evidence The qualityof evidence for each analysis is shown in table 2. In the waiting list comparison, the quality of evidence for the outcomes of pain, QoL and disability was assessed to be low to very low due to concerns regarding risk of bias, imprecision and inconsistency. In the active control comparison, the quality of evidence for pain and QoL was low due to risk of bias and imprecision, and that for disability was assessed to be very low due to risk of bias, imprecision and unexplained heterogeneity. In the add-on comparison between the active control and active control with cupping groups, the quality of evidence for pain in the dry cupping add-on group was low due to risk of bias and unexplained heterogeneity. The quality of evidence for pain outcomes was very low. The quality of evidence for disability outcomes in the add-on groups was low due to risk of bias and imprecision (table 2). VIEW INLINE VIEW POPUP Table 2 Meta-analysis of outcomes and level of evidence Discussion The present study aimed to assess the evidence supporting the effectiveness of cupping for neck pain through a comprehensive systematic literature review. We performed a systematic and inclusive search in non-Asian and Asian databases, including those based in China, Korea and Japan, where cupping is popular and widely used. Eighteen articles were selected and analysed according to the type of control group used. When compared with inactive controls, cupping significantly reduced pain, and improved function and QoL. However, the heterogeneity between studies was quite high in terms of pain reduction, and the quality of evidence was lowered as a consequence. As one study, by Chi et al,29 reported a considerably large effect size, the heterogeneity was resolved when this study was omitted in the sensitivity analysis. Although in most studies the quality of evidence was found to be low to very low, the marked pain reduction and improvement in function and QoL found to be associated with cupping may be clinically relevant. When compared with active controls, the cupping group exhibited significant reduction in pain but no significant differences in functional improvement. Analysis in pain outcomes found an MD of −0.89 (95% CI −1.42 to −0.37); however, heterogeneity was high and subgroup analysis was thus performed. Effect sizes were similar across studies using dry cupping but varied greatly across studies using wet cupping; omission of the study by Zhou et al 28 resolved the heterogeneity. Additional analyses are needed to clarify whether the differences between studies can be attributed to different types of wet cupping procedures or whether other sociopsychological factors were involved. Wet cupping involves drawing blood before cupping, and, despite being accepted in some cultures, may not be tolerated in others. Furthermore, the intensity of the procedure and amount of bleeding may also have affected study outcomes, which may have further contributed to the varying effect sizes. Alternatively, the type and frequency of procedures and patient pain severity could contribute to varying effect sizes. When used to compliment existing treatments, cupping was found to significantly reduce pain, with an MD of −0.87 (95% CI −1.14 to −0.61). However, in addition to statistical significance, the effect size of a treatment should be assessed for clinical significance. Based on four studies of cupping, Lauche et al 38 proposed the minimal clinically important difference (MCID) of VAS to be −8 (−0.8 of a 10-point scale), the NDI to be −3 and the physical component summary of SF-36 to be +5.1. From the current meta-analysis, cupping exhibited an MD of −2.42 compared with the waiting list control, −0.89 compared with the active control and −0.87 as an add-on treatment, which all surpasses the above criteria for the MCID of VAS. With regard to NDI, cupping indicated an MD of between −4.34 and −4.36, depending on the type of control, which also meets the MCID criteria. For the physical component summary, however, cupping failed to display a treatment effect larger than MCID. In contrast, cupping showed an effect size exceeding MCID when compared with the active control, which calls for further investigation. Cupping has been used for several thousand years in such diverse regions as early Egypt and China.8 In traditional Chinese medicine, cupping is widely used to eliminate stagnated Qi and Blood, and facilitate circulation.39 Since ancient times, cupping has been considered to be effective in the local treatment of areas of inflammation.40 A previous review analysing the reported mechanism of cupping suggested that the positive effects of cupping are the result of a haemodynamic mechanism facilitating muscle function, as demonstrated by the reduction of deoxy-haemoglobin and elevated oxy-haemoglobin levels in muscle areas treated with cupping.41 Other studies have suggested that cupping involves a mechanism for removing oxidative stress,42 and produces therapeutic effects through diffuse noxious inhibitory control43; this would contribute to the alleviation of pain. For these reasons, a growing number of clinical trials are investigating the effects of