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Background:The scale of the 2022 global mpox (formerly known as monkeypox) outbreak has been unprecedented. In less than 6 months, non-endemic countries have reported more than 67 000 cases of a disease that had previously been rare outside of Africa. Mortality has been reported as rare but hospital admission has been relatively common. We aimed to describe the clinical and laboratory characteristics and outcomes of individuals admitted to hospital with mpox and associated complications, including tecovirimat recipients. Methods:In this cohort study, we undertook retrospective review of electronic clinical records and pathology data for all individuals admitted between May 6, and Aug 3, 2022, to 16 hospitals from the Specialist and High Consequence Infectious Diseases Network for Monkeypox. The hospitals were located in ten cities in England and Northern Ireland. Inclusion criteria were clinical signs consistent with mpox and MPXV DNA detected from at least one clinical sample by PCR testing. Patients admitted solely for isolation purposes were excluded from the study. Key outcomes included admission indication, complications (including pain, secondary infection, and mortality) and use of antibiotic and anti-viral treatments. Routine biochemistry, haematology, microbiology, and virology data were also collected. Outcomes were assessed in all patients with available data. Findings:156 individuals were admitted to hospital with complicated mpox during the study period. 153 (98%) were male and three (2%) were female, with a median age of 35 years (IQR 30–44). Gender data were collected from electronic patient records, which encompassed full formal review of clincian notes. The prespecified options for data collection for gender were male, female, trans, non-binary, or unknown. 105 (71%) of 148 participants with available ethnicity data were of White ethnicity and 47 (30%) of 155 were living with HIV with a median CD4 count of 510 cells per mm3(IQR 349–828). Rectal or perianal pain (including proctitis) was the most common indication for hospital admission (44 [28%] of 156). Severe pain was reported in 89 (57%) of 156, and secondary bacterial infection in 82 (58%) of 142 individuals with available data. Median admission duration was 5 days (IQR 2–9). Ten individuals required surgery and two cases of encephalitis were reported. 38 (24%) of the 156 individuals received tecovirimat with early cessation in four cases (two owing to hepatic transaminitis, one to rapid treatment response, and one to patient choice). No deaths occurred during the study period. Interpretation:Although life-threatening mpox appears rare in hospitalised populations during the current outbreak, severe mpox and associated complications can occur in immunocompetent individuals. Analgesia and management of superimposed bacterial infection are priorities for patients admitted to hospital.

Introduction Patients with phantosmia, often thought to be an olfactory hallucination, can smell an odor that nobody else can smell. We describe the first case of phantosmia secondary to an intranasal bacterial infection. Case summary An 82-year old male presented to clinic with a multi-year history of phantosmia that had a severe impact on the patient’s quality of life. Prior diagnostic and treatments were unsuccessful and consisted of nasal endoscopy, brain computed tomography (CT) scan, and tooth extraction. A nasal culture returned as light growth of Pseudomonas Stutzeri. Empiric treatment with mupirocin had begun, and worsened the smell, but was stopped and switched to topical gentamicin and oral trimethoprimsulfamethoxazole.By 1 week, the smell had improved subjectively. At 5 year follow-up,with regular application of topical gentamicin the patient stated the smell was cured,rating the symptoms as a 0 out of 10. Discussion As individuals age, olfactory changes are common, however, some will experience severe, unpleasant smell sensations. After neurologic etiologies are ruled out, treatment often relies on destroying a component of the olfaction system. Future research should investigate bacterial etiologies for phantosmia. Our case had a unique intranasal culture result and was responsive to antibiotic treatment.

The sugarcane borer (SCB), Diatraea saccharalis (Lepidoptera: Crambidae), is a key pest of maize in Argentina, and genetically modified maize, producing Bacillus thuringiensis (Bt) proteins, has revolutionized the management of this insect in South America. However, field-evolved resistance to some Bt technologies has been observed in SCB in Argentina. Here we assessed a new Bt technology, MON 95379, in the laboratory, greenhouse and field for efficacy against SCB.In a laboratory leaf disc bioassay, both MON 95379 (producing Cry1B.868 and Cry1Da_7) and Cry1B.868_single maize (producing only Cry1B.868) resulted in 100% mortality of SCB. The level of Cry1B.868 in the Cry1B.868_single maize is comparable to that in MON 95379 maize. However, the Cry1Da_7 protein does not have high efficacy against SCB, as evidenced by 20% mortality on Cry1Da_7_single leaf tissue. Total (100%) mortality of SCB in a Cry1B.868_single tissue dilution bioassay indicated that Cry1B.868_single maize meets the criteria to be classified as a high dose. Similar median lethal concentration (LCMON 95379 maize will bring value to maize growers in South America by effectively managing SCB even in locations where resistance to other Bt-containing maize technologies has been reported. © 2022 The Authors. Pest Management Science published by John WileySons Ltd on behalf of Society of Chemical Industry.

