Divine Testing and the Covid Pandemic: Searching for Hope in Sufi Commentaries

The Qur’an carries many references to the created world being subjected to divine testing. It, therefore, seems obvious to ask whether the COVID pandemic that has caused so much suffering across the world and continues to ravage communities represents a test by God for faithful believers. Tests can be daunting experiences, causing apprehension and fear. To what extent should faithful believers regard the COVID pandemic as a fearful, traumatic experience? On the other hand, how can believers find ways to focus on a sense of hope in the midst of the current troubles? This paper will initially consider a range of responses to the COVID pandemic by religious leaders and commentators. It will then draw out Qur’an verses referred to in these responses and will engage with these verses through the lens of several Sufi commentaries, in a search for layered meanings below a surface reading of the verses concerned

Divine Testing and the Covid Pandemic: Searching for Hope in Sufi Commentaries

The Qur’an carries many references to the created world being subjected to divine testing. It, therefore, seems obvious to ask whether the COVID pandemic that has caused so much suffering across the world and continues to ravage communities represents a test by God for faithful believers. Tests can be daunting experiences, causing apprehension and fear. To what extent should faithful believers regard the COVID pandemic as a fearful, traumatic experience? On the other hand, how can believers find ways to focus on a sense of hope in the midst of the current troubles? This paper will initially consider a range of responses to the COVID pandemic by religious leaders and commentators. It will then draw out Qur’an verses referred to in these responses and will engage with these verses through the lens of several Sufi commentaries, in a search for layered meanings below a surface reading of the verses concerned

Exegeting Sūra al Fātiḥa for the Masses: Bediüzzaman Said Nursi and Haji Muḥammad Saʿīd bin ʿUmar

أهداف البحث: تتناول هذه المقالة وجهات النظر التفسيرية حول أشهر سورة في القرآن من مفسرين عاشا في سياقات متنوعة في أواخر القرن التاسع عشر وأوائل القرن العشرين، ويمكن القول إن بديع الزمان سعيد نورسي هو اللاهوتي الأكثر تأثيراً الذي خرج من تركيا العثمانية خلال تاريخها الطويل، وعلى النقيض من ذلك، يتمتع الحاج محمد سعيد بن عمر بسمعة محلية باعتباره باحثًا في المنطقة الماليزية الإندونيسية ولكنه غير معروف خارجها. منهج الدراسة: تستند الدراسة إلى تحليل مقارن لتفسير هذين العالمين في سورة الفاتحة، واستكشاف الأساليب التي استخدماها للوصول إلى المسلمين العاديين بتفسيرهم، وليس فقط المتعلمين تعليماً عالياً. النتائج: جاء بديع الزمان سعيد النورسي والحاج محمد سعيد بن عمر من خلفيات وسياقات مختلفة تمامًا. علاوة على ذلك، كانت أساليبهم التفسيرية مختلفة اختلافًا جوهريًا، حيث كان الأول أكثر عقلانية والأخير أكثر حرفيًا. ومع ذلك، نجح كل منهما في إنتاج تفاسير وصلت إلى الجماهير، وبالتالي نجحا في تحقيق أهدافهما العامة المتمثلة في تعزيز الالتزام الديني والروح الديناميكية للمسلمين في سياقاتهم الخاصة. أصالة البحث: هذا البحث أصيل من نواح مختلفة: أولاً- الدراسات المقارنة لسعيد النورسي مع مفسري اللغة الملاوية قليلة العدد. ثانيًا- يتطلب تحديد أوجه التشابه في النتائج على الرغم من الاختلافات في الأساليب في مجال التفسير مزيدًا من الاهتمام الأكاديمي، ويجب أن تحفز هذه المقالة الاهتمام بمزيد من هذه الدراسات.Purpose: This article considers exegetical perspectives on the best known Sūra of the Qur’ān from two exegetes who lived in diverse contexts in the late nineteenth- and early twentieth-century Caliphate. Bediüzzaman Said Nursi is arguably the most influential theologian to emerge from  in Ottoman Turkey in its long history. Haji Muḥammad Saʿīd bin ʿUmar, by contrast, enjoys a local reputation as a scholar in the Malay-Indonesian region but is unknown outside of that area. Methodology: This research is based on a comparative analysis of the exegesis of both scholars on Sūra al-Fātiḥa, exploring the techniques they used to reach ordinary Muslims with their exegesis, not just highly educated Muslims. Findings: Said Nursi and Muḥammad Saʿīd bin ʿUmar came from quite different backgrounds and contexts. Moreover, their exegetical styles were fundamentally different, with the former’s being more thematic and the latter’s being more literalist. Nevertheless, each succeeded in producing exegesis that reached the masses, thereby meeting their overall goals of reinforcing the commitment to faith and dynamic spirit of Muslims in their respective contexts. Originality: This research is original in various ways. First, comparative studies of Said Nursi and Malay-language exegetes are few in number. Second, the identification of similarities in the results of studies on exegesis despite the use of different methods requires greater scholarly attention. This article should stimulate interest in further studies on the matter

