Summary
Background
During the coronavirus disease 2019 (COVID‐19) pandemic, various adverse skin reactions to long‐term mask wearing have been reported.
Aim
To assess the clinical features of ...mask‐induced dermatoses and to recommend prevention and treatment options.
Methods
From April to August 2020, questionnaires including topics such as demographic information, pre‐existing skin disorders, reported mask‐related symptoms, daily mask‐wearing duration and frequency, types of masks used and whether the participant was a healthcare worker, were distributed to patients in 12 hospitals. Dermatologists assessed skin lesions, confirmed diagnosis and recorded treatments.
Results
Itchiness was the most frequent symptom, mostly affecting the cheeks. The most common skin disease was new‐onset contact dermatitis (33.94%), followed by new‐onset acne (16.97%) and worsening of pre‐existing acne (16.97%). Daily wearing of masks was significantly (P = 0.02) associated with new‐onset contact dermatitis. More than half of patients with pre‐existing skin problems experienced disease worsening while wearing masks. Longer duration of wearing (> 6 h/day, P = 0.04) and use of cotton masks (P < 0.001) significantly increased acne flare‐up. Healthcare workers had a higher incidence of skin disease. Skin lesions were generally mild and well tolerated with topical treatment. The study had some limitations: the effect of seasonal characteristics and other risk factors were not assessed, and the patients were visiting dermatological clinics and had interest in their skin status, thus, there may have been selection bias.
Conclusion
Mask‐induced/‐triggered dermatoses contribute to increase the dermatological burden during the pandemic.
Cytomegalovirus (CMV) colitis is a common manifestation of CMV end-organ disease, which has typically been described in immunocompromised hosts. Recently, it has been noted that this also occurs in ...immunocompetent patients. To gather relevant data about clinical presentation, prognosis, and risk factors for development of CMV colitis in immunocompetent hosts, we analyzed all cases that occurred during a 19-year period at our institution.
A case-control study was performed to identify risk factors for CMV colitis in immunocompetent hosts. Electronic medical records of individuals who were admitted and diagnosed with CMV colitis between January 1995 and February 2014 at a tertiary care university hospital were reviewed. Two non-CMV colitis patients who were age- and sex-matched were selected as controls for each case.
A total of 51 patients with CMV colitis were included in this study along with 102 control patients. Certain conditions including renal disease on hemodialysis, neurologic disease, rheumatologic disease, intensive care unit admission, and exposure to antibiotics, antacids, steroids, or red blood cell (RBC) transfusions within 1 month of diagnosis of colitis were associated with CMV colitis on univariate analysis. Among these, steroid use and RBC transfusion within 1 month were identified as independent risk factors for developing CMV colitis on multivariate analysis. The 30-day mortality rate was 7.8% without any attributable mortality.
Steroid use and RBC transfusion within 1 month of the diagnosis of colitis were independent risk factors for development of CMV colitis in immunocompetent hosts.
We search for energetic electron recoil signals induced by boosted dark matter (BDM) from the galactic center using the COSINE-100 array of NaI(Tl) crystal detectors at the Yangyang Underground ...Laboratory. The signal would be an excess of events with energies above 4 MeV over the well-understood background. Because no excess of events are observed in a 97.7 kg·yr exposure, we set limits on BDM interactions under a variety of hypotheses. Notably, we explored the dark photon parameter space, leading to competitive limits compared to direct dark photon search experiments, particularly for dark photon masses below 4 MeV and considering the invisible decay mode. Furthermore, by comparing our results with a previous BDM search conducted by the Super-Kamionkande experiment, we found that the COSINE-100 detector has advantages in searching for low-mass dark matter. This analysis demonstrates the potential of the COSINE-100 detector to search for MeV electron recoil signals produced by the dark sector particle interactions.
A search for inelastic boosted dark matter (IBDM) using the COSINE-100 detector with 59.5 days of data is presented. This relativistic dark matter is theorized to interact with the target material ...through inelastic scattering with electrons, creating a heavier state that subsequently produces standard model particles, such as an electron-positron pair. In this study, we search for this electron-positron pair in coincidence with the initially scattered electron as a signature for an IBDM interaction. No excess over the predicted background event rate is observed. Therefore, we present limits on IBDM interactions under various hypotheses, one of which allows us to explore an area of the dark photon parameter space that has not yet been covered by other experiments. This is the first experimental search for IBDM using a terrestrial detector.
Summary
What is known and objective
Economic evidence of multidisciplinary collaborative care on glycaemic improvement in uncontrolled diabetic patients is limited. Therefore, the primary objective ...of this study was to assess the cost‐effectiveness of multidisciplinary collaborative care versus usual care and the secondary objective was to assess the cost‐effectiveness of these two care approaches in relation to varying glycaemic control of patients.
Methods
An economic evaluation based on a six‐month randomized controlled trial involving high‐risk uncontrolled diabetic Asian patients with polypharmacy and multiple comorbidities was conducted from a healthcare institution perspective. The control arm received usual care, while the intervention arm received multidisciplinary care with regular clinical pharmacist follow‐up in addition to usual care. The study outcomes included glycated haemoglobin (HbA1c) change and total direct outpatient medical costs for diabetes‐related care. The cost‐effectiveness analyses were conducted for both arms and those stratified according to baseline HbA1c (Group 1:HbA1c 7.1%‐7.9%, Group 2:HbA1c ≥8.0%). The incremental cost per glycaemic improvement (HbA1c improvement of 0.1% and above) per patient was examined followed by uncertainty evaluation via probabilistic sensitivity analyses. A range of willingness‐to‐pay (WTP) thresholds (US$165.21 to US$5000.00 per glycaemic improvement) was used in analysis.
