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Background: Lifestyle therapy with resistance training is a potent measure to counteract age-related loss in muscle strength and mass. Unfortunately, many individuals fail to respond in the expected manner. This phenomenon is particularly common among older adults and those with chronic diseases (e.g. chronic obstructive pulmonary disease, COPD) and may involve endocrine variables such as vitamin D. At present, the effects of vitamin D supplementation on responses to resistance training remain largely unexplored. Methods: Ninety-five male and female participants (healthy, n = 71; COPD, n = 24; age 68 ± 5 years) were randomly assigned to receive either vitamin D3 or placebo supplementation for 28 weeks in a double-blinded manner (latitude 61°N, September-May). Seventy-eight participants completed the RCT, which was initiated by 12 weeks of supplementation-only (two weeks with 10 000 IU/day, followed by 2000 IU/day), followed by 13 weeks of combined supplementation (2000 IU/day) and supervised whole-body resistance training (twice weekly), interspersed with testing and measurements. Outcome measures included multiple assessments of muscle strength (nvariables = 7), endurance performance (n = 6), and muscle mass (n = 3, legs, primary), as well as muscle quality (legs), muscle biology (m. vastus lateralis; muscle fibre characteristics, transcriptome), and health-related variables (e.g. visceral fat mass and blood lipid profile). For main outcome domains such as muscle strength and muscle mass, weighted combined factors were calculated from the range of singular assessments. Results: Overall, 13 weeks of resistance training increased muscle strength (13% ± 8%), muscle mass (9% ± 8%), and endurance performance (one-legged, 23% ± 15%; whole-body, 8% ± 7%), assessed as weighted combined factors, and were associated with changes in health variables (e.g. visceral fat, -6% ± 21%; [LDL]serum , -4% ± 14%) and muscle tissue characteristics such as fibre type proportions (e.g. IIX, -3% points), myonuclei per fibre (30% ± 65%), total RNA/rRNA abundances (15%/6-19%), and transcriptome profiles (e.g. 312 differentially expressed genes). Vitamin D3 supplementation did not affect training-associated changes for any of the main outcome domains, despite robust increases in [25(OH)D]serum (∆49% vs. placebo). No conditional effects were observed for COPD vs. healthy or pre-RCT [25(OH)D]serum . In secondary analyses, vitamin D3 affected expression of gene sets involved in vascular functions in muscle tissue and strength gains in participants with high fat mass, which advocates further study. Conclusions: Vitamin D3 supplementation did not affect muscular responses to resistance training in older adults with or without COPD. Keywords: Cholecalciferol; Muscle plasticity; Strength training. © 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders. publishedVersion

A minimally invasive endoscopic treatment that utilizes radio-frequency energy (RFE) has received increased attention as an appropriate middle-ground approach in the treatment of refractory gastroesophageal reflux disease (GERD) and as an alternative to complicated and invasive surgical procedures. The objective of this study was to develop a longitudinal budget impact analysis from the payer perspective to estimate the direct medical costs of treatment for the refractory GERD patient population and to estimate the budgetary impact of further extending the RFE treatment option to other target populations.A retrospective analysis of claims designed to assess the longitudinal costs and budget impact on payer expenditures associated with managing and treating GERD surgically (Nissen fundoplication [NF]), endoscopically (RFE), or medically was performed. Both Medicare and commercially insured claims databases were interrogated for such population-level analyses.At current adoption rates (less than 1% of procedures), RFE demonstrated overall cost savings ranging from 7.3% to 50.5% in the 12-month time period following the index procedure (inclusive of procedure costs) when compared to medical management and fundoplication across the commercial and Medicare patient populations. Increasing the total number of RFE procedures to 2% of total cases performed generated per-member, per-month (PMPM) savings of $0.28 in the Medicare population and $0.37 in the commercially insured population. Further increases yielded higher PMPM savings.Adding to the clinical importance of RFE in filling the gap between medical and surgical management, this economic analysis demonstrates to payers that the adoption of RFE can create notable savings to their plans when compared to surgery or medical management.

Community supported agriculture (CSA) is a direct-marketing food network that has the potential to decommmodify food and support farmers while providing consumers with sustainably raised, seasonal, local food. Through an ethnographic exploration of one CSA, we describe the processes, practices, affect and effects of consumer membership within the context of non-representational theory. Carolan (2007) suggests that when non-representational ways of knowing are fostered through long-term embodied involvement in “tactile space,” “deep commitments” to the environment and others are encouraged. This study augments understandings of tactile space. Findings show that members engage in the tactile spaces of CSA (e.g. attending distribution, cooking more), but with varied effects: leading one member to voice compassion for the farmer which “is something you don’t feel in a supermarket” while another admits feeling “like I’ve been conned.” In spite of mixed experiences and affects, on balance we conclude that CSA membership does affect environmental ethics.

