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Non peer reviewed

Treatment of obstructive sleep apnoea (OSA) in adults is evolving, as new therapies have been explored and introduced in clinical practice, while other approaches have been refined or reconsidered. In this European Respiratory Society (ERS) guideline on non-continuous positive airway pressure (CPAP) therapies for OSA, we present recommendations determined by a systematic review of the literature. It is an update of the 2011 ERS statement on non-CPAP therapies, advanced into a clinical guideline. A multidisciplinary group of experts, including pulmonary, surgical, dentistry and ear–nose–throat specialists, methodologists and patient representatives considered the most relevant clinical questions (for both clinicians and patients) relating to the management of OSA. Eight key clinical questions were generated and a systematic review was conducted to identify published randomised clinical trials that answered these questions. We used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the quality of the evidence and the strength of recommendations. The resulting guideline addresses gastric bypass surgery, custom-made dual-block mandibular advancement devices, hypoglossal nerve stimulation, myofunctional therapy, maxillo-mandibular osteotomy, carbonic anhydrase inhibitors and positional therapy. These recommendations can be used to benchmark quality of care for people with OSA across Europe and to improve outcomes.

Review/Recension

This book review discusses Kokal’s central points in State Law, Dispute Processing, and Legal Pluralism: Unspoken Dialogues from Rural India. Within the review, Kokal’s arguments of legal pluralism are pointed out and linked back to theories related to this field, such as Ehrlich’s theory of living law and Luhmann’s systems theory. The review explores Kokal’s idea of parallel legal systems being interconnected and operating at the same time. The review further sets forward the importance of Kokal’s work as providing an enlightening perspective to the socio-legal discussion of what is law and if we should conceptualise it in terms of state law or adopt a more bottom-up approach to the issue, as Kokal did in her own work.

Global health research partnerships with institutions from high-income countries and low- and middle-income countries are one of the European Commission's flagship programmes. Here, we report on the ZikaPLAN research consortium funded by the European Commission with the primary goal of addressing the urgent knowledge gaps related to the Zika epidemic and the secondary goal of building up research capacity and establishing a Latin American-European research network for emerging vector-borne diseases. Five years of collaborative research effort have led to a better understanding of the full clinical spectrum of congenital Zika syndrome in children and the neurological complications of Zika virus infections in adults and helped explore the origins and trajectory of Zika virus transmission. Individual-level data from ZikaPLAN`s cohort studies were shared for joint analyses as part of the Zika Brazilian Cohorts Consortium, the European Commission-funded Zika Cohorts Vertical Transmission Study Group, and the World Health Organization-led Zika Virus Individual Participant Data Consortium. Furthermore, the legacy of ZikaPLAN includes new tools for birth defect surveillance and a Latin American birth defect surveillance network, an enhanced Guillain-Barre Syndrome research collaboration, a de-centralized evaluation platform for diagnostic assays, a global vector control hub, and the REDe network with freely available training resources to enhance global research capacity in vector-borne diseases.

After visiting the exhibition Zorn: A Swedish Superstar at the Nationalmuseum in Stockholm, I was reminded of an earlier visit to the artist’s home in Mora. Zorn placed the lights in the dining room there directly above the rear end of the table, where he sat. This might very well have been mere chance, or for practical reasons, but in hindsight it reminds us that Zorn was well aware of being a superstar in the spotlight. As an artist however, Zorn managed perfectly well to shine on his own. This becomes clear during a visit to the exhibition.