bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening for second malignancies in mycosis fungoides: non‐Hodgkin lymphoma, Hodgkin lymphoma, lung cancer, bladder cancer and melanoma
Authors: Goyal A. , O’Leary D. , Goyal K. , Rubin N. , Janakiram M.
Published: May 2021

Background

Patients with mycosis fungoides (MF) are at increased risk of developing non‐Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), lung cancer, bladder cancer and melanoma. The characteristics of patients developing these malignancies have not been specifically delineated. In addition, there are no established guidelines for screening MF patients for second malignancies.

Materials/Methods

We identified 742 patients with MF who developed second malignancies in the Surveillance Epidemiology and End Result‐18 database.

Results

The majority of second malignancy patients were white and male, mean age 55–67 years at diagnosis of MF, and mean age 61–72 years at diagnosis of second malignancy. The majority of patients diagnosed with second malignancies had early stage MF. MF patients with NHL, lung cancer, and bladder cancer tended to be diagnosed at earlier stages of the second malignancy than patients without MF and demonstrated better 5‐year overall survival. There was no improvement in stage at diagnosis or survival for MF patients who were diagnosed with melanoma compared to patients without MF.

Conclusions

Improvements in survival in MF/NHL, MF/lung cancer and MF/bladder cancer patients may reflect differences in disease biology secondary to having MF or the importance of increased contact with the healthcare system. MF/melanoma data suggest that patients require regular pigmented‐lesion‐focused skin examinations. Tools for screening include regular lymph node examinations, pigmented‐lesion‐focused examinations and detailed review of systems questions. Smoking cessation counseling is key intervention in this population, as is ensuring that all age‐ and sex‐specific cancer screenings are up‐to‐date (e.g. lung cancer screening, mammography, and colonoscopy). The utility of regular imaging for second malignancy screening and lab testing such as routine urinalysis requires additional study and expert consensus.
Platelet‐rich plasma is a promising therapy for melasma
Authors: Tuknayat Ankita , Bhalla Mala , Thami Gurvinder Pal
Published: May 2021

Introduction

Platelet‐rich plasma (PRP) is an autologous blood product which has recently been used in multiple spheres of dermatology including facial rejuvenation, androgenetic alopecia, acne scars, and wound healing. Its use in melasma is comparatively an understudied topic.

Material and methods

An extensive systematic literature search of the PubMed electronic database and Cochrane central register of controlled trials was done using the keywords “platelet rich plasma” and “melasma” in the title. Relevant studies were selected and data were analyzed by two different authors. Four articles were excluded as they did not adhere to the inclusion criteria of this review and a total of 6 articles were reviewed.The relevant references of the included articles were also traced and included.

Discussion

These studies showed that PRP has been used effectively not only as an adjuvant therapy but also as a standalone treatment for melasma. PRP contains about 30 growth factors, transforming growth factor beta (TGF‐β) being one of the growth factors having a predominant role in treatment of melasma. TGF‐β decreases signal transduction of microphthalmia‐induced transcription factor and thus decreases tyrosinase and tyrosinase‐related proteins. In addition to this, PRP also has an additional benefit of inducing collagen synthesis thus improving the quality and texture of the skin. But there is a scarcity of data and large randomized controlled trials. This review is an effort to highlight and upscale the use of this excellent blood product for melasma which is quite a treatment refractory disorder.
Bottom‐up Nation‐building: National Censuses and Local Administration in Nineteenth‐Century Spain
Authors: Salas‐Vives Pere , Pujadas‐Mora Joana Maria
Published: May 2021

It is customary to consider population censuses (and statistics in general) as exclusive to the modern State, appearing in the second half of the eighteenth century but being developed and spreading in the West during the nineteenth century. Indeed, censuses help to strengthen and legitimize such states. However, in Spain, just as in Europe and the United States, the first population censuses considered modern were the result of, on the one hand, the directives and general and provincial coordination provided by the new state statistical institutions, such as the Statistics Commission or the Institute of Geography and, on the other, municipal personnel and the previous knowledge of local conditions held by the councils and other agents, such as the clergy, intellectuals, and notables. The media were also availed of for the cause. Let us recall that the municipalities were an explicit part of the state apparatus, therefore their relevance in carrying out censuses is not an indication of failure or weakness on the part of the Spanish State regarding the process of “bottom‐up nation‐building”, but rather a way to imagine the nation through which collective involvement would build the nation from the locality.
Japanese Women’s Speech through Life‐Transitions (1989‐2000): An Analysis of Youth Language Features
Authors: Tanaka Lidia , Okano Kaori , Nakane Ikuko , Maree Claire , Iwasaki Shimako , Takagi Chie
Published: May 2021

This study analyses four women’s speech from Kobe who were interviewed by the same researcher in 1989 and in 2000. We focused on highly indexical pragmatic youth language features (discourse markers and end‐rising intonation) to understand about societal pressures that young women in Japan face when transitioning into adulthood. The analysis reveals a complex picture; some women use them more as time goes by, while others use them less. The vast ethnographic information helps us to understand their persona style (Eckert 2008), and to have an insight into their linguistic capital (Bourdieu and Boltanski 1978, Woolard 2008).
Atlantic cod aquaculture: Boom, bust, and rebirth?
Authors: Nardi George , Prickett Richard , van der Meeren Terje , Boyce Danny , Moir Jonathan
Published: May 2021