Proline is widely known as the only proteogenic amino acid with a secondary amine. In addition to its crucial role in protein structure, the secondary amino acid modulates neurotransmission and regulates the kinetics of signaling proteins. To understand the structural basis of proline import, we solved the structure of the proline transporter SIT1 in complex with the COVID-19 viral receptor ACE2 by cryo-electron microscopy. The structure of pipecolate-bound SIT1 reveals the specific sequence requirements for proline transport in the SLC6 family and how this protein excludes amino acids with extended side chains. By comparing apo and substrate-bound SIT1 states, we also identify the structural changes which link substrate release and opening of the cytoplasmic gate, and provide an explanation for how a missense mutation in the transporter causes iminoglycinuria.

Introduction: Variants of the APOL1 gene are associated with chronic kidney disease (CKD) in people of African ancestry, although evidence for their impact in people with HIV are sparse. Methods: We conducted a cross-sectional study investigating the association between APOL1 renal risk alleles and kidney disease in people of African ancestry with HIV in the UK. The primary outcome was end-stage kidney disease (ESKD; estimated glomerular filtration rate [eGFR] of 2, chronic dialysis, or having received a kidney transplant). The secondary outcomes included renal impairment (eGFR 2), albuminuria (albumin-to-creatinine ratio [ACR] >30 mg/mmol), and biopsy-proven HIV-associated nephropathy (HIVAN). Multivariable logistic regression was used to estimate the associations between APOL1 high-risk genotypes (G1/G1, G1/G2, G2/G2) and kidney disease outcomes. Results: A total of 2864 participants (mean age 48.1 [SD 10.3], 57.3% female) were genotyped, of whom, 354 (12.4%) had APOL1 high-risk genotypes, and 99 (3.5%) had ESKD. After adjusting for demographic, HIV, and renal risk factors, individuals with APOL1 high-risk genotypes were at increased odds of ESKD (odds ratio [OR] 10.58, 95% CI 6.22–17.99), renal impairment (OR 5.50, 95% CI 3.81–7.95), albuminuria (OR 3.34, 95% CI 2.00–5.56), and HIVAN (OR 30.16, 95% CI 12.48–72.88). An estimated 49% of ESKD was attributable to APOL1 high-risk genotypes. Conclusion: APOL1 high-risk genotypes were strongly associated with kidney disease in people of African ancestry with HIV and accounted for approximately half of ESKD cases in this cohort.

Despite the growing contributions of critical care anesthesiologists to clinical practice, research, and administrative leadership of intensive care units (ICUs), relatively little is known about the subspecialty-specific clinical practice environment. An understanding of contemporary clinical practice is essential to recognize the opportunities and challenges facing critical care anesthesia, optimize staffing patterns, assess sustainability and satisfaction, and strategically plan for future activity, scope, and training. This study surveyed intensivists who are members of the Society of Critical Care Anesthesiologists (SOCCA) to evaluate practice patterns of critical care anesthesiologists, including compensation, types of ICUs covered, models of overnight ICU coverage, and relationships between these factors. We hypothesized that variability in compensation and practice patterns would be observed between individuals.Board-certified critical care anesthesiologists practicing in the United States were identified using the SOCCA membership distribution list and invited to take a voluntary online survey between May and June 2021. Multiple-choice questions with both single- and multiple-select options were used for answers with categorical data, and adaptive questioning was used to clarify stem-based responses. Respondents were asked to describe practice patterns at their respective institutions and provide information about their demographics, salaries, effort in ICUs, as well as other activities.A total of 490 participants were invited to take this survey, and 157 (response rate 32%) surveys were completed and analyzed. The majority of respondents were White (73%), male (69%), and younger than 50 years of age (82%). The cardiothoracic/cardiovascular ICU was the most common practice setting, with 69.5% of respondents reporting time working in this unit. Significant variability was observed in ICU practice patterns. Respondents reported spending an equal proportion of their time in clinical practice in the operating rooms and ICUs (median, 40%; interquartile range [IQR], 20%-50%), whereas a smaller proportion-primarily those who completed their training before 2009-reported administrative or research activities. Female respondents reported salaries that were $36,739 less than male respondents; however, this difference was not statistically different, and after adjusting for age and practice type, these differences were less pronounced (-$27,479.79; 95% confidence interval [CI], -$57,232.61 to $2273.03; P = .07).These survey data provide a current snapshot of anesthesiology critical care clinical practice patterns in the United States. Our findings may inform decision-making around the initiation and expansion of critical care services and optimal staffing patterns, as well as provide a basis for further work that focuses on intensivist satisfaction and burnout.

