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73 Sex and Race/Ethnicity in Reporting of Lingering Concussion Symptoms by Adolescents
- Stephen C Bunt, Nyaz Didehbani, Cheryl H Silver, Linda S Hynan, Hannah E Wadsworth, Hudaisa Fatima, Cason Hicks, Mathew Stokes, Shane M Miller, Kathleen Bell, C M Cullum
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 176-177
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Objective:
Consideration of individual differences in recovery after concussion has become a focus of concussion research. Sex and racial/ethnic identity as they may affect reporting of concussion symptoms have been studied at single time points but not over time. Our objective was to investigate the factors of self-defined sex and race/ethnicity in reporting of lingering concussion symptoms in a large sample of adolescents.
Participants and Methods:Concussed, symptomatic adolescents (n=849; Female=464, Male=385) aged 13-18 years were evaluated within 30 days of injury at a North Texas Concussion Registry (ConTex) clinic. Participants were grouped by self-defined race/ethnicity into three groups: Non-Hispanic Caucasian (n=570), Hispanic Caucasian (n=157), and African American (n=122). Measures collected at the initial visit included medical history, injury related information, and the Sport Concussion Assessment Tool-5 Symptom Evaluation (SCAT-5SE). At a three-month follow-up, participants completed the SCAT-5SE. Pearson’s Chi-Square analyses examined differences in categorical measures of demographics, medical history, and injury characteristics. Prior to analysis, statistical assumptions were examined, and log base 10 transformations were performed to address issues of unequal group variances and nonnormal distributions. A three-way repeated measures ANOVA (Sex x Race/Ethnicity x Time) was conducted to examine total severity scores on the SCAT-5SE. Bonferroni post-hoc tests were performed to determine specific group differences. SPSS V28 was used for analysis with p<0.05 for significance. Data reported below has been back transformed.
Results:A significant interaction of Time by Race/Ethnicity was found for SCAT-5SE scores reported at initial visit and three-month follow-up (F(2, 843)=7.362, p<0.001). To understand this interaction, at initial visit, Race/Ethnicity groups reported similar levels of severity for concussion symptoms. At three month follow-up, African Americans reported the highest level of severity of lingering symptoms (M= 3.925, 95% CIs [2.938-5.158]) followed by Hispanic Caucasians(M= 2.978, 95% CIs [2.2663.845]) and Non-Hispanic Caucasians who were the lowest(M= 1.915, 95% CIs [1.6262.237]). There were significant main effects for Time, Sex, and Race/Ethnicity. Average symptom levels were higher at initial visit compared to three-month follow-up (F(1, 843)=1531.526, p<0.001). Females had higher average symptom levels compared to males (F(1, 843)=35.58, p<0.001). For Race/Ethnicity (F(2, 843)=9.236, p<0.001), Non-Hispanic Caucasians were significantly different than African Americans (p<0.001) and Hispanic Caucasians (p=0.021) in reported levels of concussion symptom severity.
Conclusions:Data from a large sample of concussed adolescents supported a higher level of reported symptoms by females, but there were no significant differences in symptom reporting between sexes across racial/ethnic groups. Overall, at three-months, the African American and Hispanic Caucasians participants reported a higher level of lingering symptoms than Non-Hispanic Caucasians. In order to improve care, the difference between specific racial/ethnic groups during recovery merits exploration into the factors that may influence symptom reporting.