The commercialization of a new species through aquaculture is much more complex than the mastery of the production process, or closing the loop, as it is sometimes referred to. Commercial aquaculture is a layer within the global seafood industry, much as wild capture is; however, it places human control at a much earlier phase in the life cycle of the harvested product. As an important species on both sides of the Atlantic, the commercialization efforts for the culture of Atlantic cod are described for four locations, Norway, United Kingdom, New England, and Atlantic Canada that highlight many similar technical challenges and the progress made from the late 1980s through 2012. We also describe some of the marketing challenges faced and how they differ. Technically, the species has been commercialized. Hatcheries and farms in all four countries were successfully established. However, there are clear differences in access to capital for research and industrial expansion from both the private and public sector, social acceptance of farmed fish, as well as the impacts on sales when marketing farmed cod in the context of a global seafood supply. Lower cost species substitution, from either the farmed or wild catch, is also a factor that can have a significant impact on long‐term successful commercialization.
Changing Gender Gaps in the Timing of First Union Formation and Sexual Initiation in Sub‐Saharan Africa
Authors: Batyra Ewa , Kohler Hans‐Peter , Furstenberg Frank F.
Published: May 2021

Gender differences in union formation and sexual initiation in sub‐Saharan Africa remain poorly documented, in large part due to a scarcity of research on the transition to adulthood among men. We adopt a novel perspective on this topic by examining gender gaps in the ages at first union and sex in 24 countries, focusing on measures of central tendency and dispersion. Gender differences in age at first union decreased, driven by postponement among women with relatively late union formation. Yet, due to concurrent persistence of early unions among a sizable portion of women's populations, within‐country heterogeneity in ages at first union increased substantially among women. Thus, although forces responsible for earlier union formation among women than men are weakening, these changes affect population strata unequally. Gender differences in age at first sex decreased to a lesser extent, but in some countries, they disappeared or reversed, uncovering a shift in the relationship between gender and timing of sexual initiation. Changes in union formation and sexual initiation are more heterogeneous across countries among men than women, indicating that these processes among men are more context specific. We show importance of studying men's behavior and exploring heterogeneity in union formation and sexual initiation both within and between populations of women and men.
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics: Results from a Longitudinal Study in Uganda
Authors: Zimmerman Linnea A. , Sarnak Dana O. , Karp Celia , Wood Shannon N. , Moreau Caroline , Kibira Simon P. S , Makumbi Fredrick
Published: May 2021

Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive users at baseline (n = 688) and contraceptive use at follow‐up among nonusers at baseline (n = 1,377). Multivariable simple and multinomial logistic regressions assessed the association of individual and community‐level contraceptive beliefs with contraceptive uptake, discontinuation and switching. One‐quarter of nonusers at baseline were using contraception at follow‐up, while 37 percent of users at baseline had discontinued and 28 percent had switched methods at follow‐up. The odds of contraceptive uptake were lower among women who strongly agreed that contraception impacted future fertility or caused conflict within a couple, relative to those who strongly disagreed (adjusted odds ratio (aOR): 0.7 and aOR: 0.6, respectively), but higher among women who strongly agreed that contraception preserved beauty (aOR: 1.6). Women who strongly agreed that it was acceptable to use contraception before having children were less likely to discontinue their method than those who strongly disagreed (adjusted relative risk ratio (aRRR): 0.5), though living in a community where more women agreed with this statement was associated with higher discontinuation (aRRR: 6.0). Family planning programs that promote positive beliefs toward family planning could improve contraceptive uptake and continuation. More research is needed to understand how contraceptive beliefs shape contraceptive decisions across the life course.
Two novel HLA alleles, HLA‐DRB1*12:90 and HLA‐DQB1*03:458, identified by next‐generation sequencing
Authors: Loginova Maria , Smirnova Daria , Kutyavina Svetlana , Paramonov Igor
Published: May 2021

Two novel HLA alleles DRB1*12:90 and DQB1*03:458 have non‐synonymous mutations in exon 3.
Description of two new HLA alleles: HLA‐A*24:02:129 and HLA‐A*24:02:135
Authors: Wang Wei , Chen Nanying , Zhang Wei , He Ji , Zhu Faming
Published: May 2021

Compared with HLA‐A*24:02:01:01, the alleles HLA‐A*24:02:129 and HLA‐A*24:02:135 each show one nucleotide substitution, respectively.
The Ghost Scrolls of Manshu‐in and Tokugen‐in A Shutter‐Stopping Tale of Visual Culture, Photo Curses, and Recontextualization
Authors: Tamura Can
Published: May 2021

This is an analysis of how photo curses caused by photographing paintings of ghosts in Japan materialize in different contexts in both the analog and digital ages. Over a period of several decades, this has included unwanted photographic prints and negatives that must be ritually destroyed by fire in a Buddhist temple and blog posts that may be dangerous to view because they include photos of the paintings. But a painting formerly considered a dangerous cult image can also transform into an artistic masterpiece when recognized by the art world, becoming widely photographed and reproduced in books and other media.
En Mi Casa Quiero Señas Photovoice as Language Advocacy
Authors: Pfister Anne E.
Published: May 2021

