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Abstract California produces many key agricultural products in the United States. Current geospatial agricultural datasets are limited in mapping accuracy, spatial context, or observation period. This study uses machine learning and high‐resolution imagery to produce a time series of crop maps to assess crop type trends and patterns across central California from 2005 to 2020. National Agriculture Imagery Program and Landsat imagery were used to classify nine crop types that are common in the study region: grain crops, field crops, rice, citrus and subtropical, deciduous fruit and nut, vineyard, berry and vegetable, pasture, and fallow/young perennial crop types. To create labeled data, we sampled 1253 fields and manually identified crop types for each examined year using high‐resolution imagery and Landsat normalized difference vegetation index time series. We applied a random forest machine learning algorithm in Google Earth Engine. Results show that the mean overall classification accuracy of the nine‐class map was 93.1%, with individual accuracies ranging from 99.3% (rice) to 89.5% (fallow/young perennial). Mann–Kendall trend tests showed significant (p

Abstract Background Currently, there is no evidence-based hormonal treatment for migraine in women. Several small studies suggest a beneficial effect of combined oral contraceptives, but no large randomized controlled trial has been performed. As proof of efficacy is lacking and usage may be accompanied by potentially severe side effects, there is a great need for clarity on this topic. Methods Women with menstrual migraine (n = 180) are randomly assigned (1:1) to ethinylestradiol/levonorgestrel 30/150 μg or vitamin E 400 IU. Participants start with a baseline period of 4 weeks, which is followed by a 12-week treatment period. During the study period, a E-headache diary will be used, which is time-locked and includes an automated algorithm differentiating headache and migraine days. Results The primary outcome will be change in monthly migraine days (MMD) from baseline (weeks − 4 to 0) to the last 4 weeks of treatment (weeks 9 to 12). Secondary outcomes will be change in monthly headache days (MHD) and 50% responder rates of MMD and MHD. Conclusions The WHAT! trial aims to investigate effectivity and safety of continuous combined oral contraceptive treatment for menstrual migraine. Immediate implementation of results in clinical practice is possible. Trial registration Clinical trials.gov NCT04007874 . Registered 28 June 2019.

BackgroundAnti-CGRP-(receptor-)monoclonal antibodies (anti-CGRP(R)-mAbs) represent a novel class of drugs for migraine treatment, but their long-term cerebrovascular and cardiovascular (CV) safety warrants further examination.MethodsIn this observational cohort study we assessed the CV safety for erenumab and fremanezumab in a real-world setting during a follow-up period of at least 1 year. Patients with hypertension or CV history were excluded. We conducted ECGs and collected clinical data at treatment initiation and thereafter every 3 months, including liver and kidney function, lipid-, electrolyte-and glucose levels.ResultsAmong patients receiving erenumab (n = 101) or fremanezumab (n = 92), 3.1% (6/193) developed abnormal ECGs or CV adverse events. Of these, three (1.6%) experienced moderate to severe CV adverse events (cerebellar stroke, spontaneous coronary artery dissection, and pericarditis) and discontinued treatment. The remaining three (1.6%) developed non-threatening ECG abnormalities without physical complaints. No significant changes were observed in liver and kidney function, lipid-, electrolyte-, or glucose levels.DiscussionWe observed CV events in 1.6% of patients with 1.5-year follow-up of anti-CGRP(R)-mAbs treatment. We advise awareness regarding CV events in patients with migraine undergoing CGRP-targeted treatment, not as a confirmation of increased risk but as a proactive measure to address potential multifactorial influences.

BackgroundThe early life factors of birthweight, child weight, height, body mass index (BMI) and pubertal timing are associated with risks of breast cancer. However, the predictive value of these factors in relation to breast cancer is largely unknown. Therefore, using a machine learning approach, we examined whether birthweight, childhood weights, heights, BMIs, and pubertal timing individually and in combination were predictive of breast cancer.MethodsWe used information on birthweight, childhood height and weight, and pubertal timing assessed by the onset of the growth spurt (OGS) from 164,216 girls born 1930-1996 from the Copenhagen School Health Records Register. Of these, 10,002 women were diagnosed with breast cancer during 1977-2019 according to a nationwide breast cancer database. We developed a feed-forward neural network, which was trained and tested on early life body size measures individually and in various combinations. Evaluation metrics were examined to identify the best performing model.ResultsThe highest area under the receiver operating curve (AUC) was achieved in a model that included birthweight, childhood heights, weights and age at OGS (AUC = 0.600). A model based on childhood heights and weights had a comparable AUC value (AUC = 0.598), whereas a model including only childhood heights had the lowest AUC value (AUC = 0.572). The sensitivity of the models ranged from 0.698 to 0.760 while the precision ranged from 0.071 to 0.076.ConclusionWe found that the best performing network was based on birthweight, childhood weights, heights and age at OGS as the input features. Nonetheless, this performance was only slightly better than the model including childhood heights and weights. Further, although the performance of our networks was relatively low, it was similar to those from previous studies including well-established risk factors. As such, our results suggest that childhood body size may add additional value to breast cancer prediction models.