Abnormal infant neurobehavior and later neurodevelopmental delays in children with critical CHD
- Kathleen Campbell, Lauren Malik, Courtney Jones, Zhining Ou, Angela Presson, Thomas A. Miller, Sarah Winter, Kristi Glotzbach
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- Journal:
- Cardiology in the Young / Volume 33 / Issue 7 / July 2023
- Published online by Cambridge University Press:
- 14 July 2022, pp. 1102-1111
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Infants with critical CHD have abnormal neurobehavior assessed by the Neonatal ICU Network Neurobehavioral Scales. This retrospective cohort study hypothesized associations between abnormal infant neurobehavior in the first month of life and later neurodevelopmental outcomes at 1−2 years of age. Associations between abnormal infant attention (orienting to and tracking stimuli) on the Neonatal ICU Network Neurobehavioral Scales and later motor, cognitive, and language neurodevelopmental outcomes on the Bayley Scales of Infant Development-III at follow-up were examined with descriptive statistics and univariable and multivariable regression. Multiple imputation was used to account for missing outcome data. 189 infants with critical CHD were included, and 69% had abnormal neurobehavioral attention scores. 58 (31%) returned as toddlers for neurodevelopmental follow-up, of which 23% had motor delay. Abnormal infant attention had high sensitivity (92%, 95% CI 60−100%) but low specificity (36%, 95% CI 23−52%) for later motor delay. Higher infant attention scores were associated with higher later motor scores in univariable analysis (coefficient 3.49, 95% CI 0.52,6.46, p = 0.025), but not in multivariable analyses. Neither cognitive nor language scores were associated with infant attention scores. Lower birth weight and male sex were significantly associated with lower motor scores in multivariable analysis (p = 0.048, 0.007). Although impaired infant attention is interdependent with other clinical and demographic risk factors, it may be a sensitive clinical marker of risk for later motor delay. In children with critical CHD, impaired infant attention may be capturing early signs of abnormal visual-motor neurodevelopment.
Anxiety symptoms and associated functional impairment in children with CHD in a neurodevelopmental follow-up clinic
- Sean Cunningham, Kathleen Campbell, Thomas Miller, Sarah Winter, Angela Presson, Zhining Ou, Kristi Glotzbach
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- Journal:
- Cardiology in the Young / Volume 33 / Issue 6 / June 2023
- Published online by Cambridge University Press:
- 20 June 2022, pp. 864-871
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Objectives:
To examine the prevalence of anxiety symptoms and associated functional impairment to adaptive skills among elementary-aged children with CHD and to determine the need for anxiety screening in this high-risk population.
Study design:In a single-centre retrospective, cohort design, caregivers reported anxiety symptoms using Conner’s scales and functional impairment to adaptive skills using the Adaptive Behavior Assessment System. A total of 194 children were stratified across two cohorts: early elementary (ages 3–6 years) and late elementary (ages 6–14 years). Descriptive statistics summarised the frequency of anxiety symptoms and functional impairment. Spearman’s correlations compared anxiety symptoms to functional impairment of adaptive functioning. Univariable logistic regressions examined demographic and clinical characteristics associated with anxiety symptoms.
Results:The majority of patients presented with anxiety, early elementary (63%), and late elementary cohorts (78%). Functional impairment was moderately correlated with anxiety symptoms in the early elementary cohort (r s = −.42, 95% CI [−0.58, −0.21], p = <.001). Greater anxiety symptoms were associated with lower cardiac complexity at primary age of surgery in the late elementary cohort (OR = 12.15, p = 0.019). Lesser anxiety symptoms were associated with having private insurance (OR = 0.25, p = 0.014).
Conclusion:This study demonstrates anxiety symptoms are common and associated with functional impairment to adaptive functioning in younger children with CHD. No clear clinical predictors exist for anxiety symptoms or functional impairment; therefore, screening for anxiety symptoms may need to be added to standard clinical assessment of all children with CHD participating in neurodevelopmental follow-up.