This article describes a collaborative photovoice project and exposition as a platform for deaf youth in Mexico to dialogue about their concerns. Issues that are often difficult to discuss with hearing adults—because of mismatched language and limited agency, among other factors—became interactive. Analysis of one photograph, within the broader context of the project, reveals the potential for photovoice to connect deaf youth with communicative tools and a variety of audiences, providing a venue for them to advocate for their need for sign language. Limitations of photovoice as an activist endeavor aimed at empowering participants are also discussed.
Shifting the Contours of Public Engagement through Ethnographic Filmmaking: Politics, Im/migrant Policing, and Farmworker Health Made Visible
Authors: Alexander William L. , Brannock Mary K. , Guevara Anthony
Published: May 2021

The article discusses our ethnographic film project that documents the effects of aggressive immigrant policing on farmworker health in North Carolina. We reflect on our filmmaking techniques and collaborative process, which challenge anti‐immigrant rhetoric by engaging viewers with humanizing representations of the predicaments and health stressors many immigrants face. Critical insights from observational cinema inform how usually unseen intimacies of everyday life expressed through personal testimonies and visual gestures can evoke empathy and reflection. We argue that such visual public anthropology is needed, as images of the immigrant experience in the United States are often distorted in contemporary political discourse.
Cultivated Affects The Artistic Politics of Landscape and Memory in Amman’s Gardens
Authors: McLaughlin‐Alcock Colin
Published: May 2021

This article analyzes two participatory art projects,Plant/LivesandGardening the Suburbs,which fostered affective encounters with the gardens of Amman, Jordan, for its participants. Building on legacies of spatially exploratory and participatory art in Amman, these projects challenged the social fragmentation and historic erasure that characterize Amman’s geography. These artworks provoked a dissensus, or awareness of contradictions inherent in Amman’s urban space, and challenged participants to collectively work through those contradictions. This process mobilized new formations of collectivity, as participants with diverse interests came together to renarrate the gardens as sites of collective meaning.
Paraethnographic Film: Virtual Enactment and Collaboration inOur Digital Selves
Authors: Boellstorff Tom
Published: May 2021

The filmOur Digital Selves: My Avatar Is Me(Bernhard Drax, director: 74m, 2018,https://youtu.be/GQw02-me0W4) chronicles the experiences and insights of disabled persons in the virtual world Second Life. In this article, I focus on the making of the film through collaboration between researchers, filmmakers, and community. By discussing techniques of what I termvirtual enactment, I explore howOur Digital Selvesconstitutesparaethnographic filmcreated through a triple collaboration between community members, filmmakers, and ethnographers. This concept can contribute to visual anthropology as a set of representational and analytical techniques responsive to emergent cultures and communities.
Anthropology’s Prophecy for #MeToo: From Hollywood to Hong Kong
Authors: Martin Sylvia J.
Published: May 2021

More than fifty years before the #MeToo movement, anthropologist Hortense Powdermaker provided ethnographic insights into patterns of masculine aggression and gender disparities in positions of power in Hollywood. Contextualizing contemporary #MeToo news reports with Powdermaker’s study and my own ethnographic research in the Hollywood and Hong Kong film industries, I examine what I call the globalization of Hollywood patriarchy through the East Asian business operations of US film producer–distributor Harvey Weinstein. Connecting anthropologist Sherry Ortner’s conceptualization of US neoliberal patriarchy with Powdermaker’s insights offers a unique perspective on contemporary and racialized expressions of power in global mass media industries.
In Galleries and Beer Cans: Experimental Photography in Explorations of Northern Swedish Landscapes
Authors: Bartlett Flora Mary
Published: May 2021

This visual essay reflexively explores experimental photographic research methods. Using cyanotypes, beer can cameras, maps, and exhibitions to make physical spaces and surfaces occupied by photography tangible, I show how these methods work with traditional anthropological approaches to orient us to how local place is represented, and how this visual critique connects with the ways landscape is experienced in contrast to historical national discourses. These methods were aimed at having a better understanding of local experiences and understandings of Northern landscapes in rural Sweden.
Unwitting Architect
Authors: Germann Julian
Published: May 2021

The global rise of neoliberalism since the 1970s is widely seen as a dynamic originating in the United States and the United Kingdom, and only belatedly and partially repeated by Germany. From this Anglocentric perspective, Germany's emergence at the forefront of neoliberal reforms in the eurozone is perplexing, and tends to be attributed to the same forces conventionally associated with the Anglo-American pioneers. This book challenges this ruling narrative. It recasts the genesis of neoliberalism as a process driven by a plenitude of actors, ideas, and interests. And it lays bare the pragmatic reasoning and counterintuitive choices of German crisis managers obscured by this master story.
This book argues that German officials did not intentionally set out to promote neoliberal change. Instead they were more intent on preserving Germany's export markets and competitiveness in order to stabilize the domestic compact between capital and labor. Nevertheless, the series of measures German policy elites took to manage the end of golden-age capitalism promoted neoliberal transformation in crucial respects: it destabilized the Bretton Woods system; it undermined socialist and social democratic responses to the crisis in Europe; it frustrated an internationally coordinated Keynesian reflation of the world economy; and ultimately it helped push the US into the Volcker interest-rate shock that inaugurated the attack on welfare and labor under Reagan and Thatcher.
From this vantage point, the book illuminates the very different rationale behind the painful reforms German state managers have demanded of their indebted eurozone partners.
Introduction
Authors: Methodieva Milena B.
Published: May 2021