Politicisation of leisure time physical activity (LTPA) has increased in many European countries. In Denmark, for example, the relationship between ‘Muslim culture’ and a majority ‘Danish’ culture in LTPA has been debated, leading to the introduction of progressively more restrictive policies. Such debates are presented in binary terms, where constructions of an indivisible, monadic, legitimate and liberal majority culture are frequently presented in opposition to an antagonistic, patriarchal, oppressive and illiberal caricature of Islamic culture. Such debates have also racialized space, labelling neighbourhoods with ethnic-minority communities ‘ghettoes’ within which parallel societies are presumed to exist. Consequently, activities which are considered to transgress ‘Danish’ practices, such as gender-segregated swimming, have seen negative political attention. For example, in Aarhus, women-only swimming has been described as a religious practice and incompatible with ‘Danish’ values such as gender equity and liberal democracy, albeit only when Muslim women are present. Debates about the legitimacy of women-only swimming in Aarhus characterise participants as oppressed by their husbands, and to reside in racialized areas of which the women only swimming sessions are an extension. Such debates have led to increased regulation (and subsequent closure) of gender-segregated swimming in municipal pools during public hours, despite permitting nude outdoor swimming in wealthier areas of the city attended by predominantly ‘ethnic Danish’ women. Such assumptions were contradicted by participants, however, who were rarely heard in the debates. Here, we contrast the lived experiences of participants with descriptions in the political debates, and describe their feelings of belonging both within and outside gender-segregated swimming spaces. For participants, such spaces were considered ‘safe,’ not from oppression from within their own community, but from the gendering and racializing majority gaze in wider public spaces. Such findings highlight a complex interplay between politics and embodied experiences of LTPA in relation to both gender and ethnicity.

Escherichia coli NfsB has been studied extensively for its potential for cancer gene therapy by reducing the prodrug CB1954 to a cytotoxic derivative. We have previously made several mutants with enhanced activity for the prodrug and characterised their activity in vitro and in vivo. Here, we determine the X-ray structure of our most active triple and double mutants to date, T41Q/N71S/F124T and T41L/N71S. The two mutant proteins have lower redox potentials than wild-type NfsB, and the mutations have lowered activity with NADH so that, in contrast to the wild-type enzyme, the reduction of the enzyme by NADH, rather than the reaction with CB1954, has a slower maximum rate. The structure of the triple mutant shows the interaction between Q41 and T124, explaining the synergy between these two mutations. Based on these structures, we selected mutants with even higher activity. The most active one contains T41Q/N71S/F124T/M127V, in which the additional M127V mutation enlarges a small channel to the active site. Molecular dynamics simulations show that the mutations or reduction of the FMN cofactors of the protein has little effect on its dynamics and that the largest backbone fluctuations occur at residues that flank the active site, contributing towards its broad substrate range.

The story of devolution in the United Kingdom is a long and chequered one which long predates the establishment of devolved legislatures in Scotland and Wales after referendums in 1997. The devolution programme of Tony Blair’s Labour Government came eighteen years after the failure of the 1974–79 Labour Government’s attempts at establishing Scottish and Welsh devolution. This article explores how after establishing a Royal Commission on the Constitution in his first Government, Wilson would be left to take up the reins of devolution again after the two elections of 1974. It focuses on how Harold Wilson, and then James Callaghan, developed, often with huge reluctance and great caution, devolution proposals that would eventually form the Scotland and Wales Bill (the Labour Government’s first set of legislative proposals for devolution). The bill endured a tortuous fate in parliament and its slow progress eventually ground to a final halt in February 1977. However, despite the bill’s failure, the work that went into developing it and the concessions that were made by the government during its aborted journey through the House of Commons had consequences that were felt during the remainder of the 1974–79 Labour Government’s fraught existence and long after.