Characteristics of healthcare personnel who reported concerns related to PPE use during care of COVID-19 patients
- Nora Chea, Stephanie Tavitian, Cedric Brown, Taniece Eure, Rebecca Alkis, Gregory Blazek, Austin Penna, Joelle Nadle, Linda Frank, Christopher Czaja, Helen Johnston, Devra Barter, Kathleen Angell, Kristen Marshall, James Meek, Monica Brackney, Stacy Carswell, Stepy Thomas, Scott Fridkin, Lucy Wilson, Ashley Fell, Sara Lovett, Sarah Lim, Ruth Lynfield, Ruth SarahShrum, Erin C. Phipps, Marla Sievers, Ghinwa Dumyati, Cate Concannon, Kathryn McCullough, Woods, Sandhya Seshadri, Christopher Myers, Rebecca Pierce, Valerie Ocampo, Judith Guzman-Cottrill, Gabriela Escutia, Monika Samper, Sandra Pena, Cullen Adre, Tiffanie Markus, Kathryn Billings, Matthew Groenewold, Ronda Sinkowitz-Cochran, Shelley Magill, Cheri Grigg, Betsy Miller
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 2 / Issue S1 / July 2022
- Published online by Cambridge University Press:
- 16 May 2022, pp. s8-s9
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Background: Healthcare facilities have experienced many challenges during the COVID-19 pandemic, including limited personal protective equipment (PPE) supplies. Healthcare personnel (HCP) rely on PPE, vaccines, and other infection control measures to prevent SARS-CoV-2 infections. We describe PPE concerns reported by HCP who had close contact with COVID-19 patients in the workplace and tested positive for SARS-CoV-2. Method: The CDC collaborated with Emerging Infections Program (EIP) sites in 10 states to conduct surveillance for SARS-CoV-2 infections in HCP. EIP staff interviewed HCP with positive SARS-CoV-2 viral tests (ie, cases) to collect data on demographics, healthcare roles, exposures, PPE use, and concerns about their PPE use during COVID-19 patient care in the 14 days before the HCP’s SARS-CoV-2 positive test. PPE concerns were qualitatively coded as being related to supply (eg, low quality, shortages); use (eg, extended use, reuse, lack of fit test); or facility policy (eg, lack of guidance). We calculated and compared the percentages of cases reporting each concern type during the initial phase of the pandemic (April–May 2020), during the first US peak of daily COVID-19 cases (June–August 2020), and during the second US peak (September 2020–January 2021). We compared percentages using mid-P or Fisher exact tests (α = 0.05). Results: Among 1,998 HCP cases occurring during April 2020–January 2021 who had close contact with COVID-19 patients, 613 (30.7%) reported ≥1 PPE concern (Table 1). The percentage of cases reporting supply or use concerns was higher during the first peak period than the second peak period (supply concerns: 12.5% vs 7.5%; use concerns: 25.5% vs 18.2%; p Conclusions: Although lower percentages of HCP cases overall reported PPE concerns after the first US peak, our results highlight the importance of developing capacity to produce and distribute PPE during times of increased demand. The difference we observed among selected groups of cases may indicate that PPE access and use were more challenging for some, such as nonphysicians and nursing home HCP. These findings underscore the need to ensure that PPE is accessible and used correctly by HCP for whom use is recommended.
Funding: None
Disclosures: None
Exercise, Arterial Stiffness, and Cerebral Vascular Function: Potential Impact on Brain Health
- Jill N. Barnes, Andrew G. Pearson, Adam T. Corkery, Nicole A. Eisenmann, Kathleen B. Miller
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- Journal:
- Journal of the International Neuropsychological Society / Volume 27 / Issue 8 / September 2021
- Published online by Cambridge University Press:
- 06 May 2021, pp. 761-775
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Exercise is associated with higher cognitive function and is a promising intervention to reduce the risk of dementia. With advancing age, there are changes in the vasculature that have important clinical implications for brain health and cognition. Primary aging and vascular risk factors are associated with increases in arterial stiffness and pulse pressure, and reductions in peripheral vascular function.
Objective:The purpose is to discuss the epidemiological, observational, and mechanistic evidence regarding the link between age-related changes in vascular health and brain health.
Methods:We performed a literature review and integrated with our published data.
Results:Epidemiological evidence suggests a link between age-related increases in arterial stiffness and lower cognitive function, which may be mediated by cerebral vascular function, including cerebral vasoreactivity and cerebral pulsatility. Age-associated impairments in central arterial stiffness and peripheral vascular function have been attenuated or reversed through lifestyle behaviors such as exercise. Greater volumes of habitual exercise and higher cardiorespiratory fitness are associated with beneficial effects on both peripheral vascular health and cognition. Yet, the extent to which exercise directly influences cerebral vascular function and brain health, as well as the associated mechanisms remains unclear.