In addition to providing an overview of the existing scholarship on the Muslims and Turks in Bulgaria, the introduction presents the subject of this book. The book follows the history of the Muslims in Bulgaria (mostly Turks but also Pomaks, Tatars, and Roma) in the first crucial decades after the establishment of modern Bulgaria on former Ottoman territories. More specifically, it focuses on the activities of a movement for cultural reform and its efforts to reshape local Muslim society, a phenomenon neglected by scholarship so far. The book seeks to bring out the history of Bulgaria’s Muslims from the confines of “minority studies,” and put it in a new framework of inquiry, while underscoring how the community also remained a part of the Ottoman world.
Memory, Language, and Jewish Francophonie
Authors: Elsky Julia
Published: May 2021

This epilogue theorizes a Jewish Francophonie, looking at the question of Jewishness within the French language among the heirs to the writers in Writing Occupation including Myriam Anissimov, Hélène Cixous, and Cécile Wajsbrot. These writers demonstrate the lasting impact of Jewish multilingualism on writerly identity, in particular in relation to the memory and postmemory of the Shoah and histories of migration. These writers also relate to Yiddish in different ways, from lamenting the disappearance of Yiddish to resisting that trope and embodying what Samuel J. Spinner has called “reading Jewish,” which is related to Jeffrey Shandler’s concept of postvernacular Yiddish. Like the authors studied in Writing Occupation, Anissimov, Cixous, and Wajsbrot shift the paradigms of dominant and dominated cultures to one of immigration and transnational circulation.
The Sultan's Communists
Authors: Heckman Alma Rachel
Published: May 2021

Structured around the stories of five prominent Moroccan Jewish Communists (Léon René Sultan, Edmond Amran El Maleh, Abraham Serfaty, Simon Lévy, and Sion Asssidon), The Sultan’s Communists examines how Moroccan Jews envisioned themselves participating as citizens in a newly independent Morocco. It also explores how Communism facilitated the participation of Moroccan Jews in Morocco’s national liberation struggle with roots in the mass upheavals of the interwar and WWII periods. Alma Heckman describes how Moroccan Communist Jews fit within the story of mass Jewish exodus from Morocco in the 1950s and ’60s, and how Communist Jews survived oppressive post-independence authoritarian rule under the Moroccan monarchy. These stories unfold in a country that, upon independence from France and Spain in 1956, allied itself with the United States (and, more quietly, Israel) during the Cold War all while attempting to claim a place for itself within the fraught politics of the post-independence Arab world. Heckman’s manuscript contributes to the growing literature on Jews in the modern Middle East, filling in the gaps on the Jewish history of 20th-century Morocco as no other previous book has done.
Scarification: A Conclusion
Authors: Heckman Alma Rachel
Published: May 2021

The conclusion summarizes the book’s main arguments while recapitulating the broad narrative and temporal sweep of its subject matter. It highlights the apparent paradox raised in the introduction of the book: how a minority of a minority, a small group of Moroccan Jewish Communists, reviled as pariahs and liabilities by many, became among the most prominent state-supported symbols of Moroccan liberalism and Muslim–Jewish interfaith harmony or convivencia in the region. It demonstrates the continuity of the Sultan’s Jews into the Sultan’s Communists, shedding light on ongoing political and cultural developments in Morocco under King Muhammad VI.
Idea Generation Mechanisms: Comparing the Influence of Classification, Combination, Building on Others, and Stimulation Mechanisms on Ideation Effectiveness
Authors: Deo Saurabh , Blej Aimane , Kirjavainen Senni , Hölttä-Otto Katja
Published: May 2021

Ideation methods have been extensively studied, and several ideation methods can be beneficial in different contexts, but it is not understood what makes a specific method work. Previous work has shown that all the ideation methods comprise of 25 fundamental ideation mechanisms in two categories: idea implementation and idea promoting mechanisms. In this study, we try to understand how individual mechanisms affect idea generation outcomes. We chose four idea promoting mechanisms: two from the process category (Classification and Combination) and two from the idea sources category (Building on Others and Stimulation). These mechanisms were selected as they are examples of comparable mechanisms that could be integrated into any other ideation method. We conducted four experiments and assessed idea quantity, novelty, and originality. Our study showed that the chosen mechanisms increased ideation performance. For the most part, the mechanisms are statistically equivalent, but we found evidence that classification outperforms combination in nonengineering concept generation exercise. We also found the building on others can be more useful than the type of stimulation used in engineering concept generation, but the difference was not found in nonengineering concept generation. Overall, we found evidence that all mechanisms improve ideation effectiveness and could be incorporated into any ideation method, but further studies are needed to build a more comprehensive understanding.
A Low-Cost Visual Grasp Aid for Neuropathy Patients Using Flexible Three-Dimensional Printed Tactile Sensors
Authors: Emon Md Omar Faruk , Russell Alex , Nadkarni Gopal , Choi Jae-Won
Published: May 2021