The female Muslim body has come under close political and public scrutiny in many Western societies. Within sport, too, Muslim women’s dress and practices have become topics of discussion. For example, gender-segregated swimming sessions catering for Muslim women have caused disputes in several European countries, including Denmark. Nevertheless, the perspectives of participants are absent in such discussions and research about the significance of sports and physical activity for minority-ethnic groups is sparse. The aim of this article is to explore the meanings Danish Muslim women ascribe to their participation in a gender-segregated swimming space. Drawing on transnational feminism that foregrounds the voices of ‘othered’ women, this article presents the results of a study, in which we used participant observation and interviews with club officials and 14 Muslim women. The participants connected swimming with well-being and self-care and portrayed women-only swimming as a space of belonging, where they felt comfortable and safe and were not only protected from the male but also the ‘white’ gaze that they encountered in other situations, such as when wearing a burkini on the beach. Consequently, contestations of belonging ‘outside’ gave particular value to the women-only swimming pool as a space free from such contestations. This finding demonstrates how Muslim women’s experiences with sport and physical activity are shaped by current public and political discourses on immigration and integration in Western societies.

Background Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments. Two oral drugs, brincidofovir and tecovirimat, have been approved for treatment of smallpox and have demonstrated efficacy against monkeypox in animals. Our aim was to describe the longitudinal clinical course of monkeypox in a high-income setting, coupled with viral dynamics, and any adverse events related to novel antiviral therapies. Methods In this retrospective observational study, we report the clinical features, longitudinal virological findings, and response to off-label antivirals in seven patients with monkeypox who were diagnosed in the UK between 2018 and 2021, identified through retrospective case-note review. This study included all patients who were managed in dedicated high consequence infectious diseases (HCID) centres in Liverpool, London, and Newcastle, coordinated via a national HCID network. Findings We reviewed all cases since the inception of the HCID (airborne) network between Aug 15, 2018, and Sept 10, 2021, identifying seven patients. Of the seven patients, four were men and three were women. Three acquired monkeypox in the UK: one patient was a health-care worker who acquired the virus nosocomially, and one patient who acquired the virus abroad transmitted it to an adult and child within their household cluster. Notable disease features included viraemia, prolonged monkeypox virus DNA detection in upper respiratory tract swabs, reactive low mood, and one patient had a monkeypox virus PCR-positive deep tissue abscess. Five patients spent more than 3 weeks (range 22–39 days) in isolation due to prolonged PCR positivity. Three patients were treated with brincidofovir (200 mg once a week orally), all of whom developed elevated liver enzymes resulting in cessation of therapy. One patient was treated with tecovirimat (600 mg twice daily for 2 weeks orally), experienced no adverse effects, and had a shorter duration of viral shedding and illness (10 days hospitalisation) compared with the other six patients. One patient experienced a mild relapse 6 weeks after hospital discharge. Interpretation Human monkeypox poses unique challenges, even to well resourced health-care systems with HCID networks. Prolonged upper respiratory tract viral DNA shedding after skin lesion resolution challenged current infection prevention and control guidance. There is an urgent need for prospective studies of antivirals for this disease.

This article scrutinises the highly contested, yet largely unexplored space of gender-segregated swimming that caters for Muslim women. Combining participant observation of weekly women-only swimming sessions with interviews of regular participants, the aim of this paper was to shed light on the ‘non-White’ space of women-only swimming and explore the lived experiences of Danish Muslim women within this specific setting. Drawing on a Foucauldian framework that situates women-only swimming in a wider space of power relationships and multiple intersecting discourses, we observed the operation of disciplinary power, particularly relating to the maintenance of hygiene and safety and tacit norms relating to the dress code and standards of modesty. However, contrary to competitive and lane swimming, here, women-only swimming sessions were loosely structured, with participants emphasising freedom, pleasure and relaxation in this context. Our findings suggest that women-only swimming offered the opportunity for participants to practise self-care, while also highlighting ambiguities relating to participants' critical self-awareness about the discourses governing their identities and sporting practices. Still, the loosely structured practice of women-only swimming poses an alternative to the current instrumentalisation of sport and physical activity, as well as dominant discourses that position sport as a culturally integrative, homogenising policy tool.