cupping on pain and various disease symptoms. Through the analysis of 135 RCTs on cupping, Cao et al 44 reported that clinical trials of wet cupping have been conducted in association with various disorders such as herpes zoster, facial paralysis, cough/dyspnoea and acne. A more recent systematic review investigated cupping in relation to overall disease45; however, although the analysis included some articles pertaining to neck pain, it did not focus on the condition. In another systematic literature review on the efficacy of cupping for lower back pain, cupping was found to lead to significant reductions in pain and improvement of function.13 46 Only one previous review has specifically evaluated the effect of cupping on neck pain, but that review was published in 2013 and analysed only five trials.13 Therefore, the results of the present study, which included 18 RCTs and did not limit inclusion by language, provide greater clinical relevance and implications. However, this study has several limitations. One significant shortcoming is that only some studies reported issues related to safety. Although severe AEs were not found in association with cupping in the studies that reported side effects, many studies did not report side effects at all. A systematic review investigating the side effects of cupping reported that the most common side effect was scar formation, and there have been some previously reported cases of severe side effects.47 However, adverse reactions to cupping may vary according to the proficiency of the practitioner, type of procedure and disinfection and sterilisation processes implemented during the treatment procedure.47 Certain severe AEs, such as infection, may be preventable as their occurrence can be directly associated with the education, training, experience and proficiency of therapists. Another limitation was the low or very low quality of evidence for all outcomes; this low quality of evidence was primarily caused by risk of bias and unexplained heterogeneity between studies. Additionally, many selected studies did not maintain rigorous standards or procedures regarding allocation and blinding. Furthermore, the outcomes included for analysis in this study were all patient-reported outcomes (ie, pain, disability, QoL), and none of the included studies were designed to assess the placebo effect of cupping. It is possible that the results may have been influenced by the fact that all outcome measures were patient-reported and the lack of blinding. Moreover, all of the included studies, with the exception of a study published by Su et al in 2016,33 were conducted only in patients with chronic neck pain. Whether the therapeutic effect of cupping is dependent on the clinical characteristics (acute vs. chronic) of neck pain remains to be elucidated. Finally, many of the included studies had small sample sizes. Nevertheless, cupping may be an important and cost-effective therapy for the treatment of neck pain. For example, Lauche et al 25 performed a clinical trial on home-based cupping. Due to the increased use of computers and smartphones around the world, the prevalence of neck pain is rising steadily,48 and this type of pain can often develop into chronic pain. Thus, this study is meaningful in that it evaluates a non-invasive, simple and effective treatment modality for patients with chronic pain. Conclusion The current results suggest that cupping may be effective for patients with neck pain in terms of reducing pain and improving function and QoL, when compared with no treatment or active controls. The level of evidence for the findings of the included studies, however, was found to be low or very low, thus preventing strong conclusions from being drawn for the effectiveness of this treatment. Although this study did not identify notable AEs in the articles reviewed, cupping is not without side effects, and further well-designed, large-scale studies employing standardised procedures are needed to thoroughly examine potential adverse effects. 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J Phys Ther Sci 2016;28:1669–72.doi:10.1589/jpts.28.1669 Google Scholar View Abstract Footnotes Contributors SK, M-RK, I-HH and YJL designed the study. SK, S-HL and YJL conducted the systematic search. SK, M-RK and YJL assessed the literature for inclusion and extracted the data. JL, J-SS and IHH monitored data collection. E-JK, D-SH, JL, J-SS and IHH interpreted the data. SK, M-RK, I-HH,and YJL wrote the draft; S-HL, E-JK, D-SH, JL and J-SS critically revised the manuscript. All authors have read and approved the final version. Funding This study was supported by the Traditional Korean Medicine R&D Program funded by the Ministry of Health & Welfare through the Korea Health Industry Development Institute (KHIDI) (HB16C0035). Competing interests None declared. Patient consent Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data sharing statement No additional data are available. 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Regarding your article: Validation of ethnoveterinary medicinal treatments Published in: Veterinary Parasitology

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