Summary Introduction We examined the positive predictive value of diagnoses of acute exacerbation of chronic obstructive pulmonary disease (COPD) in the Danish National Patient Registry. We also examined the negative predictive value of acute pneumonia or respiratory failure discharge diagnoses for absence of underlying COPD. Methods We identified all patients aged 30 years or older with acute hospital admission in Denmark from January 1st to December 31st 2008. Physicians at 34 Danish hospitals retrieved and reviewed medical records for 1581 patients with a discharge diagnosis of COPD, and for 1546 patients with a discharge diagnosis of either pneumonia or respiratory failure but no COPD diagnosis. Presence of COPD was assessed based on medical history, clinical symptoms and findings, and spirometry results. Results The overall positive predictive value for COPD was 92% (95% confidence interval [CI] = 91–93%). Among patients coded with pneumonia or respiratory failure but not COPD, 19% (95% CI = 17–21%) had COPD, corresponding to a negative predictive value for COPD of 81% (95% CI = 79–83%). Conclusions The positive predictive value of acute COPD discharge diagnoses in the Danish National Patient Registry is high. At the same time, there is a substantial underrecording of COPD during hospitalizations with other acute respiratory disorders like pneumonia and respiratory failure.

Primitive accumulation and accumulation by dispossession significantly strengthen our analyses of neo-liberalism, globalization, and capitalism in general. But processes that appear to be primitive accumulation are often better characterized as the subsumption of labor to capital. More than terminology is at stake in making this distinction: subsumption as opposed to primitive accumulation can highlight different sources of change, and different sites of possible contestation. It is time for a re-appraisal and broader conceptualization of subsumption and its relationship to primitive accumulation.

Abtract: Based on extensive interviews, this study is the first systematic attempt to map the spatio-temporal evolution of production networks linking urban, state-owned enterprises and rural, township and village-owned enterprises in reform-era China. It identifies two distinct regimes of urban-to-rural subcontracting patterns and conventions. The first, which developed and prospered from the mid-1980s until the mid-1990s, brought rural workers and the countryside into a relatively extensive relationship with urban capital, and thus represented a partial transition to capitalism. Its violent reconfiguration in the wake of a series of sectoral crises in the late 1990s led to the widespread privatisation of rural enterprises, and the emergence and consolidation of a second regime that simultaneously constituted a significant intensification of relations, the capture of the rural by the urban, and a new stage in this region’s transition. This paper argues that these regimes are analogous to the formal and real subsumption of labor to capital, respectively, and that subsumption may be a more useful analytic for understanding the process of capture and transition than primitive accumulation: the latter concept alone, without reference to the dynamics of the social/spatial division of labor, risks missing other ways that exploitive connections can be constructed between places. This paper thus seeks to recast the relationship between these two concepts, and to develop a larger vocabulary in which subsumption, like primitive accumulation, is both spatial and ongoing and internal to capitalist accumulation.

Like most emigrants to South America, photography first took root in the coastal cities before creeping inland.1 Within a few years of Father Louis Compte's demonstration of the wonders of dagucrrcotypy to an assembly at the Hotel Pharoux in Rio de Janeiro in 1840, intrepid daguerreotypists had strapped the bulky tools of their trade to mules and made the arduous trek up to the Bolivian Altiplano.2 By the 1860s, after the daguerreotype had been supplanted by various processes using glass plates, from which paper copies could be made, photography was flourishing in Bolivia.

Manufacturing based on networks of small family firms is widely regarded to have been integral to Taiwan's development success. Many studies discuss the social embeddedness, flexibility, efficiency, and competitive advantage of these networks, but there have been few systematic attempts to theorize their origins. A processual analysis of the changing spatial structure of Taiwan's industry, in its social, political, and historical contexts, reveals that Taiwan's concentrated industries of the 1950s did not disintegrate into smaller firms. Rather, there was a proliferation of new rural firms after the mid-1960s. The construction of a disintegrated, decentralized, and networked structure was driven by the contingent actions of rural household entrepreneurs, pursuing strategies of social reproduction, under circumstances resulting from, among other things, an extensive land-reform program and redistributive agricultural policies. Transactions costs and neo-Weberian authority approaches elucidate important factors, but fail to explain the creation of this new class of petty entrepreneurs, and how the conditions of their entrance shaped the networked form of organization they created. Furthermore, their actions did not result from state-led development policies as much as they were the unintended consequences of state policies, preceding by several years government efforts to support the growth of small firms and rural industry. Finally, urban-push explanations assume a passive countryside, thus ignoring the ways rural actors energetically created new structures of production out of the resources at hand.