Debates around race, ethnicity, and indigeneity, whether related to sport or society in general, are far from new. Yet in recent times, such debates have gained new urgency due to the Black Lives M...

‘Active Ageing’ is a dominant discourse in the promotion of active lifestyles for older adults. Its emphasis upon adoption of a positive mind-set and ‘good’ lifestyle choices has resulted in active...

The notion that research should impact both the academic and outside world is increasingly common, often as an ethical imperative (e.g. Evans, 2016). Yet what is considered impactful in sport, and ...

There has been a growing trend of elite athletes being fast-tracked into post-athletic high-performance coaching roles in association football and rugby union in England and Wales. This has been facilitated by an increase in bespoke and condensed formal coach education courses that are designed to accelerate current and/or former elite athletes in attaining their coaching accreditation. Hitherto, however, the individual lived experiences of former athletes on this career trajectory during their transition to coaching remains under-investigated. The purpose of this study, therefore, was to analyse how elite male association football and rugby union athletes based in England and Wales (re)created, re-negotiated or transformed their identities when negotiating a fast-tracked career pathway into a post-athletic high-performance coaching role. Fifteen male rugby union (n = 10) and association football (n = 5) athletes were interviewed on two separate occasions over twelve months. Interviews coincided with the start and end dates of the level three coach education course which they were concurrently enrolled on. Interviews focused upon how they (re)created their professional identities upon negotiating the career transition into a post-athletic high-performance coaching role. Data were critically theorised against sociological concepts associated with the theoretical frameworks of Bourdieu, Goffman and Foucault. Results identified how the development of a coaching identity was articulated through the need to define a ‘coaching philosophy’. Upholding a coach identity in an ‘honest’ disposition so athlete to coach respect could be best attained was expressed by all participants and contrasted with Goffman’s concepts of front and backstage impression management. Self-reflexive practices of Foucault’s askesis were engaged to varying levels to create a coach identity. In three cases this resulted in participants' contestation of their respective club’s identity/culture and losing employment as a coach. Finally, recommendations on how coach education structures can further support these coaches in their career transitions are made.

Objective: The past decade has seen platelet-rich plasma (PRP) become a popular therapy around the world as a treatment for androgenetic alopecia (AGA). These systematic review and meta-analyses assess the effectiveness and adverse effects of PRP to determine the role of PRP as a treatment for AGA among the other non-surgical treatment modalities.Methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and is registered under the PROSPERO ID CRD42019136329. Seven databases were searched from inception through May 2019. Meta-analyses of randomized controlled trials (RCTs) were performed to evaluate the effect of PRP treatments on hair density and hair thickness.Results: Thirty studies, including 687 patients, met our inclusion criteria. Twenty-nine studies reported beneficial results, and 24 studies reached statistical significance on a measured outcome. Ten RCTs were included. Our meta-analyses show that PRP treatment increases hair density and hair thickness.Conclusions: PRP is an autologous treatment that lacks serious adverse effects and effectively improves hair density and hair thickness in men and women with AGA. Future research should include low risk-of-bias RCTs to optimize treatment protocols, investigate variability among studies, and to obtain more data on hair thickness changes.

Gender inequity in sport organisation boards, particularly in decision-making positions, remains a significant issue. Considerable research exists on the topic yet attempts to integrate non-academic perspectives on this literature are relatively limited. We present a systematic narrative review, constructed in conjunction with the work of a ‘reflective panel’ which included sport, business and academic professionals from Europe and North America. The panel helped to inform the search strategy and reflected upon the narrative produced. In total, 154 peer-reviewed articles, book chapters and grey literature publications were included. The resultant narrative is presented according to several scales of abstraction; macro-scale studies of global/national trends; meso-scale studies of processes (re)producing gender inequity; and microscopic studies of lived experiences of gender inequity. There is consensus in the literature that, globally, women continue to be under-represented in leadership positions. Patriarchal selection practices and organisational cultures reinforce this inequity, despite evidence that men in leadership roles recognise the problem. While gender equity policies exist, actions to pursue gender equity are more limited. Patriarchal language, gendered stereotypes and person-profiling still persist, resulting in specific emotional and practical challenges for women in sports leadership positions. The reflective panel recognised an over-representation of studies from a liberal ‘Western’ tradition that conceptualises gender inequity in a specific socio-cultural and political way. Studies also often overlook the effects of the intersectionality. Finally, we suggest areas for further research, including a need to understand the electoral procedures of sports organisations beyond ‘formal’ channels, to better understand women’s lived experiences of inequity and to investigate the experiences of women who either step down or are not appointed to leadership positions.