Conclusion:Although there is evidence that exercise positively impacts cerebral vascular function, more research is necessary in humans to optimize experimental protocols and address methodological limitations and physiological considerations. Understanding the impact of exercise on cerebral vascular function is important for understanding the association between exercise and brain health and may inform future intervention studies that seek to improve cognition.
Automated data mining of the electronic health record for investigation of healthcare-associated outbreaks
- Alexander J. Sundermann, James K. Miller, Jane W. Marsh, Melissa I. Saul, Kathleen A. Shutt, Marissa Pacey, Mustapha M. Mustapha, Ashley Ayres, A. William Pasculle, Jieshi Chen, Graham M. Snyder, Artur W. Dubrawski, Lee H. Harrison
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 40 / Issue 3 / March 2019
- Published online by Cambridge University Press:
- 18 February 2019, pp. 314-319
- Print publication:
- March 2019
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Background:
Identifying routes of transmission among hospitalized patients during a healthcare-associated outbreak can be tedious, particularly among patients with complex hospital stays and multiple exposures. Data mining of the electronic health record (EHR) has the potential to rapidly identify common exposures among patients suspected of being part of an outbreak.
Methods:We retrospectively analyzed 9 hospital outbreaks that occurred during 2011–2016 and that had previously been characterized both according to transmission route and by molecular characterization of the bacterial isolates. We determined (1) the ability of data mining of the EHR to identify the correct route of transmission, (2) how early the correct route was identified during the timeline of the outbreak, and (3) how many cases in the outbreaks could have been prevented had the system been running in real time.
Results:Correct routes were identified for all outbreaks at the second patient, except for one outbreak involving >1 transmission route that was detected at the eighth patient. Up to 40 or 34 infections (78% or 66% of possible preventable infections, respectively) could have been prevented if data mining had been implemented in real time, assuming the initiation of an effective intervention within 7 or 14 days of identification of the transmission route, respectively.
Conclusions:Data mining of the EHR was accurate for identifying routes of transmission among patients who were part of the outbreak. Prospective validation of this approach using routine whole-genome sequencing and data mining of the EHR for both outbreak detection and route attribution is ongoing.
2342 Protein production as an early pharmacodynamics biomarker for RNA-targeting therapies
- Wade K. Self, Kathleen Schoch, James Bollinger, Tracy Cole, Holly Kordasiewicz, Randall Bateman, Timothy Miller
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, p. 24
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OBJECTIVES/SPECIFIC AIMS: We aimed to develop an assay to measure new protein synthesis after Antisense Oligonucleotide treatment, which we hypothesized to be the earliest biochemical identification of RNA-targeting therapy efficacy. METHODS/STUDY POPULATION: We treated 2 transgenic animal models expressing proteins implicated in neurodegenerative disease: human tau protein (hTau) and human superoxide dismutase 1 (hSOD1), with ASO against these mRNA transcripts. Animals received isotope-labeled 13C6-Leucine via drinking water to label newly synthesized proteins. We assayed target protein synthesis and concentration after ASO treatment to determine the earliest identification of ASO target engagement. RESULTS/ANTICIPATED RESULTS: hTau ASO treatment in transgenic mice lowered hTau protein concentration 23 days post-treatment in cortex (95% CI: 0.05%–64.0% reduction). In the same tissue, we observed lowering of hTau protein synthesis as early as 13 days (95% CI: 29.4%–123%). In hSOD1 transgenic rats, we observed lowering of 13C6-leucine-labeled hSOD1 in the cerebrospinal fluid 30 days after ASO treatment compared with inactive ASO control (95% CI: 12.0%–48.4%). DISCUSSION/SIGNIFICANCE OF IMPACT: In progressive neurodegenerative diseases, it is crucial to develop measurements that identify treatment efficacy early to improve patient outcomes. These data support the use of stable isotope labeling of amino acids to measure new protein synthesis as an early pharmacodynamics measurement for therapies that target RNA and inhibit the translation of proteins.