L'objet de cette etude etait la structure et les dynamiques des systemes de productions biologiques en Californie. Les AA. ont mene a peu pres soixante-dix interviews semidirectifs avec des acteurs-cles tout au long de la chaine de production en recherchant a la fois les dynamiques internes de chaque etape et les relations entre elles. La qualification de biologique ou organique qui a contribue a l'extraordinaire et recente croissance de l'industrie agro-alimentaire biologique, a aussi cree des rentes economiques et des opportunites uniques d'accumulation pour l'agribusiness. Dans cet article, les AA. montrent que le capital agro-alimentaire est en train de penetrer le segment de plus forte plus-value de la chaine de production des legumes biologiques, malgre l'existence de pratiques et d'idees allant a contre-courant du secteur conventionnel de production. Les pratiques agronomiques et de marketing sont un miroir grossissant des pratiques de l'agriculture conventionnelle. Les AA. ont identifie plusieurs exemples de ce que Goodman et al. ont appele appropriationisme la ou les processus une fois integres a l'exploitation sont transformes et reutilises en inputs et substitionnisme la ou les couts de la transformation industrielle representent une forte proportion de la valeur ajoutee

The transition from shortage to surplus sent shock waves through the sectors and up and down the commodity chains. As their cashflow problems worsened, large enterprises started to look for ways to reduce costs. They could not lay off workers, because they were state-owned enterprises (SOEs), and their own profits had disappeared quickly as they cut prices to stay competitive. So they started to look for ways to eat into the profits of their subcontractors. The first sign of trouble was smaller orders, but before long, the SOEs started switching to cheaper suppliers, as well. Developing new suppliers can be arduous and time-consuming, however, and frequently it proved easier to use the threat of switching suppliers to impose more favorable terms on existing ones. The practice of “one part, two factories” took on new significance when the SOEs realized that reduced orders could be shifted between multiple, duplicate, and dependent subcontractors. The resulting competition was very intense—”if you do not supply [gonghuo], then someone else will” (A18)—and for the first time subcontractors were compelled to compete with one another not only in terms of quality, but in terms of price, payment, and delivery, as well.1

By the late 1990s, well over half the subcontractors in these industries were in some form of bankruptcy or another and struggling to stay open. Those still working were forced to accept deteriorating terms in order to hold on to their positions in hitherto profitable commodity chains. Indeed, many now labored for greatly reduced profit, if any at all. Lacking the power to improve existing relationships, managers hoped to recapture their comfortable positions, or at least to stay open as profitable enterprises, by finding new customers in either the same or different lines of business. But “finding a way out” (zhao yige chulu) was the single most difficult obstacle they faced in the postcrisis environment. The second was getting paid. Why were some enterprises able to continue in a world of shrinking orders, reverticalization, and simultaneous crises when so many could not? Did they use the same channels, logics, and strategies as before? Or had the structures of opportunity changed?

As we have just seen, enterprises faced with the task of finding or making a way out of the relationships of the unraveling SOE-TVE nexus had three options. They could stay in their current network, even if that meant producing at cost or even below or getting trapped in cycles of debt. They could join another network by switching to a different manufacturer (i.e., from VW to GM) or a different product line (i.e., from bicycles to motorcycles). Or they could make a new network, often by reassembling the pieces of shattered production systems. In this new troika—stay, join, or make—the third option becomes visible only because we have approached firms not as discrete entities, but as nodes in complex webs of embedded resources and capacities. These resources and capacities produced in situ by earlier rounds of industrial growth remain when the web gets blown apart. They can be regathered and recombined in new forms. The preceding firms and forms disappear, but the resources remain. Network restructuring altered the survival tactics available to subcontractors. It also changed the terms and conventions of SOE-TVE relationships and made crises more manageable for some SOEs. But even more consequential still, it altered the very substrate in which the networks were embedded, changing it in ways that constituted a fundamental turning point in the region’s political economy and the development of capitalism in China.

The nexus of state-owned enterprise (SOE) and township- and village-owned enterprise (TVE) networks was very successful, until it suddenly was not. By 1999, more than ten years of accumulating profits had been fixed in place, inscribed in the urban and rural landscapes. But as I crisscrossed the countryside, I started to notice padlocked factories, their gates rusting and tall weeds growing up through their driveways. I found myself interviewing managers in dusty meeting rooms in quiet, empty factories. Township and village streets that would have been deserted during the daytime just a few years before, with everyone working in the TVEs, were now filled with people playing cards and gossiping; the TVE workers were living off their savings and small family plots. As much as two-thirds of the rural subcontractors in these sectors were bankrupt by 1999. Especially hard hit were the townships and villages with heavy concentrations in single industries.