Despite a developing literature on various facets of sporting embodiment, there is currently a research lacuna with regard to in-depth analyses of actually ‘doing’ sporting activities within specific physical cultures. In this article, we address that gap by drawing on a developing theoretical literature in sociological phenomenology to investigate a particular physical–cultural domain. Here, we present and analyse data from an ethnographic study of competitive swimmers undertaken in the UK. Responding to calls to explore the domain of ‘body pedagogics’, we investigate the embodied work involved in the skilled practice of ‘doing’ and learning how to ‘do’ competitive swimming. This embodied work plays a key part in the swimmers’ ability to inhabit the competitive swimming lifeworld. In the analysis, we highlight how the acquisition and ‘habituation’ of these body techniques and skilled behaviours are not achieved simply through the repetitive rehearsal of coherent movements over time. These processes are complex, demanding practical experimentation, discovery and the ability to adapt constantly to changes in the environment and the swimmer’s own corporeality.

Background There is growing evidence that antibody responses play a role in the resolution of SARS-CoV-2 infection. Patients with primary or secondary antibody deficiency are at increased risk of persistent infection. This challenging clinical scenario is associated with adverse patient outcome and potentially creates an ecological niche for the evolution of novel SARS-CoV-2 variants with immune evasion capacity. Case reports and/or series have implied a therapeutic role for convalescent plasma (CP) to secure virological clearance, although concerns have been raised about the effectiveness of CP and its potential to drive viral evolution, and it has largely been withdrawn from clinical use in the UK. Case presentation We report two cases in which persistent SARS-CoV-2 infection was cleared following administration of the monoclonal antibody combination casirivimab and imdevimab (REGN-COV2, Ronapreve). A 55-year-old male with follicular lymphoma, treated with B cell depleting therapy, developed SARS-CoV-2 infection in September 2020 which then persisted for over 200 days. He was hospitalised on four occasions with COVID-19 and suffered debilitating fatigue and malaise throughout. There was no clinical response to antiviral therapy with remdesivir or CP, and SARS-CoV-2 was consistently detected in nasopharyngeal swabs. Intrahost evolution of several spike variants of uncertain significance was identified by viral sequence analysis. Delivery of REGN-COV2, in combination with remdesivir, was associated with clinical improvement and viral clearance within 6 days, which was sustained for over 150 days despite immunotherapy for relapsed follicular lymphoma. The second case, a 68-year-old female with chronic lymphocytic leukaemia on ibrutinib, also developed persistent SARS-CoV-2 infection. Despite a lack of response to remdesivir, infection promptly cleared following REGN-COV2 in combination with remdesivir, accompanied by resolution of inflammation and full clinical recovery that has been maintained for over 290 days. Conclusions These cases highlight the potential benefit of REGN-COV2 as therapy for persistent SARS-CoV-2 infection in antibody deficient individuals, including after failure of CP treatment. Formal clinical studies are warranted to assess the effectiveness of REGN-COV2 in antibody-deficient patients, especially in light of the emergence of variants of concern, such as Omicron, that appear to evade REGN-COV2 neutralisation.

Welcome to this special issue of the European Journal for Sport and Society, which focuses upon the relationship between race, ethnicity, and sport. This is particularly in reference to the effects...

Sickle cell trait (SCT) has been associated with chronic kidney disease (CKD) in African Americans, although evidence for its impact in Africans and people with HIV is currently lacking. We conducted a cross-sectional study investigating the association between SCT and kidney disease in people of African ancestry with HIV in the UK.The primary outcome was estimated glomerular filtration rate (eGFR) 60 ml/min per 1.73 mA total of 2895 participants (mean age 48.1 [SD 10.3], 57.2% female) were included, of whom 335 (11.6%) had SCT and 352 (12.2%) had eGFR 60 ml/min per 1.73 mOur results extend previously reported associations between SCT and kidney disease to people with HIV. In people of African ancestry with HIV, these associations were largely restricted to those with

Examines the main features of Northern Ireland's model of indirect rule between 2017 and 2020. Reviews the operation of direct rule between 1972 and 2007, the emergence of indirect rule, and its key characteristics, including governance by civil servants. Discusses the end of indirect rule, why direct rule did not replace it, the constitutional problems of the indirect approach, and whether it could have been more democratically acceptable.