Ecological fidelity of functional traits based on species presence-absence in a modern mammalian bone assemblage (Amboseli, Kenya)
- Joshua H. Miller, Anna K. Behrensmeyer, Andrew Du, S. Kathleen Lyons, David Patterson, Anikó Tóth, Amelia Villaseñor, Erustus Kanga, Denné Reed
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- Paleobiology / Volume 40 / Issue 4 / Fall 2014
- Published online by Cambridge University Press:
- 08 April 2016, pp. 560-583
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Comparisons between modern death assemblages and their source communities have demonstrated fidelity to species diversity across a variety of environments and taxonomic groups. However, differential species preservation and collection (including body-size bias) in both modern and fossil death assemblages may still skew the representation of other important ecological characteristics. Here, we move beyond live-dead taxonomic fidelity and focus on the recovery of functional ecology (how species interact with their ecosystem) at the community level for a diverse non-volant mammal community (87 species; Amboseli, Kenya). We use published literature to characterize species, using four functional traits and their associated categorical attributes (i) dietary mode (11 attributes; e.g., browser, grazer), (ii) preferred feeding habitat (16 attributes; e.g., grassland, woodland), (iii) preferred sheltering habitat (17 attributes; e.g., grassland, underground cavity), and (iv) activity time (7 attributes; e.g., diurnal, nocturnal, nocturnally dominated crepuscular). For each functional ecological trait we compare the death assemblage's recovered richness and abundance structure of constituent functional attributes with those of the source community, using Jaccard similarity, Spearman's rho, and the Probability of Interspecific Encounter (evenness). We use Monte Carlo simulations to evaluate whether these empirical comparisons are significantly different from expectations calculated from randomized sampling of species from the source community. Results indicate that although the Amboseli death assemblage is significantly overrepresented by large-bodied species relative to the Amboseli source community, it captures many functional dimensions of the ecosystem within expectations of a randomized collection of species. Additional resampling simulations and logistic regressions further illustrate that the size bias inherent to the Amboseli death assemblage is not a major driver of deviations between the functional ecological properties of the death assemblage and its source community. Finally, the Amboseli death assemblage also enhances our understanding of the mammal community by adding nine species and two functional attributes previously unknown from the ecosystem.
Geographic ranges of genera and their constituent species: structure, evolutionary dynamics, and extinction resistance
- Michael Foote, Kathleen A. Ritterbush, Arnold I. Miller
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- Journal:
- Paleobiology / Volume 42 / Issue 2 / May 2016
- Published online by Cambridge University Press:
- 09 March 2016, pp. 269-288
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We explore the relationships among the geographic ranges of genera, the ranges and positions of their constituent species, and the number of species they contain, considering variation among coeval genera and changes within genera over time. Measuring range size as the maximal distance, or extent, between occurrences within a taxon, we find that the range of the most widespread species is a good predictor of the range of the genus, and that the number of species is a better predictor still. This analysis is complicated by a forced correlation: the range of a genus must be at least as large as that of each of its constituent species. We therefore focus on a second measure of range, the mean squared distance, or dispersion, of occurrences from the geographic centroid, which, by analogy to the analysis of variance, allows the total dispersion of a genus to be compared to the mean within-species dispersion and the dispersion among species centroids. We find that among-species dispersion is the principal determinant of genus dispersion. Within-species dispersion also plays a major role. The role of species richness is relatively small. Our results are not artifacts of temporal variation in the geographic breadth of sampled data. The relationship between changes in genus dispersion and changes in within- and among-species dispersion shows a symmetry, being similar in cases when the genus range is expanding and when it is contracting. We also show that genera with greater dispersion have greater extinction resistance, but that within- and among-species dispersion are not demonstrable predictors of survival once the dispersion of the genus is accounted for. Thus it is the range of the genus, rather than how it is attained, that is most relevant to its fate. Species richness is also a clear predictor of survival, beyond its effects on geographic range.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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99 - HIV infection: antiretroviral therapy
- from Part XII - HIV
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- By Kathleen Squires, Jefferson Medical College of Thomas Jefferson University, Christopher T. Miller, Jefferson Medical College of Thomas Jefferson University
- Edited by David Schlossberg, Temple University, Philadelphia
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- Book:
- Clinical Infectious Disease
- Published online:
- 05 April 2015
- Print publication:
- 23 April 2015, pp 645-668
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Summary
Introduction
The first cases of the human immunodeficiency virus (HIV) were first described in the early 1980s, prompting an aggressive search for a cure for this deadly virus. In 1987, the approval of zidovudine, the first medication approved for the treatment of HIV, ushered in a new age in HIV management. As our understanding of HIV evolved, new therapies gradually emerged in the 1990s, as did hope that a curative medication regimen may be discovered.
Single-drug nucleoside reverse transcriptase inhibitor therapy initially conferred only 6 to 12 months of benefit to patients before viral resistance rendered this approach ineffective. Therapeutic strategy then evolved into dual-drug therapy, which extended benefit to 2 to 3 years. Eventually the use of a three-drug regimen (i.e., highly active antiretroviral therapy, or HAART) in the mid 1990s became the predominant regimen and remains the standard of care today.
Along with these new drug developments came new frustrations, however, manifested as mutated and resistant HIV strains, high pill burdens, and significant toxicities. These multi-drug regimens subsequently have been refined over the past 10 years, to the point where many patients are able to maintain an intact immune system with no detectable virus on single-pill, triple-drug coformulated, minimally toxic antiretroviral therapy (ART) regimens. While the goal of HIV eradication has remained elusive, the modern age of ART has commonly rendered HIV disease a chronic condition that, when ideally managed, can lead to a reasonable life expectancy in patients who once considered this infection a death sentence.
Contributors
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- By Michael H. Allen, Leora Amira, Victoria Arango, David W. Ayer, Helene Bach, Christopher R. Bailey, Ross J. Baldessarini, Kelsey Ball, Alan L. Berman, Marian E. Betz, Emily A. Biggs, R. Warwick Blood, Kathleen T. Brady, David A. Brent, Jeffrey A. Bridge, Gregory K. Brown, Anat Brunstein Klomek, A. Jacqueline Buchanan, Michelle J. Chandley, Tim Coffey, Jessica Coker, Yeates Conwell, Scott J. Crow, Collin L. Davidson, Yogesh Dwivedi, Stacey Espaillat, Jan Fawcett, Steven J. Garlow, Robert D. Gibbons, Catherine R. Glenn, Deborah Goebert, Erica Goldstein, Tina R. Goldstein, Madelyn S. Gould, Kelly L. Green, Alison M. Greene, Philip D. Harvey, Robert M. A. Hirschfeld, Donna Holland Barnes, Andres M. Kanner, Gary J. Kennedy, Stephen H. Koslow, Benoit Labonté, Alison M. Lake, William B. Lawson, Steve Leifman, Adam Lesser, Timothy W. Lineberry, Amanda L. McMillan, Herbert Y. Meltzer, Michael Craig Miller, Michael J. Miller, James A. Naifeh, Katharine J. Nelson, Charles B. Nemeroff, Alexander Neumeister, Matthew K. Nock, Jennifer H. Olson-Madden, Gregory A. Ordway, Michael W. Otto, Ghanshyam N. Pandey, Giampaolo Perna, Jane Pirkis, Kelly Posner, Anne Rohs, Pedro Ruiz, Molly Ryan, Alan F. Schatzberg, S. Charles Schulz, M. Katherine Shear, Morton M. Silverman, April R. Smith, Marcus Sokolowski, Barbara Stanley, Zachary N. Stowe, Sarah A. Struthers, Leonardo Tondo, Gustavo Turecki, Robert J. Ursano, Kimberly Van Orden, Anne C. Ward, Danuta Wasserman, Jerzy Wasserman, Melinda K. Westlund, Tracy K. Witte, Kseniya Yershova, Alexandra Zagoloff, Sidney Zisook
- Edited by Stephen H. Koslow, University of Miami, Pedro Ruiz, University of Miami, Charles B. Nemeroff, University of Miami
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- Book:
- A Concise Guide to Understanding Suicide
- Published online:
- 05 October 2014
- Print publication:
- 18 September 2014, pp vii-x
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Contributors
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- By George Aiken, Andy Baker, Thomas J. Boyd, Rasmus Bro, Robert F. Chen, Paula G. Coble, Robyn N. Conmy, Rose M. Cory, Carlos E. Del Castillo, Rossana Del Vecchio, Bryan D. Downing, Rachel S. Gabor, John R. Gilchrist, Diane M. McKnight, Matthew P. Miller, Kathleen R. Murphy, Christopher L. Osburn, Darren M. Reynolds, Robert G. M. Spencer, Colin A. Stedmon