Abstract Background Associations of birthweight, childhood body size and pubertal timing with breast cancer risks by menopausal status and tumor receptor subtypes are inconclusive. Thus, we investigated these associations in a population-based cohort of Danish women. Methods We studied 162,419 women born between 1930 and 1996 from the Copenhagen School Health Records Register. The register includes information on birthweight, measured childhood weights and heights at the age of 7–13 years, and computed ages at the onset of the growth spurt (OGS) and at peak height velocity (PHV). The Danish Breast Cancer Cooperative Group database provided information on breast cancer (n = 7510), including estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2) and menopausal status. Hormone replacement therapy use came from the Danish National Prescription Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regression. Results We found that birthweight was not associated with any breast cancer subtypes. While childhood BMI was not statistically significantly associated with ER+ tumors nor consistently with ER− tumors among pre-menopausal women, consistent inverse associations were found among postmenopausal women. At the age of 7 years, the HRs for postmenopausal ER+ and ER− tumors were 0.90 (95% CI 0.87–0.93) and 0.84 (95% CI 0.79–0.91) per BMI z-score, respectively. Similarly, childhood BMI was inversely associated with pre- and postmenopausal HER2− tumors, but not with HER2+ tumors. Childhood height was positively associated with both pre- and postmenopausal ER+ tumors, but not with ER− tumors. At the age of 7 years, the HRs for postmenopausal ER+ and ER− tumors were 1.09 (95% CI 1.06–1.12) and 1.02 (95% CI 0.96–1.09) per height z-score, respectively. In general, childhood height was positively associated with HER2+ and HER2− tumors among pre- and postmenopausal women. Ages at OGS and PHV were not associated with any breast cancer subtypes. Conclusions We showed that a high BMI and short stature in childhood are associated with reduced risks of certain breast cancer subtypes. Thus, childhood body composition may play a role in the development of breast cancer.

The Oscar-winning Disney film Encanto (2021) was hailed for its authentic representation of Colombian culture, but it also sparked a discussion on film’s ability to capture aspects of a culture and even change the global image of a country. This essay does not attempt to evaluate the merit of Encanto as a conveyor of Colombian culture, but investigates the representation of the narrative mode, magic realism, as it is translated from Gabriel García Márquez’s One Hundred Years of Solitude into Disney animation to be presented to a global audience. Based on the current notion of the feminine in modern animated Disney films, we explore how it may function paratextually to guide interpretation of the feminine connection with magic. Viewers of a Disney film in 2021 may have responded differently according to their cultural background and knowledge of languages, and in this case, their familiarity with Disney productions and/or with García Márquez’s literary universe. We examine how Norwegian reviewers received the film, particularly with regard to Disney conventions, such as magical elements, and the representation of female characters.

Introduction: Body mass index (BMI) is often elevated at type 2 diabetes (T2D) diagnosis. Using latent class trajectory modelling (LCTM) of BMI, we examined whether weight loss after diagnosis influenced cancer incidence and all-cause mortality. Methods: From 1995 to 2010, we identified 7,708 patients with T2D from the Salford Integrated Record database (UK) and linked to the cancer registry for information on obesity-related cancer (ORC), non-ORC; and all-cause mortality. Repeated BMIs were used to construct sex-specific latent class trajectories. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. Results: Four sex-specific BMI classes were identified; stable-overweight, stable-obese, obese-slightly-decreasing, and obese-steeply-decreasing; comprising 41%, 45%, 13%, and 1% of women, and 45%, 37%, 17%, and 1% of men, respectively. In women, the stable-obese class had similar ORC risks as the obese-slightly-decreasing class, whereas the stable-overweight class had lower risks. In men, the obese-slightly-decreasing class had higher risks of ORC (HR = 1.86, 95% CI: 1.05–3.32) than the stable-obese class, while the stable-overweight class had similar risks No associations were observed for non-ORC. Compared to the stable-obese class, women (HR = 1.60, 95% CI: 0.99–2.58) and men (HR = 2.37, 95% CI: 1.66–3.39) in the obese-slightly-decreasing class had elevated mortality. No associations were observed for the stable-overweight classes. Conclusion: Patients who lost weight after T2D diagnosis had higher risks for ORC (in men) and higher all-cause mortality (both genders) than patients with stable obesity.