The territorial departmental select committees have largely escaped academic scrutiny since their establishment in 1979 (for Scotland and Wales) and 1994 (Northern Ireland). This article charts the history of territorial representation in Westminster, including the creation of grand committees for Scotland and Wales and a Northern Ireland Standing Committee, before explaining the forces that led to the creation of territorial departmental select committees. The article then explores the work of these committees after their formation, and explores how they have responded to the devolution dispensations in their respective nations. A key theme of this article is the influence of constitutional developments in Scotland, Wales and Northern Ireland on territorial committees at Westminster. Indeed, as this article highlights, the different timings of establishment, the asymmetric levels of (in)stability in the various devolution dispensations and prolonged suspensions of devolution in Northern Ireland have had an impact on the role of the respective territorial select committees.

As outlined in a recent paper in this publication by Seippel (2018, p. 288), over the previous three decades the discipline of sociology of sport has become ‘a voluminous scientific field with semi...

The Campbell University Drug Information Center supports health professionals by providing responses to drug-related inquiries. An inquiry was received by the Drug Information Center for a comprehensive list of oral solutions which should be protected from light. In investigating this request for information, a list of light-sensitive oral prescription drug products published in Hospital Pharmacy in 2009 was identified. This discovery highlighted the need for both an updated list and one which distinguished oral solid products and oral liquid products. The purpose of this project was to update the previously published list and to distinguish between oral solid and liquid dosage forms. The process of updating this list entailed several professional resources. A list of all oral products was obtained and then sorted to clearly identify which products were available in oral solid dosage form only, oral liquid dosage form only, and both dosage forms. Once delineated, the product labels for each medication were scoured for language indicating the product is light sensitive.

OBJECTIVE This retrospective study aimed at identifying opiate prescribing practices, the number of morphine milligram equivalents (MMEs) prescribed by orthopaedic and nonorthopaedic providers in patients with operatively treated isolated lower extremity fractures, and provide opiate prescribing recommendations. METHODS Patients older than 18 years with isolated lower extremity (unicondylar, bicondylar, tibial shaft, pilon, and ankle) fractures between 2005 and 2016 were identified. Prescribing information was obtained from the State Controlled Substance Monitoring Database. Descriptive statistics were calculated for each injury and plotted for MME use. Mann-Whitney and Wilcoxon tests were used for data analysis. To aid in clinical relevance, MMEs were converted to number of pills of oxycodone 10 mg (OC 10 mg). RESULTS Three hundred forty-one patients met our inclusion criteria. Mean age was 45 years; 56% (192/341) were men. Forty-seven percent (159/341) were prescribed opiates before their injury. Orthopaedic providers prescribed more opiates to patients with pilon fractures compared with unicondylar (P = 0.010), tibial shaft (P < 0.001), and ankle (P < 0.001) fractures. Bicondylar plateau fracture patients also received more opiates when compared with unicondylar (P = 0.001), tibial shaft (P < 0.001), and ankle (P < 0.001) fractures. Nonorthopaedic providers prescribed more opiates to patients with pilon fractures when compared with unicondylar (P = 0.006), bicondylar (P < 0.001), tibial shaft (P < 0.001), and ankle fractures (P = 0.006). Differences between orthopaedic and nonorthopaedic MMEs prescribed are significantly different for each injury type (