- Edited by Paula G. Coble, University of South Florida, Jamie Lead, University of South Carolina, Andy Baker, Darren M. Reynolds, University of the West of England, Bristol, Robert G. M. Spencer, Florida State University
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- Book:
- Aquatic Organic Matter Fluorescence
- Published online:
- 05 June 2014
- Print publication:
- 14 July 2014, pp ix-x
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Chapter 17 - Optimizing culture conditions
- from Section 2 - Culture systems
- Edited by Patrick Quinn
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- Culture Media, Solutions, and Systems in Human ART
- Published online:
- 05 April 2014
- Print publication:
- 27 March 2014, pp 235-244
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Contributors
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- By Jay M. Baltz, Diana Patricia Bernal, William R. Boone, Ching-Chien Chang, Ri-Cheng Chian, Takeo Cho, Natalie A. Clark, Joe Conaghan, Shan-Jun Dai, Anna P. Ferraretti, Luca Gianaroli, H. Lee Higdon, Theresa Jeary, Eduardo Kelly, Michelle Lane, Henry J. Leese, M. Cristina Magli, Marius Meintjes, Kathleen A. Miller, Markus H. M. Montag, André Monteiro da Rocha, David Mortimer, Sharon T. Mortimer, Zsolt Peter Nagy, Kamilla S. Pedersen, Thomas B. Pool, Patrick Quinn, Niels B. Ramsing, Sarah A. Robertson, Gary Daniel Smith, Jason E. Swain, Jeremy G. Thompson, Yao Wang, Sarah-Louise Whitear, Deirdre Zander-Fox
- Edited by Patrick Quinn
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- Book:
- Culture Media, Solutions, and Systems in Human ART
- Published online:
- 05 April 2014
- Print publication:
- 27 March 2014, pp ix-x
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Ecological Fidelity of Functional Traits Based on Species Presence-Absence in the Mammalian Bone Assemblage of Amboseli National Park, Kenya
- Joshua H. Miller, Anna K. Behrensmeyer, Andrew Du, S. Kathleen Lyons, David Patterson, Anikó B. Tóth, Amelia Villasenor, Erustus Kanga, Denne Reed
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- Journal:
- The Paleontological Society Special Publications / Volume 13 / 2014
- Published online by Cambridge University Press:
- 26 July 2017, p. 9
- Print publication:
- 2014
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Species Richness, Community Dynamics, and Time-Averaging in Recent Kenyan Ecosystems
- Anikó B. Tóth, Anna K. Behrensmeyer, Joshua H. Miller, S. Kathleen Lyons
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- Journal:
- The Paleontological Society Special Publications / Volume 13 / 2014
- Published online by Cambridge University Press:
- 26 July 2017, pp. 8-9
- Print publication:
- 2014
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Contributors
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- By Núria Duran Adroher, Sergio Aguilar-Gaxiola, Jordi Alonso, Ali Obaid Al-Hamzawi, Laura Helena Andrade, Matthias C. Angermeyer, James Anthony, Corina Benjet, Guilherme Borges, Joshua Breslau, Evelyn J. Bromet, Ronny Bruffaerts, Brendan Bunting, Huibert Burger, José Miguel Caldas de Almeida, Graça Cardoso, Somnath Chatterji, Wai Tat Chiu, Giovanni de Girolamo, Ron de Graaf, Peter de Jonge, Koen Demyttenaere, John Fayyad, Alize J. Ferrari, Silvia Florescu, Anne M. Gadermann, Meyer Glantz, Jen Green, Michael J. Gruber, Oye Gureje, Josep Maria Haro, Yanling He, Steven G. Heeringa, Hristo Hinkov, Chiyi Hu, Yueqin Huang, Irving Hwang, Robert Jin, Elie G. Karam, Norito Kawakami, Ronald C. Kessler, Lola Kola, Viviane Kovess-Masféty, Michael C. Lane, Carmen Lara, William LeBlanc, Sing Lee, Jean-Pierre Lépine, Daphna Levinson, Zhaorui Liu, Gustavo Loera, Herbert Marschinger, Katie A. McLaughlin, Maria