Neuropathy is a nerve-damaging disease that causes those affected to lose feeling in their otherwise functional limbs. It can cause permanent numbing to the peripheral limb of a patient such as a hand or foot. In this report, we present a real-time visualization aid for grasp realization that can be used by patients experiencing numbness of the limb. This wearable electronic device was developed on an open-source microcontroller-based platform. This is a very simple and inexpensive solution. It is referred to as the NeuroGlove, and it provides patients with a visual light scale to allow them to understand the strength of the grasp that they have on any object. A soft tactile sensor was additively manufactured by utilizing a multimaterial direct-print system. The sensor consists of an ionic liquid (IL)-based pressure-sensitive membrane, stretchable electrodes, and insulation membranes. The printed flexible polymeric sensor was evaluated under varying forces. Next, the fabricated sensor was integrated with a microcontroller board where it was programmed to respond in a light scale according to the applied force on the sensor. Finally, the sensor-microcontroller system was installed on a glove to demonstrate a wearable visual aid for neuropathy patients. Additive manufacturing offers the ability for customization in a design, material, and geometry that could potentially lead to printing sensors on prosthetic or robotic hands.
Development and Evaluation of an Ebola Virus Glycoprotein Mucin-Like Domain Replacement System as a New Dendritic Cell-Targeting Vaccine Approach against HIV-1
Authors: Ao Zhujun , Wang Lijun , Azizi Hiva , Olukitibi Titus Abiola , Kobinger Gary , Yao Xiaojian
Published: May 2021

Currently, there are more than 38.5 million reported cases of HIV globally. To date, there is no approved vaccine for HIV-1 infection.
Supplemental Material: Spatially variable provenance of the Chinese Loess Plateau
Authors: Zhang Haobo , Nie Junsheng , al. et
Published: May 2021

Figures S1–S5, and Tables S1–S4.
Improved renal allograft survival for pre-emptive paediatric renal transplant recipients in the UK
Authors: Marlais Matko , Martin Kate , Marks Stephen D
Published: May 2021

Background

The aim of this study was to investigate whether being on dialysis at the time of renal transplantation affected renal allograft survival in paediatric renal transplant recipients (pRTRs).

Methods

Retrospective study of UK Transplant Registry (National Health Service Blood and Transplant) data on all children (aged <18 years) receiving a kidney-only transplant from 1 January 2000 to 31 December 2015. Kaplan-Meier estimates of patient and renal allograft survival calculated and Cox regression modelling accounting for donor type. The relationship between time on dialysis and renal allograft survival was examined.

Results

2038 pRTRs were analysed: 607 (30%) were pre-emptively transplanted, 789 (39%) and 642 (32%) on peritoneal dialysis and haemodialysis, respectively, at the time of transplantation. Five-year renal allograft survival was significantly better in the pre-emptively transplanted group (90.6%) compared with those on peritoneal dialysis and haemodialysis (86.4% and 85.7%, respectively; p=0.02). After accounting for donor type, there was a significantly lower hazard of 5-year renal allograft failure in pre-emptively transplanted children (HR 0.742, p=0.05). Time spent on dialysis pre-transplant negatively correlated with renal allograft survival (p=0.002). There was no significant difference in 5-year renal allograft survival between children who were on dialysis for less than 6 months and children transplanted pre-emptively (87.5% vs 90.5%, p=0.25).

Conclusions

Pre-emptively transplanted children have improved 5-year renal allograft survival, compared with children on dialysis at the time of transplantation. Although increased time spent on dialysis correlated with poorer renal allograft survival, there was no evidence that short periods of dialysis pre-transplant affected renal allograft survival.
Dual biologic therapy in a patient with severe asthma and other allergic disorders
Authors: Caskey Joshua Ray , Kaufman David
Published: May 2021

Severe asthma is very difficult to manage in many individuals, and systemic corticosteroids are often used to prevent or manage acute exacerbations. Furthermore, comorbid allergic conditions may render standard therapies inadequate. A 51-year-old man presented with severe eosinophilic asthma requiring nearly constant oral corticosteroid usage despite using high-dose inhaled corticosteroids and secondary asthma controllers. His condition was complicated by aspirin-exacerbated respiratory disease, including severe nasal polyposis, chronic rhinosinusitis, as well as chronic idiopathic urticaria. Mepolizumab was initiated and led to dramatic improvement of asthma over 6 months. However, he continued to experience exacerbations of chronic idiopathic urticaria not responsive to H1-antihistamines. Omalizumab was added, and the patient’s urticaria attained marked improvement with only an occasional breakthrough rash. Dual biologic therapies can be a unique and useful steroid-sparing treatment option for patients with uncontrolled severe asthma and chronic idiopathic urticaria.
Body checking in non-elite adolescent ice hockey leagues: it is never too late for policy change aiming to protect the health of adolescents
Authors: Emery Carolyn A , Eliason Paul , Warriyar Vineetha , Palacios-Derflingher Luz , Black Amanda Marie , Krolikowski Maciek , Spencer Nicole , Sick Stacy , Kozak Stacy , Schneider Kathryn J , Babul Shelina , Mrazik Martin , Lebrun Constance , Goulet Claude , Macpherson Alison , Hagel Brent E
Published: May 2021

Objectives

The objective of this study is to evaluate the effect of policy change disallowing body checking in adolescent ice hockey leagues (ages 15–17) on reducing rates of injury and concussion.

