tbuckley/cabot-search huggingface dataset:
Abstract 9924: Acute Inhibition of CaMKII Over-Activation Augments Cardiomyocyte Contractility and Improves β-Adrenergic Regulation in Experimental Diabetic Cardiomyopathy
Authors: Yixi Liu, Heng-Jie Cheng, Alexei V Mikhailov, Jen-Jar Lin, Peng Zhou, David Zhao, David Herrington, Dalane Kitzman, Che Ping Cheng
Journal: Circulation (2019)

Background: Growing evidence indicates that calcium/calmodulin-dependent kinase II (CaMKII) overactivity plays a crucial role in the pathophysiology of diabetic cardiomyopathy (DCM). CaMKII has bee...
Intestinal Barrier Dysfunction Accompanies Peanut Allergy in CC027/GeniUnc Mice
Authors: Erin Steinbach, Johanna Smeekens, Layna Perini, Satyaki Roy, Ana Berglind, Michael Kulis, Martin Ferris, Terrence Furey, A. Wesley Burks, Shehzad Sheikh
Journal: Journal of Allergy and Clinical Immunology (2021)
A Single-Center, Randomized, 3-Way, Crossover Study to Evaluate the Effect of an Exhalation Delivery System on Nasal Nitric Oxide Concentrations in Patients with Chronic Sinusitis
Authors: Miguel Lanz, Per Djupesland, John McGinnis, Eric Zaccone, John Messina
Journal: Journal of Allergy and Clinical Immunology (2021)
High incidence of CDA deficiency in patients with hematological malignancies: perspectives and therapeutic implications
Authors: M. Donnette, J. Ciccolini, C. Pissier, R. Costello, F. Duffaud, S. Salas, L. Farnault, A. Tichadou, R. Arcani, P.A. Jarrot, L.H. Ouafik, G. Venton, R. Fanciullino
Journal: Annals of Oncology (2021)
The Role of Dermatologists in the Early HIV/AIDS Epidemic
Authors: Heather Milbar, William D. James
Journal: JAMA Dermatology (2021)

In 1981, the HIV/AIDS epidemic was first recognized in young gay men presenting with opportunistic infections and Kaposi sarcoma. Over the past 40 years, there has been an unparalleled and hugely successful effort on the part of physicians, scientists, public health experts, community activists, and grassroots organizations to study, treat, and prevent HIV/AIDS. Yet the role of dermatologists in the investigation of HIV/AIDS and in the treatment of infected patients has largely been neglected in the historical literature. It is important to revisit dermatologists' historic contributions and problematic biases during this epidemic and honor the legacy of the dermatologists who were instrumental in treating and advocating for patients affected by HIV/AIDS.
A little help from residual β cells has long-lasting clinical benefits
Authors: Anna Lam, Colin Dayan, Kevan C. Herold
Journal: Journal of Clinical Investigation (2021)

Following type 1 diabetes (T1D) diagnosis, declining C-peptide levels reflect deteriorating β cell function. However, the precise C-peptide levels that indicate protection from severe hypoglycemia remain unknown. In this issue of the JCI, Gubitosi-Klug et al. studied participants from the landmark and ongoing Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) study that had long-standing (about 35 years) T1D. The authors correlated severe hypoglycemia and other disease outcomes with residual C-peptide levels. While C-peptide secretion failed to associate with hemoglobin A1c (HbA1c) or microvascular complications, C-peptide levels greater than 0.03 nmol/L were linked with fewer episodes of severe hypoglycemia. These findings suggest that efforts to preserve finite β cell function early in T1D can have meaningful, long-standing health benefits for patients.
Safety, tolerability, and pharmacokinetics of BAT8001 in patients with HER2‐positive breast cancer: An open‐label, dose‐escalation, phase I study
Authors: Ruoxi Hong, Wen Xia, Liye Wang, Kaping Lee, Qianyi Lu, Kuikui Jiang, Shengfeng Li, Jinquan Yu, Jin Wei, Weijia Tang, Danyang Zhou, Xin An, Jiajia Huang, Cong Xue, Xiwen Bi, Yanxia Shi, Zhongyu Yuan, Fei Xu, Shusen Wang
Journal: Cancer Communications (2021)