Elena Medina-Mora, Elizabeth Miller, Samuel D. Murphy, Aimee Nasser Karam, Matthew K. Nock, Mark A. Oakley Browne, Siobhan O’Neill, Johan Ormel, Beth-Ellen Pennell, Maria V. Petukhova, José Posada-Villa, Rajesh Sagar, Mohammad Salih Khalaf, Nancy A. Sampson, Kathleen Saunders, Michael Schoenbaum, Kate M. Scott, Soraya Seedat, Victoria Shahly, Dan J. Stein, Hisateru Tachimori, Nezar Ismet Taib, Adley Tsang, T. Bedirhan Üstün, Maria Carmen Viana, Gemma Vilagut, Michael R. Von Korff, J. Elisabeth Wells, Harvey A. Whiteford, David R. Williams, Ben Wu, Miguel Xavier, Alan M. Zaslavsky
- Edited by Jordi Alonso, Universitat Pompeu Fabra, Barcelona, Somnath Chatterji, World Health Organization, Geneva, Yanling He
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- Book:
- The Burdens of Mental Disorders
- Print publication:
- 09 May 2013, pp ix-xii
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Contributors
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- By Christopher Ames, Cathy W. Barks, Ronald Berman, Anthony J. Berret, Robert Beuka, William Blazek, Elisabeth Bouzonviller, Jackson R. Bryer, Deborah Clarke, Gretchen Comba, Kirk Curnutt, Linda De Roche, Suzanne Del Gizzo, Kathleen Drowne, Richard Fine, Edward Gillin, Michael K. Glenday, Richard Godden, Steven Goldleaf, Peter L. Hays, Pearl James, Joel Kabot, Heidi M. Kunz, Jarom Lyle McDonald, Philip McGowan, Bonnie Shannon McMullen, Bryant Mangum, Lauren Rule Maxwell, James H. Meredith, Linda Patterson Miller, James Nagel, Michael Nowlin, Ruth Prigozy, Laura Rattray, Walter Raubicheck, Deborah Davis Schlacks, Gail D. Sinclair, Robert Sklar, Linda Wagner-Martin, James L. W. West, Doni M. Wilson
- Edited by Bryant Mangum, Virginia Commonwealth University
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- Book:
- F. Scott Fitzgerald in Context
- Published online:
- 05 February 2013
- Print publication:
- 18 March 2013, pp xi-xx
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William Winstanley’s Pestilential Poesies in The Christians Refuge: Or Heavenly Antidotes Against the Plague in this Time of Generall Contagion to Which is Added the Charitable Physician (1665)
- Kathleen Miller
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- Journal:
- Medical History / Volume 55 / Issue 2 / April 2011
- Published online by Cambridge University Press:
- 17 May 2012, pp. 241-250
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During the Great Plague of London (1665), William Winstanley veered from his better known roles as arbiter of success and failure in his works of biography or as a comic author under the pseudonym Poor Robin, and instead engaged with his reading audience as a plague writer in the rare book The Christians Refuge: Or Heavenly Antidotes Against the Plague in this Time of Generall Contagion to Which is Added the Charitable Physician (1665). From its extensive paratexts, including a table of mortality statistics and woodcut of king death, to its temporal and providential interpretation of the disease between the covers of a single text, The Christians Refuge is a compendium of contemporary understanding of plague. This article addresses The Christians Refuge as an expression of London’s print marketplace in a moment of transformation precipitated by the epidemic. The author considers the paratextual elements in The Christians Refuge that engage with the presiding norms in plague writing and publishing in 1665 and also explores how Winstanley’s authorship is expressed in the work. Winstanley has long been seen as a biographer or as a humour writer; attributing The Christians Refuge extends and challenges previous perceptions of his work.