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Riya Kalra,* Kanu Goyal, Aditi Popli* Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to Be University), Mullana, Haryana, 133207, India*These authors contributed equally to this workCorrespondence: Aditi Popli, Department of Physiotherapy, Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana, Haryana, 133207, India, Email aditi.popli.freebird@gmail.com

Yusuf Yazici,1 Lin Xie,2 Adesuwa Ogbomo,2 Lorie A Ellis,3 Kavitha Goyal,4 Amanda Teeple,5 Ece A Mutlu,6 Ismail Simsek7 1Department of Internal Medicine, Division of Rheumatology, New York University Hospital for Joint Diseases, New York, NY, USA; 2STATinMED Research, Health Economics and Outcomes Research, Ann Arbor, MI, USA; 3Janssen Scientific Affairs, Real World Value and Evidence, Titusville, NJ, USA; 4Janssen Biotech Incorporated, Immunology Medical Affairs, Horsham, PA USA; 5Jassen Scientific Affairs, LLC, Health Economics and Outcomes Research, Horsham, PA, USA; 6Rush University, Medical College, Department of Medicine, Chicago, IL, USA; 7Guven Hospital, Department of Rheumatology, Ankara, Turkey Purpose: Biosimilar IFX (CT-P13) received marketing approval in Turkey for treatment of rheumatologic diseases, including ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis (RA), inflammatory bowel disease (IBD), and psoriasis. Population data on real-world treatment patterns of CT-P13 following marketing approval in European countries are largely unreported. This study examined the prescribing and medication utilization patterns of innovator infliximab (IFX) and CT-P13 in Turkey for patients with RA or IBD naïve to either IFX.Materials and methods: Adult patients with ≥1 diagnosis claim for RA or IBD and ≥1 claim for IFX or CT-P13 were identified in the Turkish Ministry of Health database during the following identification periods: 1 Oct 2014–30 May 2015 (RA) and 1 Oct 2014–31 Dec 2015 (IBD). Continuous medical and pharmacy coverage for ≥12 months before and after the date of the first dose (index) IFX or CT-P13 was also required. Separate analyses were done for each population.Results: Seven hundred and seventy nine adult RA and 581 IBD patients met the selection criteria. The majority of RA (74%; n=575) and IBD patients (87%; n=504) were initiated on IFX. The average study observation period was 16 months for the RA and 12 months for the IBD population. Over the observation periods, discontinuation among RA patients occurred in 42% of IFX and 63% of CT-P13 while discontinuation in the IBD cohort occurred in 38% of IFX; and 62% of CT-P13.Conclusion: In this population-based study, more IFX-naïve RA and IBD patients were initially treated with IFX than CT-P13. Discontinuation and switching were observed more often and earlier among patients treated with CT-P13 regardless of disease state. Further studies are needed to understand the reasons for these observed differences. Keywords: discontinuation, switch, inflammatory bowel disease, rheumatoid arthritis