Clonal kinetics and single-cell transcriptional profiling of CAR-T cells in patients undergoing CD19 CAR-T immunotherapy

Chimeric antigen receptor (CAR) T-cell therapy has produced remarkable anti-tumor responses in patients with B-cell malignancies. However, clonal kinetics and transcriptional programs that regulate the fate of CAR-T cells after infusion remain poorly understood. Here we perform TCRB sequencing, integration site analysis, and single-cell RNA sequencing (scRNA-seq) to profile CD8+ CAR-T cells from infusion products (IPs) and blood of patients undergoing CD19 CAR-T immunotherapy. TCRB sequencing shows that clonal diversity of CAR-T cells is highest in the IPs and declines following infusion. We observe clones that display distinct patterns of clonal kinetics, making variable contributions to the CAR-T cell pool after infusion. Although integration site does not appear to be a key driver of clonal kinetics, scRNA-seq demonstrates that clones that expand after infusion mainly originate from infused clusters with higher expression of cytotoxicity and proliferation genes. Thus, we uncover transcriptional programs associated with CAR-T cell behavior after infusion.Published versio

Treatment of bleeding episodes in haemophilia A complicated by a factor VIII inhibitor in patients receiving Emicizumab. Interim guidance from UKHCDO Inhibitor Working Party and Executive Committee

Emicizumab is a bispecific antibody that activates FX to FXa in the absence of FVIII. It has been shown to reduce bleeding episodes in people with haemophilia A complicated by a FVIII inhibitor. Despite the protection against bleeds, some breakthrough bleeds are inevitable and these may require additional haemostatic treatment. Emicizumab has been associated with severe adverse events when co‐administered with activated prothrombin complex concentrate. To minimize the risk of adverse events, the UK Haemophilia Centre Doctors’ Organisation issues the following updated interim guidance to its Inhibitor Guidelines for managing patients receiving Emicizumab based on the limit published information available in February 2018

Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA)

Physical exercise is an important component in the management of type 1 diabetes across the lifespan. Yet, acute exercise increases the risk of dysglycaemia, and the direction of glycaemic excursions depends, to some extent, on the intensity and duration of the type of exercise. Understandably, fear of hypoglycaemia is one of the strongest barriers to incorporating exercise into daily life. Risk of hypoglycaemia during and after exercise can be lowered when insulin‐dose adjustments are made and/or additional carbohydrates are consumed. Glycaemic management during exercise has been made easier with continuous glucose monitoring (CGM) and intermittently scanned continuous glucose monitoring (isCGM) systems; however, because of the complexity of CGM and isCGM systems, both individuals with type 1 diabetes and their healthcare professionals may struggle with the interpretation of given information to maximise the technological potential for effective use around exercise (ie, before, during and after). This position statement highlights the recent advancements in CGM and isCGM technology, with a focus on the evidence base for their efficacy to sense glucose around exercise and adaptations in the use of these emerging tools, and updates the guidance for exercise in adults, children and adolescents with type 1 diabetes

Point-of-care testing and treatment of sexually transmitted infections to improve birth outcomes in high-burden, low-income settings: Study protocol for a cluster randomized crossover trial (the WANTAIM Trial, Papua New Guinea) [version 1; peer review: 1 approved, 1 approved with reservations]

Background: Chlamydia trachomatis , Neisseria gonorrhoeae , Trichomonas vaginalis and bacterial vaginosis have been associated with preterm birth and low birth weight, and are highly prevalent among pregnant women in many low- and middle-income settings. There is conflicting evidence on the potential benefits of screening and treating these infections in pregnancy. Newly available diagnostic technologies make it possible, for the first time, to conduct definitive field trials to fill this knowledge gap. The primary aim of this study is to evaluate whether antenatal point-of-care testing and immediate treatment of these curable sexually transmitted and genital infections (STIs) leads to reduction in preterm birth and low birth weight. Methods : The Women and Newborn Trial of Antenatal Interventions and Management (WANTAIM) is a cluster-randomised crossover trial in Papua New Guinea to compare point-of-care STI testing and immediate treatment with standard antenatal care (which includes the WHO-endorsed STI ‘syndromic’ management strategy based on clinical features alone without laboratory confirmation). The unit of randomisation is a primary health care facility and its catchment communities. The primary outcome is a composite measure of two events: the proportion of women and their newborns in each trial arm, who experience either preterm birth (delivery <37 completed weeks of gestation as determined by ultrasound) and/or low birth weight (<2500 g measured within 72 hours of birth). The trial will also evaluate neonatal outcomes, as well as the cost-effectiveness, acceptability and health system requirements of this strategy, compared with standard care. Conclusions: WANTAIM is the first randomised trial to evaluate the effectiveness, cost-effectiveness, acceptability and health system requirements of point-of-care STI testing and treatment to improve birth outcomes in high-burden settings. If the intervention is proven to have an impact, the trial will hasten access to these technologies and could improve maternal and neonatal health in high-burden settings worldwide. Registration: ISRCTN37134032

Point-of-care testing and treatment of sexually transmitted and genital infections during pregnancy in Papua New Guinea (WANTAIM trial): protocol for an economic evaluation alongside a cluster-randomised trial

INTRODUCTION: Left untreated, sexually transmitted and genital infections (henceforth STIs) in pregnancy can lead to serious adverse outcomes for mother and child. Papua New Guinea (PNG) has among the highest prevalence of curable STIs including syphilis, chlamydia, gonorrhoea, trichomoniasis and bacterial vaginosis, and high neonatal mortality rates. Diagnosis and treatment of these STIs in PNG rely on syndromic management. Advances in STI diagnostics through point-of-care (PoC) testing using GeneXpert technology hold promise for resource-constrained countries such as PNG. This paper describes the planned economic evaluation of a cluster-randomised cross-over trial comparing antenatal PoC testing and immediate treatment of curable STIs with standard antenatal care in two provinces in PNG. METHODS AND ANALYSIS: Cost-effectiveness of the PoC intervention compared with standard antenatal care will be assessed prospectively over the trial period (2017-2021) from societal and provider perspectives. Incremental cost-effectiveness ratios will be calculated for the primary health outcome, a composite measure of the proportion of either preterm birth and/or low birth weight; for life years saved; for disability-adjusted life years averted; and for non-health benefits (financial risk protection and improved health equity). Scenario analyses will be conducted to identify scale-up options, and budget impact analysis will be undertaken to understand short-term financial impacts of intervention adoption on the national budget. Deterministic and probabilistic sensitivity analysis will be conducted to account for uncertainty in key model inputs. ETHICS AND DISSEMINATION: This study has ethical approval from the Institutional Review Board of the PNG Institute of Medical Research; the Medical Research Advisory Committee of the PNG National Department of Health; the Human Research Ethics Committee of the University of New South Wales; and the Research Ethics Committee of the London School of Hygiene and Tropical Medicine. Findings will be disseminated through national stakeholder meetings, conferences, peer-reviewed publications and policy briefs. TRIAL REGISTRATION NUMBER: ISRCTN37134032

The diagnosis and management of systemic autoimmune rheumatic disease-related interstitial lung disease: British Society for Rheumatology guideline scope

Interstitial lung disease (ILD) is a significant complication of many systemic autoimmune rheumatic diseases (SARDs), although the clinical presentation, severity and outlook may vary widely between individuals. Despite the prevalence, there are no specific guidelines addressing the issue of screening, diagnosis and management of ILD across this diverse group. Guidelines from the ACR and EULAR are expected, but there is a need for UK-specific guidelines that consider the framework of the UK National Health Service, local licensing and funding strategies. This article outlines the intended scope for the British Society for Rheumatology guideline on the diagnosis and management of SARD-ILD developed by the guideline working group. It specifically identifies the SARDs for consideration, alongside the overarching principles for which systematic review will be conducted. Expert consensus will be produced based on the most up-to-date available evidence for inclusion within the final guideline. Key issues to be addressed include recommendations for screening of ILD, identifying the methodology and frequency of monitoring and pharmacological and non-pharmacological management. The guideline will be developed according to methods and processes outlined in Creating Clinical Guidelines: British Society for Rheumatology Protocol version 5.1.</p

Private Sector Union Density and the Wage Premium: Past, Present, and Future

The rise and decline of private sector unionization were among the more important features of the U.S. labor market during the twentieth century. Following a dramatic spurt in unionization after passage of the depression-era National Labor Relations Act (NLRA) of 1935, union density peaked in the mid-1950s, and then began a continuous decline. At the end of the century, the percentage of private wage and salary workers who were union members was less than 10 percent, not greatly different from union density prior to the NLRA