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Higher ivermectin dose, longer duration still futile for COVID, trial finds

A randomized, controlled trial (RCT) shows that even at a higher dose and longer treatment duration, the antimalarial drug ivermectin didn’t shorten the time to a sustained recovery from COVID-19.

In the double-blind trial, published yesterday in JAMA, a team led by Duke University researchers evaluated time to sustained recovery among 1,206 COVID-19 patients at 93 US sites from Feb 16 to Jul 22, 2022, with follow-up until Nov 10, 2022. Sustained recovery was considered at least 3 days without symptoms.

Patients were at least 30 years old and had two or more symptoms for no more than 7 days, 59.1% were women, and 83.5% reported receiving two or more COVID-19 vaccine doses.

The trial was part of the ongoing Accelerating COVID-19 Therapeutic Interventions and Vaccines 6 (ACTIV-6), which was designed to assess the effectiveness of repurposed drugs such as ivermectin in the treatment of mild to moderate COVID-19.

Of all participants, 602 were randomly assigned to receive 600 micrograms per kilogram (μg/kg) of ivermectin once daily for 6 days, and 604 received a placebo. The dose used in previous RCTs showing futility of ivermectin for COVID-19 was 400 μg/kg once daily for 3 days, which some experts suggested was insufficient.

Both groups recovered in about 11 days
The median time to sustained recovery was 11 days in both the ivermectin and placebo groups (hazard ratio [HR], 1.02). Of the ivermectin recipients, 5.7% were hospitalized, died, or visited an urgent care center or emergency department, compared with 6.0% of placebo recipients (HR, 1.0).

One ivermectin recipient died, and 4 (0.8%) were hospitalized. Among placebo recipients, 2 (0.3%) were hospitalized, and none died. Adverse events were rare in both groups.

Despite the lack of efficacy in randomized, controlled trials, media reports and clinical experience suggests that some healthcare providers in the United States and abroad still prescribe ivermectin for their COVID-19 patients, according to an editor’s note by Kirsten Bibbins-Domingo, PhD, MD, and Preeti Malani, MD, JAMA editor-in-chief and deputy editor, respectively.

The continued practice, they wrote, is «fueled in part by real or perceived lack of access to effective therapies, continued confusion or misinformation, and active disinformation about ivermectin’s efficacy, including by physicians. More must be done in partnership with others to address the misinformation that continues as we embark on the fourth year of the COVID-19 pandemic.»

Are more ivermectin trials needed?
In a related editorial, Alex John London, PhD, of Carnegie Mellon University, and Christopher Seymour, MD, of the University of Pittsburgh, noted that while evidence against ivermectin for this indication is likely sufficient, more than 10 ivermectin trials are still recruiting participants on ClinicalTrials.gov.

Despite the lack of efficacy in randomized, controlled trials, media reports and clinical experience suggests that some healthcare providers in the United States and abroad still prescribe ivermectin for their COVID-19 patients.
The number of ongoing trials on a drug already proven futile, and their inherent resource use and ethical dilemmas, beg the question of clinical equipoise, they said.

«The equipoise requirement holds that (1) research that addresses uncertainty or conflicting medical judgments of conscientious and informed experts is likely to have social value and (2) allocating individuals to interventions that are subject to such conflict or uncertainty is consistent with respect for their rights or welfare,» they wrote.

London and Seymour argue that uncertainty alone is not enough to ensure that studies fill a knowledge gap that would help clinicians and health systems effectively and equitably promote the best interests of patients.

«After considering factors that can influence the persistence of clinical equipoise, we argue that decisions about what investigations to undertake must be responsive to the relative social value of continuing to reduce uncertainty around one intervention, and stakeholders must consider whether scarce time, resources, and participant effort could be better invested examining other questions,» they wrote.

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Tattoo Artist, Entrepreneur, and Oil Painter Kirby van Beek Makes a Mark in the Industry

Kirby van Beek, a talented tattoo artist, entrepreneur, and oil painter, has emerged as a prominent figure in the world of tattooing, showcasing his expertise in black and grey realism. Known for his distinctive designs and captivating portraits with a dark twist, Kirby has established himself as a highly regarded artist, earning recognition both locally and internationally.

Kirby’s journey as a tattoo artist began at the age of 18 when he taught himself the art form while simultaneously pursuing his education in forensic science. During this time, he displayed unparalleled dedication, working at a morgue during the week and honing his tattooing skills during weekends and spare hours. Kirby’s passion for tattooing led him to work at various tattoo studios in the Netherlands, solidifying his experience and expertise in the field.

About Kirby van Beek:

Kirby van Beek is a talented tattoo artist, entrepreneur, and oil painter based in [City]. Renowned for his expertise in black and grey realism, Kirby’s distinctive designs and captivating portraits with a dark twist have earned him a prominent position in the industry. With a passion for tattooing and oil painting, Kirby aspires to become a globally recognized artist, leaving a lasting impact on the world of art.

«The things I love most about tattooing is meeting different clients and getting to know them on a personal level during a long tattoo session,» says Kirby. «There is nothing more rewarding than tattooing individuals who appreciate my art so much that they choose to wear it on their skin for life.»

Specializing in realistic black and grey tattoos, portrait tattoos, and horror tattoos, Kirby’s work has garnered attention both nationally and internationally. His talents have been showcased at several tattoo conventions abroad, and his captivating designs have been featured in prominent tattoo magazines. Additionally, he has been recognized by esteemed publications such as LINDA magazine in the Netherlands and the local newspaper BN de Stem. Furthermore, Kirby’s exceptional skills led him to participate as a tattoo artist in the Dutch version of MTV’s Just Tattoo of Us.