Yusuf Yazici,1 Lin Xie,2 Adesuwa Ogbomo,2 Lorie A Ellis,3 Kavitha Goyal,4 Amanda Teeple,5 Ismail Simsek6 1Rheumatology, New York University, School of Medicine, New York, NY, USA; 2Health Economics and Outcomes Research, STATinMED Research, Ann Arbor, MI, USA; 3Real World Value and Evidence, Janssen Scientific Affairs, Titusville, NJ, USA; 4Immunology Medical Affairs, Janssen Biotech Incorporated, Horsham, PA, USA; 5Health Economics and Outcomes Research, Jassen Scientific Affairs, LLC, Horsham, PA, USA; 6Department of Rheumatology, Guven Hospital, Ankara, Turkey Purpose: This study compared treatment patterns of Turkish patients with a diagnosis of rheumatoid arthritis (RA) who were treated with innovator Remicade® (infliximab [IFX]) and either continued IFX or switched to CT-P13. Materials and methods: Adult RA patients with ≥1 IFX claim were identified from the Turkish Ministry of Health database. Eligible patients initiated and continued IFX treatment (continuers cohort [CC]) or initiated IFX and switched to CT-P13 (switchers cohort [SC]) during the study period. The initial IFX claim date was defined as the index date. The switch/reference date was defined as the CT-P13 switch date for the SC or a random IFX date during the period of CT-P13 availability for the CC. Cohorts were matched by age, sex, and number of IFX prescriptions during baseline. Patient demographics, discontinuation, and switching were summarized. The baseline period was defined as the period from the index date to the switch/reference date. The follow-up period ranged from the switch/reference date to the end of data availability. Results: After matching, 697 patients were selected: 605 patients for the CC and 92 patients for the SC. Mean IFX duration for the baseline period was 422 days in the CC and 438 days in the SC. Median time on any infused tumor necrosis factor (TNF) antagonist therapy was 1,080 days in the CC and 540 days in the SC during the study period. During the follow-up period, discontinuation was lower in the CC (CC=33.9% vs SC=87.5%; P

BACKGROUND AND OBJECTIVES: Employee engagement has emerged as a critical factor for organizations seeking to enhance productivity, foster employee well-being, and gain a competitive advantage. Human resource management practices are vital to driving employee engagement. Therefore, based on the social exchange theory, the current study explores the interaction between human resource management practices and employee engagement. and evaluates the level of engagement (i.e., High, medium, low) of employees. Also, finds an association between engagement levels and the age group of employees. METHODS: The study administered the standardized questionnaire to employees (n= 187) working in information technology companies. A purposive random sampling research design was adopted for data collection. Confirmatory factor analysis was performed to ensure the validity of the adapted questionnaire, then simple linear regression was run in AMOS v24 software for finding the variance between human resource management practices and employee engagement. Further, chi-square and analysis of variance tests were also used in SPSS v22. FINDINGS: Human Resource Management practices such as recruiting and selection, continuous training and development opportunities, competitive rewards, career advancement, and employee involvement together explained 33 percent variance based on the coefficient of determination (R2) value, where (Beta= 0.57, p<0.001). Also found 30 employees fell in the low engaged category, 96 were in moderately engaged, 61 lay in the high engaged category, where 75 employees out of 96 (moderately engaged employee category) lay in the 20-30 age group and 31 out of 61 (high engaged employee's category) belonged to the 30-40 age group. The novelty of this study is to examine the influence of human resource management practices by taking factors such as rigorous hiring, continuous training, career advancement, competitive rewards, and employee involvement on employee engagement, particularly in the information technology industry. CONCLUSION: This study highlights the necessity for Human resource management practices to take a proactive, holistic approach to ensure congruence with corporate objectives and emphasize engagement. It also underlines the vitality of ongoing human resource management practice monitoring and growth to maintain and boost employee engagement. The study further discusses the strategies which must be adopted for enhancing the engagement level of low-engaged employees. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The present study was aimed at evaluation of the analgesic, anti-inflammatory and antipyretic activity of total methanolic and aqueous extract of Fruit of P. aculeate Linn in mice and rats. The methanolic extract of P. aculeate L Fruit at a dose of 200 mg/kg body weight has shown significant analgesic, antipyretic and antiinflammatory activity as compared to aqueous extract. The result of hot plate indicated that the total methanolic extract shows a significant increase (P<0.01) in reaction time at 2 and 3 hours comparable to the reference drug Pentazocin but lesser (P<0.05) at 1 hr. The tail immersion and hot plate test reveal that this plant has high analgesic activity. This is because some form of error may be introduced with the animal handing while the test is being elicited. Both test show highest degree of analgesia in methanolic extract compared to aqueous extract. The total methanolic extract of P. aculeate L fruit at the a dose of 200 mg/kg body weight has shown significant (p<0.001) antipyretic activity as compared to aqueous extract, it has shown significant fall in body temperature up to 4h following its admistration. The antipyretic activity stared as early as 1h and the effect was maintain for 4h. The response was comparable to that antipyretic activity of paracetamol a standard antipyretic drug. Total methanolic extract significantly inhibited Carrageenin-induced paw oedemaas compared; it may be due to possible inhibition of lipooxygenase pathway. [ABSTRACT FROM AUTHOR]