Methods

This is a prospective cohort study. Players 15–17 years-old were recruited from teams in non-elite divisions of play (lower 40%–70% by division of play depending on year and city of play in leagues where policy permits or prohibit body checking in Alberta and British Columbia, Canada (2015–18). A validated injury surveillance methodology supported baseline, exposure-hours and injury data collection. Any player with a suspected concussion was referred to a study physician. Primary outcomes include game-related injuries, game-related injuries (>7 days time loss), game-related concussions and game-related concussions (>10 days time loss).

Results

44 teams (453 player-seasons) from non-body checking and 52 teams (674 player-seasons) from body checking leagues participated. In body checking leagues there were 213 injuries (69 concussions) and in non-body checking leagues 40 injuries (18 concussions) during games. Based on multiple multilevel mixed-effects Poisson regression analyses, policy prohibiting body checking was associated with a lower rate of injury (incidence rate ratio (IRR): 0.38 (95% CI 0.24 to 0.6)) and concussion (IRR: 0.49; 95% CI 0.26 to 0.89). This translates to an absolute rate reduction of 7.82 injuries/1000 game-hours (95% CI 2.74 to 12.9) and the prevention of 7326 injuries (95% CI 2570 to 12083) in Canada annually.

Conclusions

The rate of injury was 62% lower (concussion 51% lower) in leagues not permitting body checking in non-elite 15–17 years old leagues highlighting the potential public health impact of policy prohibiting body checking in older adolescent ice hockey players.
Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study
Authors: Daugherty Sarah E , Guo Yinglong , Heath Kevin , Dasmariñas Micah C , Jubilo Karol Giuseppe , Samranvedhya Jirapat , Lipsitch Marc , Cohen Ken
Published: May 2021

Objective

To evaluate the excess risk and relative hazards for developing incident clinical sequelae after the acute phase of SARS-CoV-2 infection in adults aged 18-65.

Design

Retrospective cohort study.

Setting

Three merged data sources from a large United States health plan: a large national administrative claims database, an outpatient laboratory testing database, and an inpatient hospital admissions database.

Participants

Individuals aged 18-65 with continuous enrollment in the health plan from January 2019 to the date of a diagnosis of SARS-CoV-2 infection. Three comparator groups, matched by propensity score, to individuals infected with SARS-CoV-2: a 2020 comparator group, an historical 2019 comparator group, and an historical comparator group with viral lower respiratory tract illness.

Main outcome measures

More than 50 clinical sequelae after the acute phase of SARS-CoV-2 infection (defined as the date of first SARS-CoV-2 diagnosis (index date) plus 21 days) were identified using ICD-10 (international classification of diseases, 10th revision) codes. Excess risk in the four months after acute infection and hazard ratios with Bonferroni corrected 95% confidence intervals were calculated.

Results

14% of adults aged ≤65 who were infected with SARS-CoV-2 (27 074 of 193 113) had at least one new type of clinical sequelae that required medical care after the acute phase of the illness, which was 4.95% higher than in the 2020 comparator group. The risk for specific new sequelae attributable to SARS-Cov-2 infection after the acute phase, including chronic respiratory failure, cardiac arrythmia, hypercoagulability, encephalopathy, peripheral neuropathy, amnesia (memory difficulty), diabetes, liver test abnormalities, myocarditis, anxiety, and fatigue, was significantly greater than in the three comparator groups (2020, 2019, and viral lower respiratory tract illness groups) (all P<0.001). Significant risk differences because of SARS-CoV-2 infection ranged from 0.02 to 2.26 per 100 people (all P<0.001), and hazard ratios ranged from 1.24 to 25.65 compared with the 2020 comparator group.

Conclusions

The results indicate the excess risk of developing new clinical sequelae after the acute phase of SARS-CoV-2 infection, including specific types of sequelae less commonly seen in other viral illnesses. Although individuals who were older, had pre-existing conditions, and were admitted to hospital because of covid-19 were at greatest excess risk, younger adults (aged ≤50), those with no pre-existing conditions, or those not admitted to hospital for covid-19 also had an increased risk of developing new clinical sequelae. The greater risk for incident sequelae after the acute phase of SARS-CoV-2 infection is relevant for healthcare planning.
Telemedicine supported strengthening of primary care in WHO South East Asia region: lessons from the COVID-19 pandemic experiences
Authors: Gudi Nachiket , Konapur Rahul , John Oommen , Sarbadhikari Supten , Landry Mark
Published: May 2021