Whether to make or to buy is one of the classic questions of economic and industrial organization (Coase 1937). It was central to the constellation of questions I asked every enterprise manager. “What do you make, and what do you buy? Why? How has this changed over time? Why? Why did you subcontract this function to a township-or village-owned enterprise (TVE)? Why did you subcontract that function to a state-owned enterprise (SOE)?” Keeping a production function in-house or subcontracting it out to an SOE or a TVE was a choice between enterprise types with different characteristics and cost structures, but it was also a spatial decision. A significant degree of subcontracting went to TVEs, rather than SOEs, but how much of it went to TVEs in Shanghai’s rural counties, TVEs in other provinces, or SOEs in other cities? Did this change over time, and what can that tell us?

At the end of the 1990s, I visited an old central Shanghai meters and instruments factory with more than eight hundred employees. This state-owned enterprise (SOE), a preserved relic, offered a rare glimpse into the not so distant past. An industry insider who I had met serendipitously on the subway told me, “It still does all of its own manufacturing. They manufacture the entire thing. They don’t subcontract anything at all. They have a huge workshop with all the different machinery necessary to make the entire instruments. It’s very wasteful. For example, the plastic injection machines are sitting idle every time I go there, because they are only needed for small batches compared to their overall production” (I1). He introduced me to the 1994–99 director of the factory, who explained that “we do contract out the production of components … not exactly contract out—we send them down to lower factories in our system.” He had not started to subcontract to township- and village-owned enterprises (TVEs) until 1997, because “the workers really have their own opinions about things. They think, if we can do it ourselves, why let go of it? This kind of thinking is limited by their interests—if employment or wages are involved in any changes, they get upset.” He continued, “but now, subcontracting is in the overall interests of the factory.

Background: Adherence to medical treatment among women with ulcerative colitis (UC) prior to and during pregnancy has never been investigated. The aim was to examine predictors for and prevalence rates of nonadherence to maintenance treatment among women with UC prior to and during pregnancy. Methods: We identified 115 women with UC having given birth during 2000–2005 within a population of 1.6 million. They received a questionnaire about predictors and adherence and relapses were registered. We retrieved information on medical treatment from prescription databases and used logistic regression to estimate prevalence odds ratios (POR) for nonadherence by different predictors. Results: Among 93 (81%) respondents, 63 (68%) reported taking medication, 53 of whom had filled prescriptions for relevant medication, yielding a positive predictive value of self-reported use of medical treatment of 84.1% (95% confidence interval [CI] 72.7–92.1). Approximately 60% reported adhering to medical treatment. Those who received counseling regarding medical treatment were less likely to be nonadherent compared with no counseling, especially during pregnancy (POR 0.2, 95% CI 0.04–0.94). Of those who were nonadherent, fear of a negative effect on fertility/fetus was stated as the reason by 23% prior to and by 50% during pregnancy. Notably, 40.3% reported an episode of relapse during the pregnancy period, compared with 13.6% in the period 6 months prior to pregnancy. Conclusions: Adherence was high despite fear of a negative effect on fertility or the fetus. Counseling predicted higher adherence. This may be important because our study suggests an increase in UC activity during pregnancy. (Inflamm Bowel Dis 2010)

Neuroinflammation is instrumental in neuronal damage observed in various neuropathologies. Thus, understanding pro-inflammatory pathways of human glial cells is important in identifying potential pharmacological strategies to modulate inflammatory signaling in these cells. Microglia-derived cytokines and chemokines are instrumental in neuroinflammation and several proinflammatory mediators activate these cells to include bacterial lipopolysaccharide (LPS) that signals through toll-like receptor 4 (TLR4). Microglial TLR4 signaling is not well studied; therefore, our goal is to investigate the molecular mechanisms of TLR4 microglial signaling, which entailed treatment of human microglial cells (CHME-5) with LPS. LPS induced NF-κB activation, demonstrated by increased NF-κB p65 binding activity and phosphorylated p65 expression in CHME-5 cells. TLR4 expression also increased alongside NF-κB activation. On the other hand, co-exposure to the μ-opioid receptor antagonist, β-funaltrexamine (β-FNA), down-regulated LPS-induced NF-κB activation. To date, our data suggest that the inflammatory actions of microglial TLR4 signaling may be partly due to modulation of NF-κB activation. Thus, we have also initiated studies to elucidate the effects of LPS and β-FNA on other key TLR4 signal transduction proteins. Together, these ongoing studies are expected to further elucidate the mechanisms of LPS-induced TLR4 signaling in human microglia.