Background Although excess adult adiposity is a strong risk factor for chronic kidney disease (CKD), evidence for associations with early life body size is limited. We investigated whether childhood body mass index (BMI) trajectories are associated with adult-onset CKD and end-stage kidney disease (ESKD) using a population-based cohort. Further, we examined the role of adult-onset type 2 diabetes (T2D) in these associations. Methods and findings We included 151,506 boys and 148,590 girls from the Copenhagen School Health Records Register, born 1930 to 1987 with information on measured weights and heights at ages 6 to 15 years. Five sex-specific childhood BMI trajectories were analyzed. Information on the main outcomes CKD and ESKD, as well as T2D, came from national health registers. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using Poisson regression adjusted for year of birth. During a median of 30.8 person-years of follow-up, 5,968 men and 3,903 women developed CKD and 977 men and 543 women developed ESKD. For both sexes, the rates of CKD and ESKD increased significantly with higher child BMI trajectories in comparison with the average BMI trajectory (40% to 43% of individuals) and the below-average BMI trajectory (21% to 23% of individuals) had the lowest rates. When including T2D, most associations were significant and men (IRR = 1.39, 95% CI: 1.13 to 1.72) and women (IRR = 1.54, 95% CI: 1.28 to 1.86) with the obese childhood BMI trajectory (2% of individuals) had significantly higher CKD rates than the average BMI trajectory, whereas for ESKD, the associations were positive, but nonsignificant, for men (IRR = 1.38, 95% CI: 0.83 to 2.31) but significant for women (IRR = 1.97, 95% CI: 1.25 to 3.11) with the obese BMI trajectory. A main study limitation is the use of only hospital-based CKD diagnoses. Conclusions Individuals with childhood BMI trajectories above average had higher rates of CKD and ESKD than those with an average childhood BMI trajectory. When including T2D, most associations were significant, particularly with CKD, emphasizing the potential information that the early appearance of above-average BMI growth patterns provide in relation to adult-onset CKD beyond the information provided by T2D development. Using a population-based cohort, Julie Aarestrup and colleagues investigate whether childhood body mass index trajectories are associated with adult-onset chronic kidney disease and end-stage kidney disease. Author summary Why was this study done? Worldwide, chronic kidney disease (CKD) is common and associated with numerous adverse health effects. Severe obesity in childhood is associated with impaired kidney health. Little is known on the impact of childhood body size on subsequent development of CKD. What did the researchers do and find? Using a large Danish population-based cohort of 151,506 boys and 148,590 girls, we investigated if trajectories of childhood body mass index (BMI) development were associated with adult-onset CKD. In analyses that include type 2 diabetes, men with above-average (incidence rate ratio [IRR] = 1.07, 95% confidence interval [CI]: 1.00 to 1.14), overweight (IRR = 1.25, 95% CI: 1.14 to 1.38), and obese (IRR = 1.39, 95% CI: 1.13 to 1.72) childhood BMI trajectories had higher rates of adult-onset CKD compared to those with an average childhood BMI trajectory as did women with above-average (IRR = 1.18, 95% CI: 1.08 to 1.28), overweight (IRR = 1.24, 95% CI: 1.11 to 1.38), and obese (IRR = 1.54, 95% CI: 1.28 to 1.86) childhood BMI trajectories. What do these findings mean? Our findings highlight the importance of childhood BMI development in the identification of individuals at risk of adult-onset CKD. Our study was limited by only including the more severe CKD cases. The results suggest that the high worldwide prevalence of childhood overweight and obesity may contribute to the future burden of CKD. Furthermore, these findings open up new avenues for exploration into the mechanisms that increase the risk of this common health outcome.