The COVID-19 pandemic has exposed the fragmentation of the healthcare delivery systems and highlighted the role of resilient primary healthcare systems for a robust public health response during health emergencies. Primary care while being the first point of contact between the citizens and the health systems has received scant attention or targeted investments over the past several decades. Through this narrative review, we aim to outline the potential role of telehealth in augmenting health systems capacity. While teleconsultations have increased exponentially during the pandemic, evidence suggests that utilisation of primary care for non-emergency and non-COVID-19 conditions such as chronic medical conditions has significantly decreased, suggesting that most telemedicine utilisation has been to address an immediate crisis. In countries with pre-existing national digital health framework and enabling regulatory environments, telehealth interventions while strengthening the public health response to COVID-19 also supported the continuum of care at the primary care level. Even after COVID-19 is controlled, telemedicine has the potential to address persistent obstacles to primary care in the South East Asia region, including scarcity of trained healthcare workers, access challenges and costs associated with in-person care. Telemedicine holds promise in strengthening primary care and has the potential to catalyse achieving universal health coverage.
Continuous enteral nutrition compared with a maximal gastric vacuity strategy at the time of extubation in the intensive care unit: protocol for a non-inferiority cluster randomised trial (the Ambroisie Project)
Authors: Landais Mickael , Nay Mai-Anh , Auchabie Johann , Hubert Noemie , Rebion Anne , Robert Alain , Giraudeau Bruno , Reignier Jean , Thille Arnaud W , Tavernier Elsa , Ehrmann Stephan
Published: May 2021

Introduction

Fasting is frequently imposed to patients before extubation in the intensive care unit based on scheduled surgery guidelines. This practice has never been evaluated among critically ill patients and may delay extubation, increase nursing workload and reduce caloric intake. We are hypothesising that continuous enteral nutrition until extubation represents a safe alternative compared with fasting prior to extubation in the intensive care unit.

Methods and analysis

Adult patients ventilated more than 48 hours and receiving pre-pyloric enteral nutrition for more than 24 hours are included in this open-label cluster randomised parallel group non-inferiority trial. The participating centres are randomised allocated to continued enteral nutrition until extubation or 6-hour fasting (with concomitant gastric suctioning when feasible) prior to extubation. The primary outcome is extubation failure (ie, reintubation within 7 days following extubation).

Ethics and dissemination

This study has been approved by the national ethics review board (comité de protection, des personnes Sud Mediterranée III No 2017.10.02 bis) and patients are included after informed consent. Results will be submitted for publication in peer-reviewed journals.

Trial registration number

ClinicalTrials.gov Registry (NCT03335345).
Physical-mental multimorbidity in children and youth: a scoping review
Authors: Romano Isabella , Buchan Claire , Baiocco-Romano Leonardo , Ferro Mark A
Published: May 2021

Objective

Efforts to describe the current state of research are needed to advance the field of physical-mental multimorbidity (ie, the co-occurrence of at least one physical illness and at least one mental disorder) among children and youth. Our objective was to systematically explore the breadth of physical-mental multimorbidity research in children and youth and to provide an overview of existing literature topics.

Design

Scoping review.

Methods

We conducted a systematic search of four key databases: PubMed, EMBASE, PsycINFO and Scopus as well as a thorough scan of relevant grey literature. We included studies of any research design, published in English, referring to physical-mental multimorbidity among children and youth aged ≤18 years. Studies were screened for eligibility and data were extracted, charted and summarised narratively by research focus. Critical appraisal was employed using the modified Quality Index (QI).

Results

We included 431 studies and 2 sources of grey literature. Existing research emphasises the co-occurrence of anxiety, mood and attention disorders among children with epilepsy, asthma and allergy. Evidence consists of mostly small, observational studies that use cross-sectional data. The average QI score across applicable studies was 9.1 (SD=1.8).

Conclusions

There is a pressing need for more robust research within the field of child physical-mental multimorbidity.
STOP leg clots—Swedish multicentre trial of outpatient prevention of leg clots: study protocol for a randomised controlled trial on the efficacy of intermittent pneumatic compression on venous thromboembolism in lower leg immobilised patients
Authors: Svedman Simon , Alkner Björn , Berg Hans E , Domeij-Arverud Erica , Jonsson Kenneth , Nilsson Helander Katarina , Ackermann Paul W
Published: May 2021

Introduction

Leg immobilisation in a cast or an orthosis after lower limb injuries is associated with a high risk of complications of venous thromboembolism (VTE) and hampered healing. Current pharmacoprophylaxes of VTE are inefficient and associated with adverse events. Intermittent pneumatic compression (IPC) could represent a novel, efficient and safe VTE-prophylactic alternative that may enhance injury healing. The aim of STOP leg clots is to assess the efficacy of adjuvant IPC-therapy on reduction of VTE incidence and improvement of healing in lower leg immobilised outpatients.

