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Background and purpose: Large societal costs of stroke should not be ignored. We aimed to estimate patients' productivity losses and informal care costs during the first year after ischemic stroke. Methods: A cross‐sectional survey was performed within the STROKE69 regional population‐based cohort study. At 1 year post‐stroke, each patient and the corresponding main informal caregiver received questionnaires followed by a telephone interview if necessary. Time losses were valued using the human capital approach and proxy good method for patients with and without a professional activity, respectively. Results: Among the 222 patients with ischemic stroke (58% men; mean age 68 years; and 86% with a modified Rankin Scale (mRS) score of <3 at 3 months), 54%, 32%, and 25% received informal, formal, and both cares, respectively. Among the 108 main informal caregivers, 63% were women, 74% lived with the patient, and 57% were retired or unemployed. The mean cost of productivity losses was estimated at €7589 ± €12 305 per patient in the first post‐stroke year with 5.4%, 71.2%, and 23.4% of these being attributed to presenteeism, absenteeism, and leisure time, respectively. Informal care was given at an average of 25 h/week. The annual mean estimated total cost of informal care was €10 635 per caregiver. Conclusions: Informal care and productivity losses of patients with ischemic stroke during the first post‐stroke year represent a significant economic burden for society comparable to direct costs. These costs should be included in economic evaluations with the adoption of a societal perspective to avoid underestimating the societal stroke economic burden. [ABSTRACT FROM AUTHOR]

Syndiniales are a parasitic order within the eukaryotic lineage Dinophyceae ( Alveolata). Here, we analysed the taxonomy of this group using 43655 18S rRNA gene sequences obtained either from environmental data sets or cultures, including 6874 environmental sequences from this study derived from Atlantic and Mediterranean waters. A total of 5571 out of the 43655 sequences analysed fell within the Dinophyceae. Both bayesian and maximum likelihood phylogenies placed Syndiniales in five main groups (I–V), as a monophyletic lineage at the base of ‘core’ dinoflagellates (all Dinophyceae except Syndiniales), although the latter placement was not bootstrap supported. Thus, the two uncultured novel marine alveolate groups I and II, which have been highlighted previously, are confirmed to belong to the Syndiniales. These groups were the most diverse and highly represented in environmental studies. Within each, 8 and 44 clades were identified respectively. Co-evolutionary trends between parasitic Syndiniales and their putative hosts were not clear, suggesting they may be relatively ‘general’ parasitoids. Based on the overall distribution patterns of the Syndiniales-affiliated sequences, we propose that Syndiniales are exclusively marine. Interestingly, sequences belonging to groups II, III and V were largely retrieved from the photic zone, while Group I dominated samples from anoxic and suboxic ecosystems. Nevertheless, both groups I and II contained specific clades preferentially, or exclusively, retrieved from these latter ecosystems. Given the broad distribution of Syndiniales, our work indicates that parasitism may be a major force in ocean food webs, a force that is neglected in current conceptualizations of the marine carbon cycle. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Despite the French pregnancy prevention program (PPP), a considerable number of pregnancies are potentially exposed to oral isotretinoin. New measures were taken by the French Medicines Agency, including the restriction of initial isotretinoin prescriptions to dermatology specialists in May 2015 and a new information campaign on teratogenicity in January 2019.The aims were to: describe, between 2014 and 2021, compliance with PPP recommendations: isotretinoin use as a second‐line treatment, first prescription by a dermatology specialist, monthly prescription renewal and pregnancy testing (PT); assess the effect of the 2015 and 2019 measures on PT compliance; and identify the determinants of PT noncompliance.A retrospective cohort study was conducted among women aged 11–50 years initiating isotretinoin between 2014 and 2021 using the French Health Data System. PT compliance corresponded to pregnancy test completion and specific delays between prescription and dispensation. Time series analyses were performed to evaluate the effect of the 2015 and 2019 measures on PT compliance, and log‐binomial and Poisson multivariate regression models were used to identify the determinants of PT noncompliance.Isotretinoin was prescribed as a second‐line treatment in 64% of initiations, mainly by dermatology specialists (92%). A new monthly prescription was observed in 98% of dispensations. PT compliance reached 61%, 72% and 25% at initiation, renewals and end of treatment, respectively. The 2015 measure was associated with better PT compliance at initiation and renewals. The 2019 measure had no significant effect on PT compliance at the initiation or end of treatment but was associated with a decrease in PT compliance at renewals. Age, low socioeconomic level, initiation by a nondermatology specialist and during summer were associated with PT noncompliance.Understanding factors associated with PT noncompliance could help to target specific subpopulations of women treated with isotretinoin. [ABSTRACT FROM AUTHOR]