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Objective: Adverse respiratory outcomes in post-9/11 veterans with elevated urinary metal measures and enrolled in the VA's Toxic Embedded Fragment registrywere compared to thosewithout elevated urinary metals. Methods: Veterans completed questionnaires, underwent pulmonary physiology tests (pulmonary function and oscillometry), and provided urine samples for analysis of 13 metals. Respiratory symptoms, diagnoses, and physiology measures were compared in veterans with ≥1 urine metal elevation to those without metal elevations, adjusted for covariates, including smoking. Results: Among 402 study participants, 24% had elevated urinemetals, often just exceeding upper limits of reference values. Compared to veterans without elevated metals, those with elevated metals had had higher FEV1 values but similar frequencies of respiratory symptoms and diagnoses and abnormalities on pulmonary physiology tests. Conclusions: Mild systemic metal elevations in post-9/11 veterans are not associated with adverse respiratory health outcomes. [ABSTRACT FROM AUTHOR]

Migrant Asian massage workers in North America first experienced the impacts of COVID-19 in the final weeks of January 2020, when business dropped drastically due to widespread xenophobic fears that the virus was concentrated in Chinese diasporic communities. The sustained economic devastation, which began at least 8 weeks prior to the first social distancing and shelter in place orders issued in the U.S. and Canada, has been further complicated by a history of aggressive policing of migrant massage workers in the wake of the war against human trafficking. Migrant Asian massage businesses are increasingly policed as locales of potential illicit sex work and human trafficking, as police and anti-trafficking initiatives target migrant Asian massage workers despite the fact that most do not provide sexual services. The scapegoating of migrant Asian massage workers and criminalization of sex work have led to devastating systemic and interpersonal violence, including numerous deportations, arrests, and deaths, most notably the recent murder of eight people at three Atlanta-based spas. The policing of sex workers has historically been mobilized along fears of sexually transmitted disease and infection, and more recently, within the past two decades, around a moral panic against sex trafficking. New racial anxieties around the coronavirus as an Asian disease have been mobilized by the state to further cement the justification of policing Asian migrant workers along the axes of health, migration, and sexual labor. These justifications also solidify discriminatory social welfare regimes that exclude Asian migrant massage workers from accessing services on the basis of the informality and illegality of their work mixed with their precarious citizenship status. This paper draws from ethnographic participant observation and survey data collected by two sex worker organizations that work primarily with massage workers in Toronto and New York City to examine the double-edged sword of policing during the pandemic in the name of anti-trafficking coupled with exclusionary policies regarding emergency relief and social welfare, and its effects on migrant Asian massage workers in North America. Although not all migrant Asian massage workers, including those surveyed in this paper, provide sexual services, they are conflated, targeted, and treated as such by the state and therefore face similar barriers of criminalization, discrimination, and exclusion. This paper recognizes that most migrant Asian massage workers do not identify as sex workers and does not intend to label them as such or reproduce the scapegoating rhetoric used by law enforcement. Rather, it seeks to analyze how exclusionary attitudes and policies towards sex workers are transferred onto migrant Asian massage workers as well whether or not they provide sexual services. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between neuromuscular blocking agents and outcome, intracranial pressure, and medical complications in children with severe traumatic brain injury., Design: A secondary analysis of a randomized, controlled trial of therapeutic hypothermia., Setting: Seventeen hospitals in the United States, Australia, and New Zealand., Patients: Children (< 18 yr) with severe traumatic brain injury., Interventions: None for this secondary analysis., Measurements and Main Results: Children received neuromuscular blocking agent on the majority of days of the study (69.6%), and the modified Pediatric Intensity Level of Therapy scores (modified by removing neuromuscular blocking agent administration from the score) were increased on days when neuromuscular blocking agents were used (9.67 ± 0.21 vs 5.48 ± 0.26; p < 0.001). Children were stratified into groups based on exposure to neuromuscular blocking agents (group 1 received neuromuscular blocking agents each study day; group 2 did not). Group 1 had increased number of daily intracranial pressure readings more than 20 mm Hg (4.4 ± 1.1 vs 2.4 ± 0.5;p = 0.015) and longer ICU and hospital length of stay (p = 0.003 and 0.07, respectively, Kaplan-Meier). The Glasgow Outcome Score-Extended for Pediatrics at hospital discharge and 3, 6, and 12 months after traumatic brain injury and medical complications observed during the acute hospitalization were similar between groups., Conclusions: Administration of neuromuscular blocking agents was ubiquitous and daily administration of neuromuscular blocking agents was associated with intracranial hypertension but not outcomes-likely indicating that increased injury severity prompted their use. Despite this, neuromuscular blocking agent use was not associated with complications. A different study design-perhaps using randomization or methodologies-of a larger cohort will be required to determine if neuromuscular blocking agent use is helpful after severe traumatic brain injury in children.