Methods and analysis

STOP leg clots is a multicentre randomised controlled superiority trial. Eligible patients (700 patients/arm) with either an acute ankle fracture or Achilles tendon rupture will be randomised to either addition of IPC during lower-leg immobilisation or to treatment-as-usual. The primary outcome will be the total VTE incidence, that is, symptomatic and asymptomatic deep venous thrombosis (DVT) or symptomatic pulmonary embolism (PE), during the leg immobilisation period, approximately 6–8 weeks. DVT incidence will be assessed by screening whole leg compression duplex ultrasound at removal of leg immobilisation and/or clinically diagnosed within the time of immobilisation. Symptomatic PE will be verified by CT.

Secondary outcomes will include patient-reported outcome using validated questionnaires, healing evaluated by measurements of tendon callus production and changes in VTE-prophylactic mechanisms assessed by blood flow and fibrinolysis. Data analyses will be blinded and based on the intention-to-treat.

Ethics and dissemination

Ethical approval was obtained by the ethical review board in Stockholm, Sweden, Dnr 2016/1573-31. The study will be conducted in accordance with the Helsinki declaration. The results of the study will be disseminated in peer-reviewed international journals.

Trial registration

NCT03259204.

Time schedule

1 September 2018 to 31 December 2022
Prospective observational study of gender and ethnicity biases in respiratory protective equipment for healthcare workers in the COVID-19 pandemic
Authors: Carvalho Clarissa Y M , Schumacher Jan , Greig Paul Robert , Wong Danny J N , El-Boghdadly Kariem
Published: May 2021

Objective

To describe success rates of respiratory protective equipment (RPE) fit testing and factors associated with achieving suitable fit.

Design

Prospective observational study of RPE fit testing according to health and safety, and occupational health requirements.

Setting

A large tertiary referral UK healthcare facility.

Population

1443 healthcare workers undergoing quantitative fit testing.

Main outcome measures

Quantitative fit test success (pass/fail) and the count of tests each participant required before successful fit.

Results

Healthcare workers were fit tested a median (IQR) 2 (1–3) times before successful fit was obtained. Males were tested a median 1 (1–2) times, while females were tested a median 2 (1–2) times before a successful fit was found. This difference was statistically significant (p<0.001). Modelling each fit test as its own independent trial (n=2359) using multivariable logistic regression, male healthcare workers were significantly more likely to find a well-fitting respirator and achieve a successful fit on first attempt in comparison to females, after adjusting for other factors (adjusted OR=2.07, 95% CI): 1.66 to 2.60, p<0.001). Staff who described their ethnicity as White were also more likely to achieve a successful fit compared with staff who described their ethnicity as Asian (OR=0.47, 95% CI: 0.38 to 0.58, p<0.001), Black (OR=0.54, 95% CI: 0.41 to 0.71, p<0.001), mixed (OR=0.50 95% CI: 0.31 to 0.80, p=0.004) or other (OR=0.53, 95% CI: 0.29 to 0.99, p=0.043).

Conclusions

Male and White ethnicity healthcare workers are more likely to achieve RPE fit test success. This has broad operational implications to healthcare services with a large female and Black, Asian and minority ethnic group population. Fit testing is imperative in ensuring RPE effectiveness in protecting healthcare workers during the COVID-19 pandemic and beyond.
Soluble type immune checkpoint regulators using multiplex luminex immunoassay in chronic hepatitis B patients
Authors: Fadriquela Ailyn , Kim Cheol-Su , Lee Kyu-Jae , Kang Seong Hee , Kim Moon Young , Lee Jong-Han
Published: May 2021

Aims

Soluble immune checkpoint regulators (sICs) were reported to have clinical impact on the diagnosis and progress of various diseases. This study compared the serum levels of 16 sICs in patients with chronic hepatitis B (CHB) to elucidate their clinical significance.

Methods

The sICs of 86 patients with CHB and 50 healthy controls (HCs) were measured using luminex-based multiplex assay. The sICs were correlated with laboratory markers and sIC levels were compared in cirrhotic and non-cirrhotic groups.

Results

The levels of soluble programmed death-ligand 1, soluble cluster of differentiation 80/B7-1 (sCD80/B7-1), soluble cluster of differentiation 86/B7-2, soluble B-lymphocyte and T-lymphocyte attenuator, soluble herpes virus entry mediator, soluble cluster 28, soluble cluster of differentiation 40, soluble glucocorticoid-induced TNFR-related protein, soluble ligand for receptor TNFRSF18/AITR/GITR, soluble Toll-like receptor 2 and soluble inducible T-cell costimulator (sICOS) were decreased, while soluble T-cell immunoglobulin and mucin-domain containing-3 (sTIM-3) was increased in patients with CHB. Soluble programmed cell death protein 1 and sTIM-3 both positively correlated with hepatitis B virus (HBV) DNA level and increased in entecavir or tenofovir used group. The sTIM-3 positively correlated with aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase and gamma-glutamyl transferase to platelet ratio and fibrosis-4. Soluble cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) decreased in the liver cirrhosis (LC) group compared with the non-LC group. sCD80/B7-1 decreased LC risk, while soluble lymphocyte-activation gene increased LC risk by logistic regression analysis.

Conclusions

Our results showed the preliminary data on dysregulated sICs in patients with CHB that may have clinical significance in diagnosis of patients with CHB. It can be applied to develop therapeutic target of HBV infection.