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Background The study evaluates and compares the accuracy of nine peak flow meters (“PFMs”) and spirometers that are currently available in Europe and have Conformité Européene (“CE”) marking. The CE marking is a manufacturer’s declaration that their product complies with European health regulations and it is a requirement for marketing medical devices in Europe. Methods The nine devices were selected as they all had received or were in the process of receiving CE approval in Europe and were readily obtainable. The devices were bench tested following the ISO 23747:2015 accuracy guidelines for medical devices measuring peak flow. All standards, including accuracy, from these guidelines must be met to obtain CE marking. This study was performed with a certified piston pump testing apparatus. The apparatus chosen was the pulmonary waveform generator manufactured by Piston Medical Ltd. Using predefined flow (time) and volume (time) waveforms, peak flow meters and spirometers were tested for validation and calibration. Three CE guideline tests were utilised, and standards require that all three tests are passed for the device to obtain certification. Results Of the nine devices that were tested, two passed and seven failed. The devices that passed the tests were the Smart Peak Flow® and the Mini Wright®. Conclusions A high percentage of devices failed accuracy testing in this study. This is a concern as the CE marking is a manufacturer’s certification documenting the accuracy, reliability and safety of devices. Of the seven devices that failed all have the CE marking. All tested devices are on the market in Europe based upon studies conducted by each of the manufacturers. The data used to obtain CE certification of these devices, however, are not in the public domain.

This is an ethnographic study of economic and social life in a mountainous region of Flores, Indonesia, inhabited by people known in anthropological literature as the Ngadha. The basic structures of affiliation in Ngadha social life are not static, but are dynamic processes. They change in form, grow and subdivide, and are filled with opportunities for advancement and risks of demotion, and ultimately disintegration. People pursue these opportunities, and counter these risks, through the skillful management of circulations or flows. These include circulations of material objects, which cross and recross the boundary between goods and commodities; circulations of people, who flow in and out of various affiliations at different moments; and circulations of energies, linked to dispositions of labor and food. These circulations connect humans, animals, and spiritual beings joining the living to the dead. With their variable currents and innumerable eddies, these flows form the substance of Ngadha forms of affiliation. As described by Fox et al (1980) the metaphor of the \"flow of life\" describes circulations of goods and essences that are seen as necessary for the reproduction of human life in eastern Indonesian societies. These cannot be stockpiled and still remain vital, but undergo continual processes of depletion and replenishment. I argue that this concept of flow can help illuminate aspects of Ngadha life beyond strategies of marriage exchange. Circulations--repeated, ongoing, expanding, and endless--can be seen at every point of life, from loans between friends, to the construction of houses, to the most spectacular feasts and rituals. These movements are essential to the repeated reconstitution of social groups, which decay if they are not continually renewed. They also bring attention to a central tension between sets of values that are coeval in the Ngadha community: sedentarism, continuity, and accumulation on the one hand, and mobility, agency, and apparent dispersal on the other. Ngadha society is best seen as an assemblage of moving parts, where ritual and communal acts of renewal do not so much re-establish set structures but produce coherence out of constant flow, sowing a little to harvest a lot. This process is epitomized most dramatically in distributions of food called meghe--literally, \"food\" or \"to eat,\" especially food that fortifies a person before traveling or dying, or food used to host guests (Arndt 1961: 323)--which produce social outcomes even when much of the food is given to pigs.

The role of clothing in the management of eczema (also called atopic dermatitis or atopic eczema) is poorly understood. This trial evaluated the effectiveness and cost-effectiveness of silk garments (in addition to standard care) for the management of eczema in children with moderate to severe disease. This was a parallel-group, randomised, controlled, observer-blind trial. Children aged 1 to 15 y with moderate to severe eczema were recruited from secondary care and the community at five UK medical centres. Participants were allocated using online randomisation (1:1) to standard care or to standard care plus silk garments, stratified by age and recruiting centre. Silk garments were worn for 6 mo. Primary outcome (eczema severity) was assessed at baseline, 2, 4, and 6 mo, by nurses blinded to treatment allocation, using the Eczema Area and Severity Index (EASI), which was log-transformed for analysis (intention-to-treat analysis). A safety outcome was number of skin infections. Three hundred children were randomised (26 November 2013 to 5 May 2015): 42% girls, 79% white, mean age 5 y. Primary analysis included 282/300 (94%) children (n = 141 in each group). The garments were worn more often at night than in the day (median of 81% of nights [25th to 75th centile 57% to 96%] and 34% of days [25th to 75th centile 10% to 76%]). Geometric mean EASI scores at baseline, 2, 4, and 6 mo were, respectively, 9.2, 6.4, 5.8, and 5.4 for silk clothing and 8.4, 6.6, 6.0, and 5.4 for standard care. There was no evidence of any difference between the groups in EASI score averaged over all follow-up visits adjusted for baseline EASI score, age, and centre: adjusted ratio of geometric means 0.95, 95% CI 0.85 to 1.07, (p = 0.43). This confidence interval is equivalent to a difference of -1.5 to 0.5 in the original EASI units, which is not clinically important. Skin infections occurred in 36/142 (25%) and 39/141 (28%) of children in the silk clothing and standard care groups, respectively. Even if the small observed treatment effect was genuine, the incremental cost per quality-adjusted life year was £56,811 in the base case analysis from a National Health Service perspective, suggesting that silk garments are unlikely to be cost-effective using currently accepted thresholds. The main limitation of the study is that use of an objective primary outcome, whilst minimising detection bias, may have underestimated treatment effects. Silk clothing is unlikely to provide additional benefit over standard care in children with moderate to severe eczema. Current Controlled Trials ISRCTN77261365.

A Correction to this paper has been published: https://doi.org/10.1038/s41591-020-01181-w

Background Eczema is a chronic, itchy skin condition that can have a large impact on the quality of life of patients and their families. People with eczema are often keen to try out non-pharmacological therapies like silk therapeutic garments that could reduce itching or the damage caused by scratching. However, the effectiveness and cost-effectiveness of these garments in the management of eczema has yet to be proven. The CLOTHES Trial will test the hypothesis that ‘silk therapeutic garments plus standard eczema care’ is superior to ‘standard care alone’ for children with moderate to severe eczema. Methods/Design Parallel group, observer-blind, pragmatic, multi-centre randomised controlled trial of 6 months’ duration. Three hundred children aged 1 to 15 years with moderate to severe eczema will be randomised (1:1) to receive silk therapeutic garments plus standard eczema care, or standard eczema care alone. Primary outcome is eczema severity, as assessed by trained and blinded investigators at 2, 4 and 6 months (using the Eczema Area and Severity Index (EASI)). Secondary outcomes include: patient-reported eczema symptoms (collected weekly for 6 months to capture long-term control); global assessment of severity; quality of life of the child, family and main carer; use of standard eczema treatments (emollients, corticosteroids applied topically, calcineurin inhibitors applied topically and wet wraps); frequency of infections; and cost-effectiveness. The acceptability and durability of the clothing will also be assessed, as will adherence to wearing the garments. A nested qualitative study will assess the views of a subset of children wearing the garments and their parents, and those of healthcare providers and commissioners. Randomisation uses a computer-generated sequence of permuted blocks of randomly varying size, stratified by recruiting hospital and child’s age (< 2 years; 2 to 5 years; > 5 years), and concealed using a secure web-based system. The sequence of treatment allocations will remain concealed until randomisation and data collection are complete. Recruitment is taking place from November 2013 to May 2015, and the trial will be completed in 2016. Full details of results will be published in the National Institute for Health Research Journal series. Trial registration Current Controlled Trials ISRCTN77261365 (registered 11 November 2013).

Second report on the state of journalism in the UK argues that scientists who behave as if they are beyond reproach have lost their understanding of the meaning of science. (Original abstract - amended)

Artists Ian Pollock and Janet Silk have had an exclusive collaborative relationship since 1993, and hold a collaborative MFA from the University of California at Berkeley. They discuss the concept of the \"Third Mind,\" the entity that emerges when the energy of two collaborators comes together.

The American artists Ian Pollock and Janet Silk describe a project entitled Local 411 which they carried out in San Francisco using public telephone systems to address issues relating to the gentrification of the city's Yerba Buena Redevelopment Zone. The authors identify the power of the public telephone as a communications medium and explain the three strategies they employed in this project to alert the general public to the historical resonances of the area in which redevelopment is taking place: the first strategy used recordings of the memories of former residents of the area in a custom voicemail area, where they could be accessed at any time by telephone; the second strategy allowed former residents to record their own contributions to the voicemail system, thus expanding the testimony to the history of the area; and the third strategy involved the use of performance artists who placed calls to telephone booths in the development areas, whereby unsuspecting members of the general public who picked up the ringing telephones found themselves the recipients of an educational exposition on the area's history. The authors relate this project to their earlier Area Code project and assess its value in raising public awareness of the impact of urban planning on the erosion of shared memories.

John, who works at Lockerbie Golf Club, Dumfriesshire, added: \"I knew to keep my hand above my head to stop blood loss.