Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

How far is America from here? Selected proceedings of the First World Congress of the International American Studies Association, 22-24 May 2003 /

How Far is America From Here? approaches American nations and cultures from a comparative and interdisciplinary perspective. It is very much at the heart of this comparative agenda that “America” be considered as a hemispheric and global matter. It discusses American identities relationally, whether the relations under discussion operate within the borders of the United States, throughout the Americas, and/or worldwide. The various articles here gathered interrogate the very notion of “America”: which, whose America, when, why now, how? What is meant by “far”—distance, discursive formations, ideals and ideologies, foundational narratives, political conformities, aberrations, inconsistencies? Where is here—positionality, geographies, spatial compressions, hegemonic and subaltern loci, disciplinary formations, reflexes and reflexivities? These questions are addressed with regard to the multiple Americas within the USA and the bi-continental western hemisphere, as part of and beyond inter-American cultural relations, ethnicities across the national and cultural plurality of America, mutual constructions of North and South, borderlands, issues of migration and diaspora. The larger contexts of globalization and America's role within this process are also discussed, alongside issues of geographical exploration, capital expansion, integration, transculturalism, transnationalism and global flows, pre-Columbian and contemporary Native American cultures, the Atlantic slave trade, the environmental crisis, U.S. literature in relation to Canadian or Latin American literature, religious conflict both within the Americas and between the Americas and the rest of the world, with such issues as American Zionism, American exceptionalism, and the discourse of/on terror and terrorism... Back cover.Acknowledgements / Theo D'haen, Paul Giles, Djelal Kadir and Lois Parkinson Zamora; AMERICAN STUDIES FROM AN INTERNATIONAL AMERICAN STUDIES PERSPECTIVE. Defending America against Its Devotees / Djelal Kadir; The Tenacious Grasp of American Exceptionalism: A Response to Djelal Kadir, "Defending America against Its Devotees" / Amy Kaplan; Resisting Terror, Resisting Empire: The Evolving Ethos of American Studies / Kousar J. Azam; How far from America is America? / Werner Sollors; INTERNATIONAL, TRANSNATIONAL, HEMISPHERIC AMERICA. Through the Fun House Mirror: The Fulbright Teaching Experience in Germany / Janice L. Reiff; American Diplomats in South Africa and the Emergence of Apartheid, 1948-1953 / J. P. Brits; The Quest for Cultural Identity in the African Diaspora in the Americas and Europe in the Early Twentieth Century / Allison Blakely; Notes on Border(land)s and Transculturation in the ‘Damp and Hungry Interstices' of the Americas / Roland Walter; Antropofagismo and the ‘Cannibal Logic' of Hemispheric American Studies / Justin Read;AMERICAN SOCIAL, ETHICAL, AND RELIGIOUS MENTALITIES. Is Truth Defunct? / Kathleen Haney; True Ethics: American Morality in (Post-)Modern Times / Bernd Klähn; "In All People I See Myself": The New American Sprituality and the Paradoxes of Cultural Pluralism / Mary Kupiec Cayton; COMPARATIVE PERSPECTIVES, LITERARY COUNTERPOINTS. The End of History? Contemporary World Fiction and the Testing of American Ideologemes / Jerry A. Varsava; Excentric Positionalities: Mimicry and Changing Constructions of the Center in the Americas / Amaryll Chanady; Approaches to Margaret Atwood's The Edible Woman / Amporn Srisermbhok; How Far is Modernity From Here? Brazil, Portugal: Two Novels in Portuguese / Helena Carvalhão Buescu; How Far is T. S. Eliot From Here? The Young Poet's Imagined World of Polynesian Matahiva / Tatsushi Narita; Cities in Ruins: The Recuperation of the Baroque in T. S. Eliot and Octavio Paz / Cecilia Enjuto Rangel; An ‘American Venture': Self-Representation and Self-Orientalization in Turkish-American Selma Ekrem's Unveiled / Gönül Pultar; Damnosa Hereditas: Sorting the National Will in Fuentes' 'La Muerte de Artemio Cruz, and Pynchon's 'The Crying of Lot 49' / Pedro García-Caro; American Culture Meets Post-Colonial Insight: Visions of the United tates in Salman Rushdie's Fury / Rodney Stephens;AMERICAN IDENTITIES. Juan de Velasco's (S.J.) Natural History: Differentiating the Kingdom of Quito / Silvia Navia Méndez-Bonito; Creole Identity in Eighteenth-Century Peru: Race and Ethnicity / Jerry M. Williams; Locating the American Voice: Space Relation as Self-Identification in henry David Thoreau's Vision / Albena Bakratcheva; Home away from Home: The Construction of Germany and America in Elsie Singmaster's The Lèse-Majesté of Hans Heckendorn (1905) / Carmen Birkle; The In-between Space: Ekphrasis and Translation in the Poems "Objetos y apariciones" by Octavio Paz and "Objects & Apparitions" by Elizabeth Bishop / Irene Artigas Albarelli; Reconfiguring Female Characters of the American West: Marilynne Robinson's Housekeeping / Corina Anghel; Homing In? The Critical/creative Transformation of a Genre / Helen M. Dennis; Multilingual Narrative and the Refusal of Translation: Theresa Hak Kyung Cha's Dictee and R. Zamora Linmark's Rolling the R's / Joshua L. Miller; Ty Pak: Korean American Literature as ‘Guilt Payment' / Kirsten Twelbeck; ‘Buried Alive in the Blues': Janis Joplin and the Souls of White Folk / Gavin James Campbell; How Far is the Canadian Border from America?: A Case Study in Racial Profiling / Helen McClure;SPACE AND PLACE IN AMERICAN STUDIES. Space and Place in Geography and American Studies / Sheila Hones, Julia Leyda, Khadija Fritsch-El Alaoui; Innocents Abroad? The U.S. and the World in National Geographic / Anders Olsson; ‘Is it down on any map?' Space Symbols and American Ideology in Melville's Typee / Cinzia Schiavini; Willa Cather's Deep Southwest / Rosario Faraudo; The Transitional in the American Cities: Introduction / Dorothea Löbbermann; Schizopolis: Border Cinema and the Global City (of Angels) / Camilla Fojas; All the World's in L.A.: Public Concerts in the Global City / Marina Peterson; New York City as America: Examples from Auster and DeLillo / Markku Salmela; Transient Figures in New York: Tourists and Street People / Dorothea Löbbermann; Notes on Contributors.How Far is America From Here? approaches American nations and cultures from a comparative and interdisciplinary perspective. It is very much at the heart of this comparative agenda that “America” be considered as a hemispheric and global matter. It discusses American identities relationally, whether the relations under discussion operate within the borders of the United States, throughout the Americas, and/or worldwide. The various articles here gathered interrogate the very notion of “America”: which, whose America, when, why now, how? What is meant by “far”—distance, discursive formations, ideals and ideologies, foundational narratives, political conformities, aberrations, inconsistencies? Where is here—positionality, geographies, spatial compressions, hegemonic and subaltern loci, disciplinary formations, reflexes and reflexivities? These questions are addressed with regard to the multiple Americas within the USA and the bi-continental western hemisphere, as part of and beyond inter-American cultural relations, ethnicities across the national and cultural plurality of America, mutual constructions of North and South, borderlands, issues of migration and diaspora. The larger contexts of globalization and America's role within this process are also discussed, alongside issues of geographical exploration, capital expansion, integration, transculturalism, transnationalism and global flows, pre-Columbian and contemporary Native American cultures, the Atlantic slave trade, the environmental crisis, U.S. literature in relation to Canadian or Latin American literature, religious conflict both within the Americas and between the Americas and the rest of the world, with such issues as American Zionism, American exceptionalism, and the discourse of/on terror and terrorism... Back cover

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially