Supplemental Series Research Articles

Supplemental Patch Testing Identifies Allergens Missed by Standard Screening Series.

Background: Supplemental patch testing is an adjunct to standard patch test screening series. Objective: To determine the demographics, characteristics, frequency, relevance, and interpretation of patch test reactions for supplemental patch testing. Methods: Retrospective study of patients tested 2017-2020 with North American Contact Dermatitis Group (NACDG) and supplemental screening series (Supplemental Series A [SSA], Supplemental Series B [SSB]). Demographics, characteristics, reaction strengths, relevance, and final interpretation were recorded. Results: Cohort included 791 patients; 73.5% female, 68.6% age >40 years. 74.1% were White, 15.2% Black, 5.7% Asian, and 1.5% Hispanic. The most common Dermatitis sites were scattered/generalized (27.2%), face (24.0%), and hands (23.5%). For 2017-2018 and 2019-2020, respectively, 82% (318/388) and 78.4% (316/403) had ≥1 "allergic" reaction. In addition, 13.5% (52/385) and 11.7% (47/403) had SSA reactions, and 38.1% (115/302) and 31.5% (101/321) had SSB reactions. In the 87 (2017-2018) and 99 (2019-2020) patients with negative NACDG testing, 17 (19.5%) and 12 (12.1%) had supplemental reactions. Of the 34 supplemental allergens with reaction frequency ≥1%, 58.8% (20/34) are not part of the American Contact Dermatitis Society 90 (2020) or NACDG 2021-2022 screening series. The highest frequency allergens from this group were dodecyl and octyl gallate, cinnamic alcohol, phenyl salicylate, hexahydro-1,3,5-tris-(2-hydroxyethyl) triazine, and abitol. Conclusions: Supplemental patch testing identifies additional relevant allergens in patients with suspected allergic contact Dermatitis.

Witnesses to the Living God: Three Paradigms for Approaching the Politics of Nouvelle Théologie*

Witnesses to the Living God: Three Paradigms for Approaching the Politics of <i>Nouvelle Théologie</i>*

Effects of cruciate embedding fascia-bone flap technique on grade II–III cerebral spinal fluid leak in endoscopic endonasal surgery

BackgroundCerebral spinal fluid (CSF) leak remains an important issue in endoscopic endonasal surgery (EES). A standard protocol for skull base closure has not yet been established, and the application of rigid buttress has not been given sufficient attention. To emphasize the functions of support and fixation from rigid buttress in reconstruction, we introduced the cruciate embedding fascia-bone flap (CEFB) technique using autologous bone graft to buttress the fascia lata attachment to the partially sutured skull base dural defect and evaluated its efficacy in a consecutive case series of grade II–III CSF leaks in EES.MethodsData from consecutive patients diagnosed with sellar region lesions with grade II–III CSF leaks during EES were collected from May 2015 to May 2020. Skull base reconstructions were performed with the CEFB or the conventional pedicle vascularized nasoseptal flap (PNSF). Related clinical data were analysed. The combined use of the CEFB and PNSF was applied to an additional supplemental case series of patients with grade III leak and multiple high-risk factors.ResultsThere were 110 and 65 patients included in the CEFB and PNSF groups, respectively. The CEFB demonstrated similar effects on the incidence of postoperative CSF leak (2.7%), intracranial infection (4.5%), and lumbar drainage (LD) placement (5.5%) as PNSF (3.1%, 3.1%, and 6.2%), but with less epistaxis (CEFB: 0%, PNSF: 6.2%) and nasal discomforts (CEFB: 0%, PNSF: 7.7%). The LD duration (CEFB: 6.67 ± 2.16 days, PNSF: 10.50 ± 2.38 days), bed-stay time (CEFB: 5.74 ± 1.58 days, PNSF: 8.83 ± 3.78 days) and hospitalization time (CEFB: 10.49 ± 5.51 days, PNSF: 13.58 ± 5.50 days) were shortened in the CEFB group. The combined use of CEFB and PNSF resulted in 0 postoperative CSF leaks in the supplemental case series of 23 highly susceptible patients.ConclusionThis study suggested that the new CEFB technique has the potential to prevent postoperative CSF leak in EES. The results indicated that it can be used effectively without PNSF in suitable cases or applied in addition to a PNSF with high compatibility when necessary. Its effectiveness should be further verified with a larger cohort and better design in the next step.Trial Registration Current Controlled Trials ChiCTR2100044764 (Chinese Clinical Trial Registry); date of registration: 27 March 2020. Retrospectively registered

A Mixed Methods Assessment of Home-Based Video Pretransplant Lung Education.

Introduction: Patients awaiting lung transplantation must learn new information to successfully navigate the transplant process. A supplemental video series was piloted to patients at home during the Covid-19 pandemic to improve pre-transplant education. Methods: A mixed methods study was undertaken to assess patient experiences with this method of education, confirm the ideal timing of the education, and identify gaps that require further attention. Semi-structured interviews were conducted with 17 one-on-one or dyadic (patients and caregivers) who viewed the video series at home. A third-party researcher (not involved in creation of the educational materials) conducted the interviews by phone, which were audio recorded and then transcribed verbatim. NVivo 12 Pro for Windows software was used to code the data and identify emerging themes. Results: Participants indicated that home-based videos were applicable, and informative and helpful (4.7 on 5-point Likert scale) and appreciated the advice and experiences of real patients. They were satisfied with their transplant education (4.2/5). While there were few aspects that the participants disliked about the videos, the interviews elicited outstanding questions about the transplant process (eg, logistical aspects of travel) and transplant concerns (eg, medications, expenses, and precautions in daily life). Conclusion: Patients being assessed or listed for lung transplant valued the novel electronic video education, and we will implement the home-based process into standard of care after the patient's initial visit with the transplant respirologist. Pre-transplant education will be tailored to help address the outstanding gaps identified in this program evaluation.

Minor Archives from First-Millennium BCE Babylonia: The Rēˀi-sisê Archive from Sippar (The Archive of Šamaš-Iddin Son of Niqūdu Descendant of Rēˀi-sisê)

This contribution provides editions of all known texts belonging to the archive of the Rēˀi-sisê family from Sippar. It further includes a discussion of the (relatively modest scale) business profile of its main protagonist, Šamaš-iddin/Niqūdu//Rēˀi-sisê, who was active during the second half of the sixth century BCE (546/530–518 BCE). The present study is the third installation of a larger collaborative effort to make available the Minor Archives from First Millennium BCE Babylonia, the results of which are to be published in volumes of this journal. A companion volume containing copies of all tablets published in this series as well as a comprehensive prosopography is in preparation for the Journal of Cuneiform Studies Supplemental Series.

The Hittite Gilgamesh. By Gary Beckman. The Journal of Cuneiform Studies Supplemental Series 6. Atlanta: Lockwood Press for the American Schools of Oriental Research, 2019. Pp. xv + 95. $59.95 (cloth).

Previous articleNext article No AccessBook ReviewsThe Hittite Gilgamesh. By Gary Beckman. The Journal of Cuneiform Studies Supplemental Series 6. Atlanta: Lockwood Press for the American Schools of Oriental Research, 2019. Pp. xv + 95. $59.95 (cloth).Richard H. BealRichard H. BealThe Oriental Institute of the University of Chicago Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of Near Eastern Studies Volume 80, Number 2October 2021 Article DOIhttps://doi.org/10.1086/716036 Views: 100Total views on this site For permission to reuse a book review in this section, please contact [email protected]PDF download Crossref reports no articles citing this article.

Human total fertility rate affected by ambient temperatures in both the present and previous generations.

Elevated temperatures negatively affect human reproduction through several processes that regulate nutrient uptake and resource allocation in pregnant women. These can interfere with foetal development, resulting in low birth weight neonates with altered development trajectories. Temperatures that affect the current generation could, therefore, also have an impact on the following generation. We asked whether heat stress affected offspring fertility by asking if current and past ambient temperatures influenced total fertility rates (TFR) in human populations distributed across the world. We analysed time series data in 65 countries using simple regression analyses based on maximum temperatures and temperature amplitudes over 55 years. Supplemental longer time series (up to 100 years) provided information on response patterns in Northern Europe and Greenland's colder climates. There were clear and strong effects of temperatures on the TFR in the concurrent and the previous generation. Our temperature-based models account for 71-95% of the variation in TRF in European countries and Greenland, and 56-99% of the variation in 65 countries worldwide. Our findings are consistent with studies of seasonal variation in fertility and suggest that increased temperatures will negatively influence populations subjected to monthly maximum temperatures above 15-20 °C, while fertility in colder climates benefits from elevated temperatures. Our results provide strong evidence that ambient temperatures have important effects on human fertility, and that these effects persist into the following generation.

The future is now! A supplemental webinar series to the First International Pediatric Cardio-Oncology Meeting

Planning for the First International Pediatric Cardio-Oncology Meeting has been underway since early 2019, with the original date in October 2020 delayed due to the COVID-19 pandemic. But patients continue to need care, research carries on, and the ability to learn from our colleagues remains one of the most important tools in our collective ability to advance the field. Through collaboration with Heart University (www.heartuniversity.org), a free web-based global education resource and training tool with an emphasis on acquired and congenital heart disease, we are able to provide colleagues around the world with focused sessions similar to those that will be expanded at the in-person meeting. The first such two-hour webinar was presented live online on December 16, 2020, and moving forward similar webinars will be offered approximately every other month for the next year leading up to the in-person meeting in 2022, with all sessions available online afterward for on-demand viewing. Although we are excited to get together with our colleagues in person, why wait until then to share what we know? The future is now!

Developing a cosmetic series: Results from the ESSCA network, 2009‐2018

There is considerable variability across European patch test centres as to which allergens are included in local and national cosmetics series. To propose a standardized, evidence-based cosmetic series for Europe based on up-to-date analysis of relevant contact allergens. We collated data from the European Surveillance System on Contact Allergies (ESSCA) from 2009 to 2018 to determine which cosmetic allergens produce a high yield of contact allergy. Contact allergens with a prevalence of >0.3% that were considered relevant were included. Rare contact allergens were excluded if deemed no longer relevant or added to a supplemental cosmetic series for further analysis. Sensitization prevalences of 39 cosmetic contact allergens were tabulated. Thirty of these allergens yielded >0.3% positive reactions and are therefore included in our proposed European cosmetic series. Six were considered no longer relevant and therefore excluded. Three were included in a supplementary European cosmetic series. An additional nine allergens were included in either the core or supplemental European cosmetic series following literature review. We have derived a potential European cosmetic series based upon the above methods. This will require ongoing investigation based upon the changing exposure profiles of cosmetic allergens as well as new and evolving substances.

Patch Test Practice Patterns of Members of the American Contact Dermatitis Society.

Patch testing is the criterion standard for diagnosis and management of allergic contact dermatitis. Limitations on the number of allergens tested can negatively impact patient care. This study reports clinical practice patterns of American Contact Dermatitis Society (ACDS) members. In October and November 2018, the US-based members of the ACDS received an electronic survey regarding their procedures and experiences with patch testing. We evaluated the type of practice, number of patients tested, type of screening and supplemental series, number of allergens tested, and billing and reimbursement concerns. There were 149 respondents; 62% use ACDS Core 80, 70% "sometimes" or "always" test with supplemental series, and 70% "sometimes" or "always" test patient products. Participants estimated that supplemental series identify relevant allergens 35% of the time. Approximately 66% most commonly test more than 81 allergens per patient, and 78% expressed concerns regarding fair reimbursement. Most ACDS members routinely test more than 81 allergens per patient. Barriers to fair payment for beyond a fixed number of patches at any one visit may impede the diagnosis of allergic contact dermatitis, prolong suffering, and worsen outcomes.

Minor Archives from First-Millennium Bce Babylonia: The Archive of Iššar-Tarībi from Sippar

The present contribution provides full editions of all texts belonging to the archive of the Sipparean businessman Iššar-tarībi, who was active during the last years of the Neo-Babylonian kingdom and the early years of Achaemenid rule, as well as a brief discussion of its central features. It is part of a larger collaborative effort to make available the so-called “satellite archives” of the Ṣāḫiṭ-ginê A archive and related and unrelated smaller archives from Sippar. The results will be published in forthcoming volumes of this journal; archives in preparation include those of Adad-šamê, Mušēzib, Rēˀi-sisê, and Ša-nāšišu A (Y. Levavi), Balīhu, Aqūba, and Šamaš-iddin/Rēmūt (J. Hackl), as well as Šangû-Šamaš and Šangû-Ištar-Bābili (M. Gross). A companion volume containing copies of all tablets published in this series as well as a comprehensive prosopography is in preparation for the JCS Supplemental Series.

2535. The Stairway to Antibiotic Heaven: Evaluating a Scaffolded Video Series on Empiric Antibiotic Selection

BackgroundInappropriate antibiotic use and spread of resistance is a well-known problem. In academic settings, house staff often make initial decisions regarding antibiotic use. Recently, there has been increasing interest in using “whiteboard animations” as a way of delivering educational content. We introduced a supplemental series of short whiteboard animation videos on empiric antibiotic selection during a blended transition to residency course for fourth year medical students. Our aim was to determine whether the videos were an effective learning resource.MethodsA total of eight whiteboard animation videos on empiric antibiotic selection were created using Camtasia. Learning was scaffolded using a pneumonia case and an antibiotic “ladder” to provide context for the antibiotics discussed. Questions were interspersed throughout the videos. Students completed an eight question pretest and then an eight question post-test after completing the modules. Qualtrics was used to randomly select questions for the pre- and post-tests from a common question bank. After each individual video module, students were also offered a post-module survey with Likert scaled questions evaluating student perception of the module. All tests and surveys were anonymous. Scores of pre- and post-tests were compared with unpaired t-tests.ResultsWe received a total of 37 pre-tests and 14 post-tests. The average score on the pre-test was 66% compared with 93% on the post-test (P < 0.0001). We also received seventy-four post-module surveys across the eight videos. When asked whether the particular video module was an effective way to learn about antibiotic coverage, 98% of responses responded “agree” or “strongly agree.” 90% of responses also answered “agree” or “strongly agree” when asked if they were more likely to remember the spectrum of activity of the presented antibiotics after watching the module.ConclusionWhile further studies are needed our results suggest that whiteboard animation videos may be an effective way to teach empiric antibiotic selection to medical students preparing for internship.Disclosures All authors: No reported disclosures.

Patients with negative patch tests: Retrospective analysis of North American Contact Dermatitis Group (NACDG) data 2001-2016

Little is known regarding the characteristics of patients with negative patch test (NPT) results. To characterize patients with NPT results. Retrospective cross-sectional analysis of 34,822 patch tested patients. NPT results were defined as negative or irritant final interpretations of all North American Contact Dermatitis Group screening allergens and no relevant allergens on supplemental series. Almost one-third of patients (n=10,888 [31.3%]) had NPT results. Patients with NPT results were significantly more likely to be male (P<.0001), be age 40years or younger (P=.0054), be nonwhite (P=.0005), and have dermatitis primarily having a scattered generalized distribution (P=.0007) or primarily located on the lips (P=.0214) or eyelids (P=.0364). However, the absolute differences in age, race, and site were small and may not be clinically meaningful. Patients with NPT results were significantly less likely to have occupationally related skin disease (P<.0001). Overall, 8.3% of patients with NPT results had occupationally related skin disease, with precision production worker/machine operator (28.5%), health care worker (17.0%), and mechanic/repairer (7.5%) being the most commonly related occupations. In all, 22.9% of patients with NPT results had relevant irritants and 41.6% of irritants were occupationally related; cosmetics/health care products and soaps were common sources for both occupationally related and non-occupationally related irritants. Retrospective cross-sectional study of tertiary referral population. Patients with NPT results have distinct characteristics.

Online Health Promotion to Reduce Cancer Risk: Lessons From Learning With Alaska’s Tribal Primary Care Providers