Abstract Background The introductions of anti‐ human epidermal growth factor receptor‐2 (HER2) agents have significantly improved the treatment outcome of patients with HER2‐positive breast cancer. BAT8001 is a novel antibody‐drug conjugate targeting human epidermal growth factor receptor‐2 (HER2)‐expressing cells composed of a trastuzumab biosimilar linked to the drug‐linker Batansine. This dose‐escalation, phase I study was designed to assess the safety, tolerability, pharmacokinetics, and preliminary anti‐tumor activity of BAT8001 in patients with HER2‐positive locally advanced or metastatic breast cancer. Methods This trial was conducted in subjects with histologically confirmed HER2‐positive breast cancer (having evaluable lesions and an Eastern Cooperative Oncology Group performance status of 0 or 1) using a 3 + 3 design of escalating BAT8001 doses. Patients received BAT8001 intravenously in a 21‐day cycle, with dose escalation in 5 cohorts: 1.2, 2.4, 3.6, 4.8, and 6.0 mg/kg. The primary objective was to evaluate the safety and tolerability of BAT8001. Preliminary activity of BAT8001 was also assessed as a secondary objective. Results Between March 2017 to May 2018, 29 HER2‐positive breast cancer patients were enrolled. The observed dose‐limiting toxicities were grade 4 thrombocytopenia and grade 3 elevated transaminase. The maximum tolerated dose was determined to be 3.6 mg/kg. Grade 3 or greater adverse events (AEs) occurred in 14 (48.3%) of 29 patients, including thrombocytopenia in 12 (41.4%) patients, aspartate aminotransferase increased in 4 (13.8%) patients, γ‐glutamyl transferase increased in 2 (6.9%) patients, alanine aminotransferase increased in 2 (6.9%) patients, diarrhea in 2 (6.9%) patients. Objective response was observed in 12 (41.4%; 95% confidence interval [CI] = 23.5%‐61.1%) and disease control (including patients achieving objective response and stable disease) was observed in 24 (82.8%; 95% CI = 64.2%‐94.2%) patients. Conclusions BAT8001 demonstrated favorable safety profiles, with promising anti‐tumor activity in patients with HER2‐positive locally advanced or metastatic breast cancer. BAT8001 has the potential to provide a new therapeutic option in patients with metastatic HER2‐positive breast cancer.
A multilayered post-GWAS assessment on genetic susceptibility to pancreatic cancer
Authors: Evangelina López de Maturana, Juan Antonio Rodríguez, Lola Alonso, Oscar Lao, Esther Molina-Montes, Isabel Adoración Martín-Antoniano, Paulina Gómez-Rubio, Rita Lawlor, Alfredo Carrato, Manuel Hidalgo, Mar Iglesias, Xavier Molero, Matthias Löhr, Christopher Michalski, José Perea, Michael O’Rorke, Victor Manuel Barberà, Adonina Tardón, Antoni Farré, Luís Muñoz-Bellvís, Tanja Crnogorac-Jurcevic, Enrique Domínguez-Muñoz, Thomas Gress, William Greenhalf, Linda Sharp, Luís Arnes, Lluís Cecchini, Joaquim Balsells, Eithne Costello, Lucas Ilzarbe, Jörg Kleeff, Bo Kong, Mirari Márquez, Josefina Mora, Damian O’Driscoll, Aldo Scarpa, Weimin Ye, Jingru Yu, Montserrat García-Closas, Manolis Kogevinas, Nathaniel Rothman, Debra T Silverman, Demetrius Albanes, Alan A Arslan, Laura Beane-Freeman, Paige M Bracci, Paul Brennan, Bas Bueno-de-Mesquita, Julie Buring, Federico Canzian, Margaret Du, Steve Gallinger, J Michael Gaziano, Phyllis J Goodman, Marc Gunter, Loic LeMarchand, Donghui Li, Rachael E Neale, Ulrika Peters, Gloria M Petersen, Harvey A Risch, Maria José Sánchez, Xiao-Ou Shu, Mark D Thornquist, Kala Visvanathan, Wei Zheng, Stephen J Chanock, Douglas Easton, Brian M Wolpin, Rachael Z Stolzenberg-Solomon, Alison P Klein, Laufey T Amundadottir, Marc A Marti-Renom, Francisco X Real, Núria Malats
Journal: Genome Medicine (2021)