Understanding the pathophysiology of the coronavirus disease 2019 (COVID-19) infection remains a significant challenge of our times. The gingival crevicular fluid being representative of systemic status and having a proven track record of detecting viruses and biomarkers forms a logical basis for evaluating the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The study aimed to assess gingival crevicular fluid (GCF) for evidence of SARS-CoV-2 in 33 patients who were deemed to be COVID-19 positive upon nasopharyngeal sampling. An attempt was also made to comparatively evaluate it with saliva in terms of its sensitivity, as a diagnostic fluid for SARS-CoV-2. GCF and saliva samples were collected from 33 COVID-19–confirmed patients. Total RNA was extracted using NucliSENS easyMAG (bioMérieux) and eluted in the elution buffer. Envelope gene (E gene) of SARS-CoV-2 and human RNase P gene as internal control were detected in GCF samples by using the TRUPCR SARS-CoV-2 RT qPCR kit V-2.0 (I) in an Applied Biosystems 7500 real-time machine. A significant majority of both asymptomatic and mildly symptomatic patients exhibited the presence of the novel coronavirus in their GCF samples. Considering the presence of SARS-CoV-2 RNA in the nasopharyngeal swab sampling as gold standard, the sensitivity of GCF and saliva, respectively, was 63.64% (confidence interval [CI], 45.1% to 79.60%) and 64.52% (CI, 45.37% to 80.77%). GCF was found to be comparable to saliva in terms of its sensitivity to detect SARS-CoV-2. Saliva samples tested positive in 3 of the 12 patients whose GCF tested negative, and likewise GCF tested positive for 2 of the 11 patients whose saliva tested negative on real-time reverse transcription polymerase chain reaction. The results establish GCF as a possible mode of transmission of SARS-CoV-2, which is the first such report in the literature, and also provide the first quantifiable evidence pointing toward a link between the COVID-19 infection and oral health. [ABSTRACT FROM AUTHOR]

Edible packaging received significant attention in recent years. The main advantage of edible packaging over synthetic packaging is that they are environment friendly. The material used in edible packaging (lipids, polysaccharides, proteins) is generally recognized as safe and it acts as a barrier to gases, light and moisture. Spices have been traditionally used for its medicinal value. Spice extract or its essential oil possesses various bioactive compounds which are known for their antioxidant and antimicrobial property. Incorporation of spice extract or its essential oil into edible packaging exerts antimicrobial activity against the food pathogens thus preventing food spoilage and enhances the shelf-life and also increases the nutritional value of the final product. Antioxidant properties of spices retard the lipid oxidation. Dietary allergy and intolerance are also associated with packaging material and spices. Because of the high cost of film-forming material, scaling-up of edible packaging has remained a problem. [ABSTRACT FROM AUTHOR]

Background: Prior studies have demonstrated improved disease‐specific survival of mycosis fungoides (MF) patients over the last 50 years. Objective: To analyse patterns of survival and incidence from 1973 to 2016 and determine whether apparent improvements in MF‐specific survival are due to lead‐time bias rather than improvements in treatment. Methods: We performed an analysis of 10 155 patients diagnosed with MF from 1973 to 2016 in the United States cancer registries of SEER‐18. We also performed a literature review of papers including stage data for unselected populations of MF patients prior to 2000. Results: Incidence of MF increased from 3.0 per million person‐years in the 1970s to 5.9 in the 2010s. For all cohorts, non‐Hodgkin lymphoma (including MF) was the leading cause of death. Survival analysis demonstrated marked improvement in disease‐specific and overall survival from the 1970s to 2010s. Based on systematic review of the literature, 32%–73% of patients diagnosed prior to 2000 were diagnosed with early‐stage disease, as opposed to 81% of patients in the SEER 2000–2016 cohort (P < 0.035 for all cohorts). Conclusions: Although there have been improvements in MF‐related survival over the last 50 years, these may reflect improvements in our ability to diagnose early‐stage disease rather than improved treatment. [ABSTRACT FROM AUTHOR]