Background: Alaska's tribal primary care providers in rural Alaska - community health aides and practitioners (CHA/Ps) - requested online education about cancer for themselves and their communities. Aim: A research team at the Alaska Native Tribal Health Consortium engaged in community-based participatory action research to develop culturally respectful online cancer education to support CHA/Ps to increase their knowledge, reduce their own cancer risk, and share cancer information. Methods: This project created ten online learning modules, a semester-long online course that combined the modules with synchronous conversations, and a supplemental webinar series. All modules were community-based and collaboratively developed with input from a community advisory group of CHA/Ps, content experts, and interested partners. Learners completed an evaluation survey at the end of each module and webinar. Course participants completed a precourse assessment, and evaluations at the end of each module, at the end of the course, two-months postcourse, and six-months postcourse. Results: While evaluation is ongoing, as of March 2018, 194 unique individuals, including 27 course participants, had completed 1,288 module evaluation surveys. Learners reported an increase in cancer knowledge, and intentions to reduce their personal cancer risk and share cancer information as a result of the online learning. On 98% of completed surveys, learners shared that they planned to change their interactions with patients as a result of the learning, including talking more about cancer screening, cutting down/quitting tobacco, being more physically active, and eating healthy. A total of 88% of unique learners planned to reduce their personal cancer risk as a result of the learning, including by quitting tobacco, having recommended cancer screenings, exercising, and eating healthier. Comparison of pre and postcourse survey responses showed CHA/Ps’ had changed to eat more fruits and vegetables and exercise more, as well as felt more knowledgeable about cancer, and more comfortable both with finding medically-accurate cancer information online and talking to their patients, families, and communities about cancer. Conclusion: This culturally respectful education strategy may be adaptable to other populations to support primary care providers and their communities to reduce cancer risk. This intervention may be of particular interest to health care providers, public health professionals, and those interested in health systems in rural and remote regions and in areas with limited medical infrastructure.

266 Nickel coreactions and polysensitization to metals in adults

Allergic contact dermatitis to metals is a significant clinical and public health problem. Some patients may be sensitized to multiple metals, thereby complicating allergen avoidance strategies by patients and manufacturers. However, little is known about the frequency and predictors of polysensitization to metals. We sought to determine the frequency of ≥1 metal coreactions to nickel and metal polysensitization (positive reactions to ≥2 different metals). We performed a retrospective chart review of 484 adults (age ≥ 18, mean±sd: 46.7±14.6 years), who were patch-tested at the Northwestern Medicine patch-testing clinic from 2014-2017. Patients were patch-tested with the North American Contact Dermatitis Group (NACDG) standard series and supplemental metal series if indicated. Positive patch test reactions to ≥ 1 metal allergen were observed in 210 (43.3%) of patients, with nickel (19.1%), gold (11.8%) and palladium (11.1%) being most common. Among patients with positive reactions to nickel, 38.0%, 16.3% and 2.2% had positive reactions to 1, 2 or 3 additional metals, respectively. Overall, polysensitization to metals occurred in 13.9% of patients. In multivariable multinomial logistic regression models, polysensitization to metal allergens was associated with female sex (adjusted odds ratio [95% confidence interval]: 10.23 [2.38-43.98]) and polysensitization to non-metal allergens (2.07 [1.01-4.23]), inversely associated with older age (0.94 [0.92-0.97]), but not associated with non-white race/ethnicity (1.24 [0.62-2.48]) or birthplace outside the US (1.11 [0.48-2.55]). These results suggest that nickel-sensitized patients have high rates of metal co-reactions, and that polysensitization to metals is common. These results may help guide future strategies for allergen avoidance.

Foot contact dermatitis: nitrofurazone as the main cause in a retrospective, cross-sectional study over a 16-year period from Turkey.

The major causative agents in allergic contact dermatitis of the foot may differ from country to country. Sufficient data on foot eczema in patients from Turkey are lacking. To identify the clinically relevant contact allergens in foot eczema and determine the role of patch test series and patients' own materials in the detection of the responsible allergens. Among 1753 patients patch tested between 1996 and 2012 in our clinic, 53 with suspected allergic foot eczema were enrolled in this retrospective, cross-sectional study. Forty nine patients were patch tested with the extended European baseline series, 49 with supplemental series including rubber, leather, topical drugs, textile, cosmetic series containing preservatives and emulgators and varnish/plastic/glue series, and 37 with their own substances. Thirty of the 53 patch tested patients showing sensitization to at least one clinically relevant allergen were diagnosed with allergic foot eczema. The main eliciting agent was nitrofurazone (n = 8), followed by leather shoe allergens, ie, potassium dichromate (n = 6), p-tert-butylphenol formaldehyde resin and formaldehyde, in the second range. Rubber shoe allergens were less frequently observed (n = 3). In more than 1/3 of the patients, the causative agent could only be identified by testing the patient's own substances and/or supplemental series. Nitrofurazone was the leading causative agent followed by leather shoe allergens. Pediatric patients were frequently sensitized with shoe allergens. Patch testing with patient's own substances had a critical value in the detection of the causative agent in a significant number of patients.