Pancreatic cancer (PC) is a complex disease in which both non-genetic and genetic factors interplay. To date, 40 GWAS hits have been associated with PC risk in individuals of European descent, explaining 4.1% of the phenotypic variance. We complemented a new conventional PC GWAS (1D) with genome spatial autocorrelation analysis (2D) permitting to prioritize low frequency variants not detected by GWAS. These were further expanded via Hi-C map (3D) interactions to gain additional insight into the inherited basis of PC. In silico functional analysis of public genomic information allowed prioritization of potentially relevant candidate variants. We identified several new variants located in genes for which there is experimental evidence of their implication in the biology and function of pancreatic acinar cells. Among them is a novel independent variant in NR5A2 (rs3790840) with a meta-analysis p value = 5.91E-06 in 1D approach and a Local Moran's Index (LMI) = 7.76 in 2D approach. We also identified a multi-hit region in CASC8-a lncRNA associated with pancreatic carcinogenesis-with a lowest p value = 6.91E-05. Importantly, two new PC loci were identified both by 2D and 3D approaches: SIAH3 (LMI = 18.24), CTRB2/BCAR1 (LMI = 6.03), in addition to a chromatin interacting region in XBP1-a major regulator of the ER stress and unfolded protein responses in acinar cells-identified by 3D; all of them with a strong in silico functional support. This multi-step strategy, combined with an in-depth in silico functional analysis, offers a comprehensive approach to advance the study of PC genetic susceptibility and could be applied to other diseases.
Robotic-assisted Versus Laparoscopic Surgery: Outcomes from the First Multicentre, Randomised, Patient-blinded Controlled Trial in Radical Prostatectomy (LAP-01)
Authors: Jens-Uwe Stolzenburg, Sigrun Holze, Petra Neuhaus, Iason Kyriazis, Hoang Minh Do, Anja Dietel, Michael C. Truss, Corinn I. Grzella, Dogu Teber, Markus Hohenfellner, Robert Rabenalt, Peter Albers, Meinhard Mende
Journal: European Urology (2021)
Systematic review and meta-analysis of anakinra, sarilumab, siltuximab and tocilizumab for COVID-19
Authors: Fasihul A Khan, Iain Stewart, Laura Fabbri, Samuel Moss, Karen Robinson, Alan Robert Smyth, Gisli Jenkins
Journal: Thorax (2021)

Background There is accumulating evidence for an overly activated immune response in severe COVID-19, with several studies exploring the therapeutic role of immunomodulation. Through systematic review and meta-analysis, we assess the effectiveness of specific interleukin inhibitors for the treatment of COVID-19. Methods Electronic databases were searched on 7 January 2021 to identify studies of immunomodulatory agents (anakinra, sarilumab, siltuximab and tocilizumab) for the treatment of COVID-19. The primary outcomes were severity on an Ordinal Scale measured at day 15 from intervention and days to hospital discharge. Key secondary endpoints included overall mortality. Results 71 studies totalling 22 058 patients were included, 6 were randomised trials. Most studies explored outcomes in patients who received tocilizumab (60/71). In prospective studies, tocilizumab was associated with improved unadjusted survival (risk ratio 0.83, 95% CI 0.72 to 0.96, I 2 =0.0%), but conclusive benefit was not demonstrated for other outcomes. In retrospective studies, tocilizumab was associated with less severe outcomes on an Ordinal Scale (generalised OR 1.34, 95% CI 1.10 to 1.64, I 2 =98%) and adjusted mortality risk (HR 0.52, 95% CI 0.41 to 0.66, I 2 =76.6%). The mean difference in duration of hospitalisation was 0.36 days (95% CI −0.07 to 0.80, I 2 =93.8%). There was substantial heterogeneity in retrospective studies, and estimates should be interpreted cautiously. Other immunomodulatory agents showed similar effects to tocilizumab, but insufficient data precluded meta-analysis by agent. Conclusion Tocilizumab was associated with a lower relative risk of mortality in prospective studies, but effects were inconclusive for other outcomes. Current evidence for the efficacy of anakinra, siltuximab or sarilumab in COVID-19 is insufficient, with further studies urgently needed for conclusive findings. PROSPERO registration number CRD42020176375.
Residual β cell function in long-term type 1 diabetes associates with reduced incidence of hypoglycemia
Authors: Rose A. Gubitosi-Klug, Barbara H. Braffett, Susan Hitt, Valerie Arends, Diane Uschner, Kimberly Jones, Lisa Diminick, Amy B. Karger, Andrew D. Paterson, Delnaz Roshandel, Santica Marcovina, John M. Lachin, Michael Steffes, Jerry P. Palmer
Journal: Journal of Clinical Investigation (2021)