Background: Adult overweight is a potential bladder cancer (BC) risk factor, but little is known about size earlier in life. Aim: To investigate if birth weight, childhood body mass index (BMI), height and growth are associated with adult BC. Subjects and methods: Anthropometric information from birth and ages 7–13 on 315,763 individuals born 1930–1989 in the Copenhagen School Health Records Register was linked to national registers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regression. Results: 1145 individuals (839 men) were diagnosed with BC. Sex differences were not detected. Childhood BMI had positive associations and height had inverse associations with BC; at age 13, HR = 1.10 (95% CI: 1.02–1.18) per BMI z-score and HR = 0.94 (95% CI: 0.89–1.00) per height z-score. A pattern of above-average increases in BMI from 7 to 13 years had higher hazards of BC than average increases. Above-average growth in height was not significantly associated with BC. Compared with birth weights of 3.5 kg, low (2.5 kg) and high (4.5 kg) values were associated with increased hazards of BC; HR = 1.26 (95% CI: 1.01–1.58) and HR = 1.36 (95% CI: 1.09–1.70), respectively. Conclusions: A high BMI, a short height, excess BMI gain in childhood and low and high birth weights are associated with increased hazards of BC.

Background: Body size in adult life is likely associated with risks of endometriosis and adenomyosis, yet little is known about associations with body size earlier in life. Aim: To examine whether birth weight, childhood body mass index (BMI) and height are associated with risks of endometriosis and adenomyosis. Subjects and methods: From the Copenhagen School Health Records Register, 171,447 girls born 1930–1996, with measured weights and heights at ages 7–13 were included. Outcomes were obtained from health registers. Cox regressions were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI). Results: During follow-up, 2149 endometriosis cases and 1410 adenomyosis cases were diagnosed. Childhood BMI was inversely associated with endometriosis (HR = 0.92 [95% CI: 0.88–0.96] per z-score at age 7). In contrast, childhood height was positively associated with endometriosis (HR = 1.09 [95% CI: 1.05–1.14] per z-score at age 7). Associations with childhood body size did not differ by endometriosis location. Childhood BMI and height had limited associations with adenomyosis. Birth weight was not associated with endometriosis or adenomyosis. Conclusion: Lean and tall girls are more often diagnosed with endometriosis, but not adenomyosis. These findings suggest that indicators of endometriosis risk are already apparent at early ages.

Occupational burnout among special education teachers results in increased attrition, and lower student and teacher outcomes. The purpose of this quantitative correlational study was to establish a framework of occupational burnout within special education and adaptive leadership theory. The quantitative correlational study surveyed K-12 special education teachers who taught during the COVID-19 pandemic. Sixty-seven eligible respondents completed the online survey including demographics, Maslach Burnout Inventory Educators Survey, Adaptive Leadership with Authority Scale, and sections of Pandemic Experiences and Perceptions Survey. A statistical correlation between teacher occupational burnout and adaptive leadership indicated supervisors using adaptive leadership strategies had less teacher attrition.

Mange lærere ønsker å bruke film i engelskundervisningen, men ser kanskje ikke umiddelbart hvordan dette kan forankres i læreplanmål eller hvilke arbeidsmåter man kan velge. Denne artikkelen ser på hvordan Kunnskapsløftet (2017) åpner for mer bruk av film og hvilke muligheter som ligger i å se elevenes forkunnskaper om visuelle tekster og sjangre som bidrag i byggingen av literacy-kompetanse. Det vises til forskning og utviklingsarbeid innen kunstfagene som fremholder viktigheten av at elever får utvikle språk til å fortelle historier basert på visuelle inntrykk (Bamford, 2008; Yenawine, 2014). Det beskrives videre hvordan lærere kan overføre lesestrategier fra disse fagene til engelskundervisningen for å gi elevene bedre rammer for å forstå og bruke film og andre visuelle narrative tekster i en språkfaglig sammenheng. Artikkelen ser nærmere på hvordan sjangerlære (Mjør et. al., 2006; Stafford, 2011) kan være et møtepunkt mellom film og skjønnlitteratur. Å integrere film bedre i engelskfaget kan også bidra til å styrke elevenes metakognitive kompetanse. Metodene som beskrives illustrerer hvordan visuelle tekster og kunnskap om læringsstrategier og forståelse for egne læringsprosesser i møte med slike tekster kan utløse mer kritisk tenkning og selvstendig læring. Nøkkelord: film, literacy, lesestrategier, sjangerlære, eventyr, fantasy, kritisk tenkning. Reading films Abstract This article addresses teachers who are looking to integrate film into their English syllabus and who are searching for related methods that will enable them to fulfil both subject and core curriculum aims (Kunnskapsløftet 2017). I explore methods and approaches for the utilization of Norwegian students’ extensive knowledge of visual texts and genres in the teaching of literacy and metacognitive competence. The discussion draws on research and teaching practices that demonstrate how arts integration into other subjects facilitates student output and metacognitive and higher order thinking (Bamford, 2008; Yenawine, 2014). My emphasis is on the combined use of reading comprehension and visual thinking strategies in the teaching of film in EFL courses and I propose genre-based teaching (Mjør et al., 2006; Stafford, 2011) as a viable approach to a more comprehensive literacy instruction, including both literary and film narratives. I also look at how encouraging the transfer of students’ prior knowledge of film and narrative patterns can contribute to greater learner autonomy. Keywords: film, literacy, reading strategies, visual thinking strategies, genre-based teaching, critical thinking.