Looking ahead, Kirby aspires to become a world-renowned tattoo artist and oil painter, with a particular focus on portrait tattoos and dark horror tattoos.

His ultimate goal is to reach clients and famous individuals around the globe, sharing his unique artistry and leaving an indelible mark on the industry. In the future, Kirby envisions opening an art show to showcase his diverse body of work.

To learn more about Kirby van Beek and explore his captivating portfolio, visit his official Instagram page (@kirbyvanbeek) or his website www.the-continental.nl.

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DJ Khenya Takes Center Stage at Blue Marlin Ibiza, Spreading Joy and Connection

The music of DJ Khenya pulsates with rhythm and emotion. A rich mélange of sun-kissed sounds that blend percussive beats with indie and deep house. The artist’s journey to Ibiza has laid the foundation for a musical expression that communicates joy and connectivity. Taking the reins at Blue Marlin Ibiza, Khenya’s vibrations will inspire dance floor dreamers to move and let go.

From the stage at Blue Marlin Ibiza, DJ Khenya has shared experiences alongside some of the most influential names in the music industry. When asked about the impact of these experiences, the artist responded humbly: «The truth is I feel lucky. I have total admiration for them as they are a source of inspiration for me.»

The energy at Blue Marlin Ibiza is unlike any other, according to DJ Khenya. He describes the place as «a life experience,» synonymous with summer and with all the ingredients to feel in a state of bliss when you’re there. He thanks the team for being like a family to him and for everything they’ve done.

This summer, DJ Khenya will take his audience on a journey filled with unforgettable emotions. He comments, «My goal is to transmit uplifting and unforgettable sensations. My audience is what sets my heart on fire, and I want them to feel my desire to make them dance.»

The path that led DJ Khenya to become a DJ began in Havacia, Cuba, where he grew up in an environment where rhythm, dance, and poetry are like the air we breathe. With son and salsa running through his veins, his first experience at an electronic music party in the early 2000s marked a shift in his life. Khenya recalls hearing ‘The Underground’ by Celeda and says, «It was a different Cuba, and I loved it. I think from that moment, something changed inside me. A seed had been planted, and life would take me in that direction.»

Having traveled the world and now based in Ibiza, DJ Khenya reflects on how these experiences have shaped his identity as an artist. He comments, «Traveling the world is a privilege that every human being should have, especially an artist because when you have these experiences, you can understand different ways of life and the musicality of each place. Creativity is born from that knowledge, and I still have a lot to learn in that sense.»

This summer, DJ Khenya promises to take Blue Marlin Ibiza to new heights with his unique music and his desire to make everyone dance. The experience is guaranteed to be a celebration of life, joy, and connection through music.

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Oliver Rouz: Weaving Ink and Inspiration into a Legacy

Born on February 13th, 1988, Oliver Rouz’s path to success is one marked by determination, passion, and the pursuit of creative endeavors. From a young age, Oliver exhibited a profound love for various forms of creativity, which ultimately led him to become one of the country’s most celebrated tattoo artists.

During his school years, Oliver’s artistic talent set him apart. His favorite cartoon characters became his canvas as he tirelessly recreated them in his own style. However, drawing was merely a pastime during his teenage years, a source of pleasure until music took center stage in his life.

In 2005, Oliver formed the «Fairy Tale Jelissa Rose» band, a pivotal moment that expanded his horizons. Immersed in the music community, he developed a newfound fascination with tattoos and ink artistry, spurred by the band’s association with the tattoo culture.

A serendipitous encounter with Artem at the «Quick Silver» shop in Moscow in 2010 marked a turning point. Artem’s influence led Oliver to consider a life-altering decision. By 2012, Oliver, now ignited by a passion for tattoos, made a bold move to another city, all while nurturing his tattoo aspirations.

Artem’s transformation into a tattoo artist himself inspired Oliver further. As fate would have it, an opportunity arose in 2012 for them to collaborate and open their tattoo studio in Moscow. This venture required Oliver’s dedicated efforts, alongside his commitment to saving funds to fuel their creative endeavor.

Oliver’s tattooing prowess flourished within a year, prompting a return to his hometown to establish several home-like studios. Yet, he recognized that true growth beckoned him back to Moscow. Thus, in 2017, he joined Good Hands Tattoo, laying the foundation for his continued ascent.

Oliver’s indomitable spirit and devotion to his craft bore fruit, as evidenced by his stint at Black Point studio, born out of a collective dream. His trajectory exemplifies the power of dedication, leading him to become a recognized tattoo luminary within the nation.

Oliver’s journey, however, extends beyond tattooing. From his early affinity for music, highlighted by the formation of his punk rock band at 14, to his involvement in the music industry and flirtation with global recognition, his story embodies the resilience required to navigate creative industries.

A pivotal moment arrived in 2021 when Oliver, undeterred by previous setbacks, chose to channel his creative energy into designing game art. Leaving behind a stable job, he invested his savings of around $5,000 to embark on a transformative journey. Guided by Hexeth’s interview and tutorials, Oliver delved into the realm of game design.

Fueled by dedication and a newfound purpose, Oliver’s creative expression culminated in designing elements for popular games like CS:GO and RUST. Through unwavering commitment and rigorous self-education, he harnessed the potential of his artistic flair.

Today, Oliver Rouz’s name resonates as a testament to the potential of human determination. His path from a young artist with a penchant for creation to a revered tattoo and game artist serves as an inspiration to countless dreamers. Oliver’s legacy continues to evolve, as he pushes the boundaries of his craft and inspires others to chase their passions unrelentingly.

For more information and to view Oliver’s work, visit his Instagram profile: @oliverrouz.