BACKGROUND. We investigated residual β cell function in Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study participants with an average 35-year duration of type 1 diabetes mellitus (T1DM).
A simple nomogram for predicting failure of non-invasive respiratory strategies in adults with COVID-19: a retrospective multicentre study
Authors: Ling Liu, Jianfeng Xie, Wenjuan Wu, Hui Chen, Shusheng Li, Hongli He, Yuetian Yu, Ming Hu, Jinxiu Li, Ruiqiang Zheng, Xuyan Li, Haibo Qiu, Zhaohui Tong, Bin Du, Eddy Fan, Yi Yang, Arthur S Slutsky
Journal: The Lancet Digital Health (2021)
Covid-19: Five steps to escape the cycle of lockdowns
Authors: Kamran Abbasi
Journal: BMJ (2021)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Covid-19: Five steps to escape the cycle of lockdowns Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
A SARS-CoV-2 Cluster in an Acute Care Hospital
Authors: Michael Klompas, Meghan A. Baker, Chanu Rhee, Robert Tucker, Karen Fiumara, Diane Griesbach, Carin Bennett-Rizzo, Hojjat Salmasian, Rui Wang, Noah Wheeler, Glen R. Gallagher, Andrew S. Lang, Timelia Fink, Stephanie Baez, Sandra Smole, Larry Madoff, Eric Goralnick, Andrew Resnick, Madelyn Pearson, Kathryn Britton, Julia Sinclair, Charles A. Morris
Journal: Annals of Internal Medicine (2021)