BACKGROUND The pyramided genetically modified maize (Zea mays [L.]) event MON 95379, expressing the Cry1B.868 and Cry1Da_7 proteins, was designed to protect against larval feeding damage by the fall armyworm, Spodoptera frugiperda (FAW). Here, we conducted laboratory, greenhouse, and field studies to assess the dose and field efficacy of MON 95379 against FAW and inform the development of insect resistance management plans. RESULTS The Cry1B.868 and Cry1Da_7 proteins were active against susceptible FAW neonates in diet‐incorporation bioassays: median lethal concentration [LC50] (95% CI) = 62.8 (42.6–87.6) μg/ml diet for Cry1B.868 and 9.4 (5.3–18.6) μg/ml diet for Cry1Da_7. In laboratory leaf disc bioassays, MON 95379 maize and experimental maize lines expressing the individual components were effective in controlling susceptible FAW. In whole‐plant assays, MON 95379 controlled FAW resistant to the Cry1A.105 and Cry2Ab2 proteins. Likewise, under field conditions, MON 95379 maize expressing Cry1B.868 and Cry1Da_7 was highly effective at protecting plants against the larval feeding of FAW. CONCLUSIONS The expression of Cry1B.868 and Cry1Da_7 in MON 95379 consistently protected maize plants against larval feeding by FAW and represents an alternative to manage trait resistance issues in South America. © 2021 Bayer Crop Science‐US. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., The pyramided genetically modified maize (Zea mays [L.]) event MON 95379, expressing the Cry1B.868 and Cry1Da_7 proteins was designed to protect against larval feeding damage of the fall armyworm, Spodoptera frugiperda (FAW). The expression of Cry1B.868 and Cry1Da_7 in MON 95379 consistently protected maize plants against larval feeding of FAW and represents an alternative to manage trait resistance issues in South America.

Healthcare workers (HCWs) are known to be at increased risk of infection with SARS-CoV-2, although whether these risks are equal across all roles is uncertain. Here we report a retrospective analysis of a large real-world dataset obtained from 10 March to 6 July 2020 in an NHS Foundation Trust in England with 17,126 employees. 3,338 HCWs underwent symptomatic PCR testing (14.4% positive, 2.8% of all staff) and 11,103 HCWs underwent serological testing for SARS-CoV-2 IgG (8.4% positive, 5.5% of all staff). Seropositivity was lower than other hospital settings in England but higher than community estimates. Increased test positivity rates were observed in HCWs from BAME backgrounds and residents in areas of higher social deprivation. A multiple logistic regression model adjusting for ethnicity and social deprivation confirmed statistically significant increases in the odds of testing positive in certain occupational groups, most notably domestic services staff, nurses, and health-care assistants. PCR testing of symptomatic HCWs appeared to underestimate overall infection levels, probably due to asymptomatic seroconversion. Clinical outcomes were reassuring, with only a small minority of HCWs with COVID-19 requiring hospitalization (2.3%) or ICU management (0.7%) and with no deaths. Despite a relatively low level of HCW infection compared to other UK cohorts, there were nevertheless important differences in test positivity rates between occupational groups, robust to adjustment for demographic factors such as ethnic background and social deprivation. Quantitative and qualitative studies are needed to better understand the factors contributing to this risk. Robust informatics solutions for HCW exposure data are essential to inform occupational monitoring.

Background: Individuals with an extremity amputation are predisposed to persistent pain that reduces their quality of life. Residual limb pain is defined as pain that is felt in the limb after amputation. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review of 5 databases from inception to June 2020 was performed and is registered under the PROSPERO ID: CRD42020199297. Included studies were clinical trials with residual limb pain assessed at a minimum follow-up of 1 week. Meta-analyses of residual limb pain prevalence and severity were performed with subgroups of extremity and amputation etiology. Results: Twenty clinical trials met criteria and reported on a total of 1347 patients. Mean patient ages ranged from 38 to 77. Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. Mean residual limb pain severity at the 6 months or longer follow-up was 4.19 out of 10 for cancer amputations, 2.70 for traumatic amputations, 0.47 for vasculopathy amputations, 1.01 for lower extremity amputations, and 3.56 for upper extremity amputations. Conclusions: Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. Promising methods of reducing long-term pain are preoperative pain control, nerve or epidural blocks, use of memantine, calcitonin-containing blocks, and prophylactic nerve coaptations.

In this article, we address an existing lacuna in the sociology of the senses, by employing sociological phenomenology to illuminate the under-researched sense of temperature, as lived by a social group for whom water temperature is particularly salient: competitive pool swimmers. The research contributes to a developing ‘sensory sociology’ that highlights the importance of the socio-cultural framing of the senses and ‘sensory work’, but where there remains a dearth of sociological exploration into senses extending beyond the ‘classic five’ sensorium. Drawing on data from a three-year ethnographic study of competitive swimmers in the UK, our analysis explores the rich sensuousities of swimming, and highlights the role of temperature as fundamentally affecting the affordances offered by the aquatic environment. The article contributes original theoretical perspectives to the sociology of the senses and of sport in addressing the ways in which social actors in the aquatic environment interact, both intersubjectively and intercorporeally, as thermal beings.