Results and discussion
Overall, the intervention arm had greater improvement in HbA1c (I: mean −0.4% 95% CI −0.6 to −0.2 vs C: mean −0.1% 95% CI −0.2 to 0.1; P = .014) and lower mean total direct outpatient medical costs per patient in comparison with the control arm (I: US$516.77 ± 222.10 vs C: US$607.78 ± 268.39; P < .001). The intervention arm was the dominant strategy across varying baseline HbA1c with higher probability of Group 2 being cost‐effective at higher WTP threshold.
What is new and conclusions
The multidisciplinary collaborative care arm was cost‐effective in managing Asian patients with varying baseline HbA1c control. The multidisciplinary collaborative care also showed greater probability of being cost‐effective among Asian patients with poorly uncontrolled glycaemia.
In November 2006, the City of Hammond, Louisiana, began discharging secondarily treated, disinfected municipal effluent through a distribution pipeline to a 14,000 ha emergent wetland complex ...referred to as the East Joyce Wetlands. The primary goals were to improve local water quality by taking effluent that would normally be discharged to local waterways and directing it to wetlands that were hydrologically isolated and degraded by saltwater intrusion. During the 2007 growing season there was robust growth of marsh vegetation with a near doubling of productivity compared to controls, however, during winter 2007 there was a massive decline in vegetation and transition to open water in the 121 ha of wetlands in the direct path of effluent discharge. Herbivory by nutria was found to be the cause of the decline, but not before several other causes were hypothesized and largely accepted by the public, specifically that the cause of the vegetation decline was due to excess nutrients that increased rates of soil decomposition and limited root growth of plants. Studies show these hypotheses were flawed due to scale and methodology issues. Intensive nutria removal began in the spring of 2008 and continued through the winter of 2008–2009, with approximately 2000 nutria killed, and vegetation recovery began during the spring of 2009, which was most pronounced and consistent nearest the discharge pipe. Vegetative cover increased dramatically from the near complete loss after nutria grazing to near 80% by 2015, and wetland recovery has continued to the present.
•Treated municipal effluent was discharged into 121 ha of emergent wetlands.•Within two years, the entire 121 ha wetland turned to open water.•Two main hypotheses emerged of why: increased decomposition and nutria herbivory.•Herbivory by nutria was found to be the cause based on several lines of evidence.•Increased decomposition hypothesis rejected due to a lack of supportive evidence.
Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, ...risky decision, and decision-making style of individuals with IGD.
We recruited 87 individuals with IGD and 87 without IGD (matched controls). All participants underwent an interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnostic criteria for IGD and completed an adaptive decision-making task; the Preference for Intuition and Deliberation Scale, Chen Internet Addiction Scale, and Barratt Impulsivity Scale were also assessed on the basis of the information from the diagnostic interviews.
The results demonstrated that the participants in both groups tend to make more risky choices in advantage trials where their expected value (EV) was more favorable than those of the riskless choice. The tendency to make a risky choice in advantage trials was stronger among IGD group than that among controls. Participants of both groups made more risky choices in the loss domain, a risky option to loss more versus sure loss option, than they did in the gain domain, a risky option to gain more versus sure gain. Furthermore, the participants with IGD made more risky choices in the gain domain than did the controls. Participants with IGD showed higher and lower preferences for intuitive and deliberative decision-making styles, respectively, than controls and their preferences for intuition and deliberation were positively and negatively associated with IGD severity, respectively.
These results suggested that individuals with IGD have elevated EV sensitivity for decision-making. However, they demonstrated risky preferences in the gain domain and preferred an intuitive rather than deliberative decision-making style. This might explain why they continue Internet gaming despite negative consequences. Thus, therapists should focus more on decision-making styles and promote deliberative thinking processes to mitigate the long-term negative consequences of IGD.
Current standard treatment, including non-anthracycline-based chemotherapy and optimal combining of radiotherapy, has dramatically improved outcomes of patients with extranodal natural killer/T-cell ...lymphoma (ENKTL) during the last decade. This study was conducted to investigate the clinical outcome of ENKTL patients with relapsed or progressive disease after initial current standard therapy.
We retrospectively reviewed patients diagnosed with ENKTL at six centers in four countries (China, France, Singapore, and South Korea) from 1997 to 2015 and analyzed 179 patients who had relapsed or progressed after initial current standard therapy.
After a median follow-up of 58.6 months (range 27.9–89.2), the median second progression-free survival (PFS) was 4.1 months 95% confidence interval (CI) 3.04–5.16 and overall survival (OS) was 6.4 months (95% CI 4.36–8.51). Multivariate Cox-regression analysis revealed that elevated lactate dehydrogenase, multiple extranodal sites (≥2), and presence of B symptoms were associated with inferior OS (P < 0.05). OS and PFS were significantly different according to both prognostic index of natural killer lymphoma (PINK) and PINK-E (Epstein-Barr virus) models. Salvage chemotherapy with l-asparaginase (l-Asp)-based regimens showed a significantly better clinical benefit to response rate and PFS, although it did not lead to OS improvement. First use of l-Asp in the salvage setting and l-Asp rechallenge at least 6 months after initial treatment were the best candidates for salvage l-Asp containing chemotherapy.
Most patients with relapsed or refractory ENKTL had poor prognosis with short survival. Further studies are warranted to determine the optimal treatment of patients with relapsed or refractory ENKTL.
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