The H1N1 influenza infection usually coincides with the typical scrub typhus season in North India. This leads to diagnostic difficulties due to their similar and non-specific symptoms. We describe three patients with confirmed co-infection of pandemic (H1N1) influenza and scrub typhus who had presented with acute respiratory distress syndrome. A systematic review of database yielded one case of scrub typhus and H1N1 influenza co-infection reported from South Korea. Co-infection of influenza with tropical infections may not be uncommon in endemic countries and hence a high index of suspicion on the part of physicians coupled with appropriate investigations are needed. The true burden of co-infections needs to be evaluated during outbreaks of influenza in a systematic manner. [ABSTRACT FROM AUTHOR]

Summary: Background: Phase III studies showed that some patients maintained response for ≥ 6 months following ustekinumab discontinuation. Objectives: To assess clinical responses with extended ustekinumab maintenance dosing intervals. Methods: Adults with moderate‐to‐severe plaque psoriasis received ustekinumab at weeks 0, 4 and 16 during open‐label treatment. Patients achieving a week‐28 Physician's Global Assessment (PGA) score of cleared/minimal (PGA = 0/1) were randomized 1 : 4 to group 1 [approved every 12 weeks (q12 wk) maintenance] or group 2 (q12–24 wk; response‐based dosing determined by time to loss of PGA = 0/1). Key end points included the number of visits with PGA = 0/1 (primary end point) and ≥ 75% improvement in Psoriasis Area and Severity Index (PASI 75) between weeks 88 and 112, and PGA/PASI responses between weeks 28 and 112. Results: Overall, 378 patients achieved PGA = 0/1 at week 28 and were randomized to group 1 (n = 76) or group 2 (n = 302). Patients in group 1 had numerically greater mean numbers of visits with PGA = 0/1 than group 2 and also with PASI 75 from week 88 to 112. A higher proportion of patients in group 1 (55%) than group 2 (39%) had PGA = 0/1 at all seven visits from week 88 to 112. Maintenance of response was observed with dose‐interval extension beyond q12 wk in a subset of patients. Extending the dosing interval did not affect antibody development or safety. Conclusions: Efficacy was better maintained among week‐28 PGA responders randomized to continue q12 wk ustekinumab vs. extending maintenance dosing based on clinical response, although some patients maintained high levels of efficacy with up to q24 wk dosing. [ABSTRACT FROM AUTHOR]

Epidemiology of primary cutaneous T-cell lymphoma and subcutaneous panniculitis-like T-cell lymphoma in the U.S.A. from 2006 to 2015: a Surveillance, Epidemiology, and End Results-18 analysis Dear Editor, Primary cutaneous gamma/delta T-cell lymphoma (pcGDTCL) is a rare, aggressive T-cell lymphoma that presents with ulcerated nodules, extranodal dissemination, constitutional symptoms and often, haemophagocytic lymphohistiocytosis.[1] pcGDTCL is so named because of the gamma/delta ( ) phenotype of the T-cell receptor (TCR). pcGDTCL is a histological mimic of subcutaneous panniculitis-like T-cell lymphoma (SPTCL), a lymphoma with an / TCR phenotype. GLO:F03/01oct19:bjd17985-fig-0001.jpg PHOTO (COLOR): (a) Kaplan-Meier plot describing the survival distribution function for 37 cases of primary cutaneous gamma/delta T-cell lymphoma (pcGDTCL) and 132 cases of subcutaneous panniculitis-like T-cell lymphoma (SPTCL). [Extracted from the article]