Little is known about clusters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in acute care hospitals.
Association of Performance Status With Survival in Patients With Advanced Non–Small Cell Lung Cancer Treated With Pembrolizumab Monotherapy
Authors: Kartik Sehgal, Ritu R. Gill, Page Widick, Poorva Bindal, Danielle C. McDonald, Meghan Shea, Deepa Rangachari, Daniel B. Costa
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Despite approximately 40% of patients having Eastern Cooperative Oncology Group (ECOG) performance status (PS) scores of at least 2 in the real world, most landmark clinical trials that led to the use of pembrolizumab as standard of care in advanced non–small cell lung cancer (NSCLC) excluded this group. <h3>Objective</h3> To evaluate whether an ECOG PS score of at least 2 at the start of therapy is associated with progression-free survival (PFS) and overall survival (OS) in advanced NSCLC treated with pembrolizumab monotherapy. <h3>Design, Setting, and Participants</h3> This cohort study included all consecutive patients with advanced NSCLC who underwent treatment with palliative pembrolizumab monotherapy from February 2016 to October 2019 at a single academic cancer center, with data censoring on January 15, 2020. <h3>Exposures</h3> ECOG PS score at start of therapy, with 0 and 1 indicating fully active or restricted in strenuous activity and scores of 2 and higher indicating increasing disability. <h3>Main Outcomes and Measures</h3> PFS and OS, measured from initiation of pembrolizumab monotherapy. <h3>Results</h3> Of 74 patients (median [range] age, 68.5 [33-87] years; 36 [48.7%] women; 53 [71.6%] White individuals) with median follow-up of 19.5 (95% CI, 13.4-27.8) months, 45 (60.8%) had an ECOG PS of 0 or 1, while 29 (39.2%) had an ECOG PS of at least 2. There were no significant differences in the baseline characteristics, except in age. Compared with patients with PS scores of 0 or 1, those with PS scores of at least 2 had significantly lower disease control rates (38 [88.4%] vs 15 [53.6%];<i>P</i> = .002), shorter median PFS (7.9 [95% CI, 4.6-15.4] months vs 2.3 [95% CI, 1.8-4.8] months;<i>P</i> = .004), and shorter median OS (23.2 [14.0 vs 35.7] months vs 4.1 [95% CI, 2.1-6.9] months;<i>P</i> &lt; .001). Among those potentially eligible for subsequent cancer-directed therapy beyond pembrolizumab monotherapy, patients in the group with PS scores of at least 2 were less likely to receive it than those with PS scores of 0 or 1 (2 [8.3%] vs 14 [45.2%];<i>P</i> = .003). Multivariable adjustment for baseline characteristics confirmed ECOG PS of at least 2 as an independent risk factor for worse PFS (HR, 2.02; 95% CI, 1.09-3.74;<i>P</i> = .03) and worse OS (HR, 2.87; 95% CI, 1.40-5.89;<i>P</i> = .004). <h3>Conclusions and Relevance</h3> In this cohort study, having an ECOG PS score of at least 2 was associated with poorer prognosis for treatment of advanced NSCLC with palliative pembrolizumab monotherapy. Further prospective studies are needed to evaluate more objective and consistent measures of functional status to facilitate identification of patients with borderline performance status who may achieve durable clinical benefit from treatment with pembrolizumab monotherapy.
Severe Acute Kidney Injury in Patients with COVID-19 and Acute Respiratory Distress Syndrome (vol 202, pg 1299, 2020)
Authors: K. Chaibi, M. Dao, T. Pham, V. D. Gumucio-Sanguino, F. A. Di Paolo, A. Pavot, Y. Cohen, D. Dreyfuss, X. Perez-Fernandez, S. Gaudry
Journal: American Journal of Respiratory and Critical Care Medicine (2021)
Acute esophageal necrosis (black esophagus) with active upper gastrointestinal bleeding: What to do?
Authors: Igor Braga Ribeiro, Gustavo de Oliveira Luz, Gabriel Mayo Vieira de Souza, Mateus Bond Boghossian, Epifânio Silvino do Monte Junior, Marcos Eduardo Lera dos Santos, Eduardo Guimarães Hourneaux de Moura
Journal: Endoscopy (2021)

Corrected by:Correction: Acute esophageal necrosis (black esophagus) with active upper gastrointestinal bleeding: What to do?Endoscopy 2021; 53(12): C12-C12DOI: 10.1055/a-1389-8570
SARS-CoV-2 transmission during rugby league matches: do players become infected after participating with SARS-CoV-2 positive players?
Authors: Ben Jones, Gemma Phillips, Simon Kemp, Brendan Payne, Brian Hart, Matthew Cross, Keith A Stokes
Journal: British Journal of Sports Medicine (2021)

To examine the interactions between SARS-CoV-2 positive players and other players during rugby league matches and determine within-match SARS-CoV-2 transmission risk.Four Super League matches in which SARS-CoV-2 positive players were subsequently found to have participated were analysed. Players were identified as increased-risk contacts, and player interactions and proximities were analysed by video footage and global positioning system (GPS) data. The primary outcome was new positive cases of SARS-CoV-2 within 14 days of the match in increased-risk contacts and other players participating in the matches.Out of 136 total players, there were 8 SARS-CoV-2 positive players, 28 players identified as increased-risk contacts and 100 other players in the matches. Increased-risk contacts and other players were involved in 11.4±9.0 (maximum 32) and 4.0±5.2 (maximum 23) tackles, respectively. From GPS data, increased-risk contacts and other players were within 2 m of SARS-CoV-2 positive players on 10.4±18.0 (maximum 88) and 12.5±20.7 (maximum 121) occasions, totalling 65.7±137.7 (maximum 689) and 89.5±169.4 (maximum 1003) s, respectively. Within 14 days of the match, one increased-risk contact and five players returned positive SARS-CoV-2 reverse transcriptase PCR (RT-PCR) tests, and 27 increased-risk contacts and 95 other participants returned negative SARS-CoV-2 RT-PCR tests. Positive cases were most likely traced to social interactions, car sharing and wider community transmission and not linked to in-match transmission.Despite tackle involvements and close proximity interactions with SARS-CoV-2 positive players, in-match SARS-CoV-2 transmission was not confirmed. While larger datasets are needed, these findings suggest rugby presents a lower risk of viral transmission than previously predicted.
グルタミン酸-システインリガーゼ触媒性サブユニット(GCLC)遺伝子多型は若年健常人においてLDL酸化と関連がある
Authors: Imamura A, Okumura K, Mizuno T, Matsui H, Numaguchi Y, Miura M, Hayashi Y, Murohara T
Journal: Circulation (2004)
Blood test monitoring of immunomodulatory therapy in inflammatory disease
Authors: Nathaniel J Spencer, Anthony A Fryer, Adam D Farmer, Christopher J Duff
Journal: BMJ (2021)