Background: Telemedicine offers a promising solution to enhance the delivery and personalization of headache care. Integrating electronic (e-)tools enables the objective monitoring of migraine. Objectives: This study aims to demonstrate the relevance of e-tools for personalized headache care, assess patient and caregiver compliance and satisfaction, and present their use in enhancing care. Methods: Firstly, a systematic review was performed to validate the diagnostic accuracy of e-diaries for diagnosing migraine. Secondly, we collected e-diary data prospectively from diagnosed adult migraine patients at the Leiden Headache Center. Finally, questionnaires were sent to evaluate satisfaction of patients and health care providers with the Leiden e-headache diary and video consultations. Results: In the systematic review, the Leiden Headache Center's e-diary was the only validated tool. Patients (n = 1,009) were followed for a median of 181 days (interquartile range [IQR] 84–240). Compliance was 96.4% (IQR 85.2 − 99.1%), with 10.8% of days missing. Factors positively associated with compliance were older age (p < 0.001), female sex (p < 0.001), higher e-diary grade (p < 0.001), and clinical use (p = 0.04). The e-diary received a median score of 8/10 and was well-liked by patients (n = 535) and providers (n = 23). Video consultations were a good alternative for physical visits according to 76.9% of patients and 84.6% of providers. Conclusion: Validated e-headache diaries and video consultations in telemedicine enhance headache care accessibility, providing convenient care at preferred times and locations. [ABSTRACT FROM AUTHOR]

California produces many key agricultural products in the United States. Current geospatial agricultural datasets are limited in mapping accuracy, spatial context, or observation period. This study uses machine learning and high‐resolution imagery to produce a time series of crop maps to assess crop type trends and patterns across central California from 2005 to 2020. National Agriculture Imagery Program and Landsat imagery were used to classify nine crop types that are common in the study region: grain crops, field crops, rice, citrus and subtropical, deciduous fruit and nut, vineyard, berry and vegetable, pasture, and fallow/young perennial crop types. To create labeled data, we sampled 1253 fields and manually identified crop types for each examined year using high‐resolution imagery and Landsat normalized difference vegetation index time series. We applied a random forest machine learning algorithm in Google Earth Engine. Results show that the mean overall classification accuracy of the nine‐class map was 93.1%, with individual accuracies ranging from 99.3% (rice) to 89.5% (fallow/young perennial). Mann–Kendall trend tests showed significant (p < 0.05) declines in field crop and pasture area during the study period, while deciduous fruit and nut, citrus and subtropical, and fallow/young perennial crop types experienced significant increases. At an aggregate level, there was a general shift from annual crop types to perennial crop types. These data provide a 16‐year time span of spatially explicit crop type classifications, trends, and patterns in central California that can be used to aid managers and decision makers for resource planning or hazard mitigation. Core Ideas: Available crop type maps of central California are limited in mapping accuracy or observation period.We created a series of high‐accuracy maps of crop areas using remote sensing data and machine learning.Central California has experienced an increase in deciduous fruit and nut crops and a decrease in field crops.Southern Sacramento River Valley and the western Tulare Lake regions show high temporal crop type transitions. [ABSTRACT FROM AUTHOR]