Current Research at Kültepe-Kanesh: An Interdisciplinary and Integrative Approach to Trade Networks, Internationalism, and Identity. Edited by Levent Atici, Fikri Kulakoğlu, Gojko Barjamovic, and Andrew Fairbairn. The Journal of Cuneiform Studies Supplemental Series, Number 4. Atlanta: Lockwood Press, 2014. Pp. ix + 222. $89.95 (cloth).

<i>Current Research at Kültepe-Kanesh: An Interdisciplinary and Integrative Approach to Trade Networks, Internationalism, and Identity</i>. Edited by Levent Atici, Fikri Kulakoğlu, Gojko Barjamovic, and Andrew Fairbairn. The Journal of Cuneiform Studies Supplemental Series, Number 4. Atlanta: Lockwood Press, 2014. Pp. ix + 222. $89.95 (cloth).

Cheryl Bridges Johns Pentecostal Formation: A Pedagogy among the Oppressed, Journal of Pentecostal Theology Supplemental Series (1998; reprint, Eugene, OR: Wipf &amp; Stock, 2010). 154 pp. $18.00 paperback.

Cheryl Bridges Johns Pentecostal Formation: A Pedagogy among the Oppressed, Journal of Pentecostal Theology Supplemental Series (1998; reprint, Eugene, OR: Wipf &amp; Stock, 2010). 154 pp. $18.00 paperback.

Patch Test Reactions Associated With Sunscreen Products and the Importance of Testing to an Expanded Series

Both active and inactive ingredients in sunscreen may cause contact dermatitis. This study aimed to describe allergens associated with a sunscreen source. A cross-sectional analysis of patients patch tested by the North American Contact Dermatitis Group between 2001 and 2010 was performed. Of 23,908 patients patch tested, 219 (0.9%) had sunscreen coded as an allergen source. Patients who were male, with occupational dermatitis, or older (older than 40 years) had significantly lower rates of allergic reactions to sunscreens; the most commonly affected areas were the face and exposed sites (P < 0.0001). The top 3 most frequent allergens in sunscreens were benzophenone-3 (70.2% for 10% concentration, 64.4% for 3% concentration), DL-alpha-tocopherol (4.8%), and fragrance mix I (4.0%). Less than 40% of positive patch test reactions were detected by the North American Contact Dermatitis Group screening series of 65 to 70 allergens. A supplemental antigen series is important in detecting allergy to sunscreens.

Diagnosis and Prevalence of Lanolin Allergy

Current evaluation of suspected allergic contact dermatitis to lanolin includes patch testing to lanolin alcohol (30% in petrolatum). Using this method, the prevalence of lanolin allergy is low (1.8%-2.5%). The objective of this study was to determine whether patch testing to a single lanolin derivative results in underdiagnosis compared with patch testing to 12 lanolin derivatives. Patients were prospectively patch tested to (1) lanolin alcohol (30% in petrolatum) in our standard allergen series; (2) Amerchol L101 (50% in petrolatum) in our cosmetic series; and (3) 10 lanolin derivatives (using concentrations and vehicles recommended in the literature) in a supplemental series. Of 286 patients, the overall prevalence of positive reactions to lanolin in at least 1 of the 3 patch test series was 6.29% (95% confidence interval [CI], 3.48%-9.11%) (n = 18). The prevalence rates of lanolin allergy using the standard, cosmetic, and supplemental series were 1.05% (95% CI, 0%-2.23%), 3.85% (95% CI, 1.62%-6.07%), and 3.85% (95% CI, 1.62%-6.07%), respectively. Amerchol L101 was associated with increased reaction rates compared with the standard (odds ratio, 3.81; P = 0.007) and supplemental (odds ratio, 8.85; P < 0.001) series, whereas reaction rates were similar for the standard and supplemental series (P = 0.78). Amerchol L101 and patients' own products should be added to a standard patch testing allergen series to adequately identify lanolin allergy.