### What you need to know

Immunomodulation is the cornerstone of treatment in many immune mediated inflammatory disorders, including inflammatory bowel disease, autoimmune rheumatic disease, and inflammatory skin diseases. Most require pre-treatment screening blood tests and regular blood test monitoring thereafter to detect potential toxicity. This article seeks to provide a simplified overview of blood test monitoring requirements, and is aimed at general practitioners who, increasingly, are taking responsibility for monitoring and prescribing these medications.

### What patients say

Patients may have concerns about taking an immunomodulatory medication. We held a focus group with eight patients who were taking immunomodulatory therapy (three with Crohn’s disease and five with ulcerative colitis), who told us:

General practitioners care for a wide range of patients who are treated with immunomodulators. Commonly prescribed immunomodulators are listed in box 1. The conditions treated include psoriasis (UK prevalence 2.2-2.8%2), rheumatoid arthritis (UK prevalence 1%3), and inflammatory bowel disease (worldwide prevalence 0.3%4). In the UK, prescribing responsibilities are transferred from specialist care to primary care using Effective Shared Care Agreements, written local agreements between specialist services and GPs. A large proportion of GPs are either directly …
Covid-19: What happened to randomised controlled trials?
Authors: Charles P Warlow
Journal: BMJ (2021)

A woman in her mid-50s with IgA nephropathy, sarcoidosis and steroid-induced diabetes mellitus presented with generalised paraesthesia and spontaneous tetany. She had received denosumab 60 mg subcutaneously 8 weeks previously for parathyroid hormone independent hypercalcaemia. At admission, she had severe hypocalcaemia (5 mg/dL), hypophosphataemia (1.9 mg/dL), hypomagnesaemia (1.4 mg/dL) and elevated serum creatinine (1.48 mg/dL) with prolonged QTc (corrected QT interval) on electrocardiograph. She initially received intravenous calcium and magnesium followed by oral calcium carbonate and calcitriol. Her prednisolone dose was tapered to 5 mg/day. Evaluation showed secondary hyperparathyroidism (1474 pg/mL) and elevated 1,25-dihydroxy vitamin D (195 pg/mL). After 1 week of oral calcium carbonate (3000 mg/day) and calcitriol (1.5 µg/day), she achieved normocalcaemia (8.1 mg/dL). To conclude, denosumab for hypercalcaemia with renal insufficiency causes prolonged severe symptomatic hypocalcaemia and hypophosphataemia mimicking hungry bone syndrome. It is important to periodically monitor for hypocalcaemia after denosumab.
Here I Am Again, Santa!
Journal: Journal of the National Comprehensive Cancer Network (2020)

Here I Am Again, Santa!Dear Santa, I hope this season finds you in good health.Although I always begin with that, this year it has special meaning.Given that the world is in the midst of a pandemic, I imagine even the North Pole has its issues.It can't be easy for you to wear a mask over that big white beard, and you probably had to build a field factory so the elves could work safely at a distance.I hope you have a warm place for them to wash their hands; no sense risking frostbite!At least you all kept your jobs, because children everywhere need you more than ever this year.This is a bit awkward to bring up, but I need to remind you that I have not received a single thing I've asked for the past few years.I know you sent a diamond bracelet last year since you couldn't figure out how to end unnecessary authorizations for medical care.That was a nice touch, and I am truly grateful.But honestly, can you get what I ask for, just once?I've been really good, I promise!I've followed all the usual precautions for COVID-19, and I didn't even get a black market haircut or a manicure.And I haven't attended any parties.