Background Although excess adult adiposity is a strong risk factor for chronic kidney disease (CKD), evidence for associations with early life body size is limited. We investigated whether childhood body mass index (BMI) trajectories are associated with adult-onset CKD and end-stage kidney disease (ESKD) using a population-based cohort. Further, we examined the role of adult-onset type 2 diabetes (T2D) in these associations. Methods and findings We included 151,506 boys and 148,590 girls from the Copenhagen School Health Records Register, born 1930 to 1987 with information on measured weights and heights at ages 6 to 15 years. Five sex-specific childhood BMI trajectories were analyzed. Information on the main outcomes CKD and ESKD, as well as T2D, came from national health registers. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using Poisson regression adjusted for year of birth. During a median of 30.8 person-years of follow-up, 5,968 men and 3,903 women developed CKD and 977 men and 543 women developed ESKD. For both sexes, the rates of CKD and ESKD increased significantly with higher child BMI trajectories in comparison with the average BMI trajectory (40% to 43% of individuals) and the below-average BMI trajectory (21% to 23% of individuals) had the lowest rates. When including T2D, most associations were significant and men (IRR = 1.39, 95% CI: 1.13 to 1.72) and women (IRR = 1.54, 95% CI: 1.28 to 1.86) with the obese childhood BMI trajectory (2% of individuals) had significantly higher CKD rates than the average BMI trajectory, whereas for ESKD, the associations were positive, but nonsignificant, for men (IRR = 1.38, 95% CI: 0.83 to 2.31) but significant for women (IRR = 1.97, 95% CI: 1.25 to 3.11) with the obese BMI trajectory. A main study limitation is the use of only hospital-based CKD diagnoses. Conclusions Individuals with childhood BMI trajectories above average had higher rates of CKD and ESKD than those with an average childhood BMI trajectory. When including T2D, most associations were significant, particularly with CKD, emphasizing the potential information that the early appearance of above-average BMI growth patterns provide in relation to adult-onset CKD beyond the information provided by T2D development., Author(s): Julie Aarestrup 1,*, Kim Blond 1, Dorte Vistisen 2,3, Marit E. Jørgensen 2,4,5, Marie Frimodt-Møller 2, Britt W. Jensen 1, Jennifer L. Baker 1 Introduction The burden of chronic [...]

Background: Anti-CGRP-(receptor-)monoclonal antibodies (anti-CGRP(R)-mAbs) represent a novel class of drugs for migraine treatment, but their long-term cerebrovascular and cardiovascular (CV) safety warrants further examination. Methods: In this observational cohort study we assessed the CV safety for erenumab and fremanezumab in a real-world setting during a follow-up period of at least 1year. Patients with hypertension or CV history were excluded. We conducted ECGs and collected clinical data at treatment initiation and thereafter every 3months, including liver and kidney function, lipid-, electrolyte-and glucose levels. Results: Among patients receiving erenumab (n = 101) or fremanezumab (n = 92), 3.1% (6/193) developed abnormal ECGs or CV adverse events. Of these, three (1.6%) experienced moderate to severe CV adverse events (cerebellar stroke, spontaneous coronary artery dissection, and pericarditis) and discontinued treatment. The remaining three (1.6%) developed non-threatening ECG abnormalities without physical complaints. No significant changes were observed in liver and kidney function, lipid-, electrolyte-, or glucose levels. Discussion: We observed CV events in 1.6% of patients with 1.5-year followup of anti-CGRP(R)-mAbs treatment. We advise awareness regarding CV events in patients with migraine undergoing CGRP-targeted treatment, not as a confirmation of increased risk but as a proactive measure to address potential multifactorial influences. [ABSTRACT FROM AUTHOR]

Background and purpose: The aim was to evaluate the effect of anti‐calcitonin gene related peptide (CGRP) (ligand or receptor) antibodies on depressive symptoms in subjects with migraine and to determine whether depressive symptoms predict treatment response. Methods: Patients with migraine treated with erenumab and fremanezumab at the Leiden Headache Centre completed daily E‐headache diaries. A control group was included. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) and the Center for Epidemiological Studies Depression Scale (CES‐D) questionnaires at baseline (T0) and after 3 months (T1). First, the effect of treatment on the reduction in HADS‐D and CES‐D scores was assessed, with reduction in depression scores as the dependent variable and reduction in monthly migraine days (MMD) and treatment with anti‐CGRP medication as independent variables. Second, depression as a predictor of treatment response was investigated, using the absolute reduction in MMD as a dependent variable and age, gender, MMD, active depression, impact, stress and locus of control scores as independent variables. Results: In total, n = 108 patients were treated with erenumab, n = 90 with fremanezumab and n = 68 were without active treatment. Treatment with anti‐CGRP medication was positively associated with a reduction in the HADS‐D (β = 1.65, p = 0.01) compared to control, independent of MMD reduction. However, the same effect was not found for the CES‐D (β = 2.15, p = 0.21). Active depression predicted poorer response to erenumab (p = 0.02) but not to fremanezumab (p = 0.09). Conclusion: Anti‐CGRP (ligand or receptor) monoclonals lead to improvement of depressive symptoms in individuals with migraine, independent of migraine reduction. Depression may predict treatment response to erenumab but not to fremanezumab. [ABSTRACT FROM AUTHOR]