BACKGROUND AND AIMS: Pruritus may seriously impair quality of life in patients with cholestatic diseases such as primary or secondary sclerosing cholangitis (PSC, SSC) and primary biliary cholangitis (PBC). Pharmacologic strategies show limited efficacy and can provoke serious side effects. We hypothesized that bezafibrate, a broad peroxisome proliferator-activated receptor (PPAR) agonist, relieves cholestasis-associated itch by alleviating hepatobiliary injury. The aim of this investigatorinitiated FITCH trial (Fibrates for cholestatic ITCH) was to assess effects of bezafibrate on pruritus in patients with PSC, PBC, and SSC. METHODS: Patients with moderate to severe pruritus (!5 of 10 on visual analog scale [VAS]) due to PSC, PBC, or SSC were recruited for this double-blind, randomized, placebocontrolled trial between 2016 and 2019. Patients received once-daily bezafibrate (400 mg) or placebo for 21 days. The primary end point was !50% reduction of pruritus (VAS; intention-to-treat). RESULTS: Of 74 randomized patients, 70 completed the trial (95%; 44 PSC, 24 PBC, 2 SSC). For the primary end point, bezafibrate led in 45% (41% PSC, 55% PBC) and placebo in 11% to !50% reduction of severe or moderate pruritus (P ¼ .003). For secondary end points, bezafibrate reduced morning (P ¼ .01 vs placebo) and evening (P ¼ .007) intensity of pruritus (VAS) and improved the validated 5D-Itch questionnaire (P ¼ .002 vs placebo). Bezafibrate also reduced serum alkaline phosphatase (À35%, P ¼ .03 vs placebo) correlating with improved pruritus (VAS, P ¼ .01) suggesting reduced biliary damage. Serum bile acids and autotaxin activity remained unchanged. Serum creatinine levels tended to mildly increase (3% bezafibrate, 5% placebo, P ¼ .14). CONCLUSIONS: Bezafibrate is superior to placebo in improving moderate to severe pruritus in patients with PSC and PBC.

The present discourse on Islam can be regarded as a cultural racist discourse. The construction of Muslims as the 'Other' necessarily implies constructing a 'Self'. This article deals with the dialectical process of reification by studying Dutch female converts to Islam. Ruptures in the relationships between converts and their relatives can illuminate Dutch national and cultural identity. Converts change important markers of identity such as name and appearance. They also trespass Dutch values connected to cultural practice such as food, feasting and funerals. The most important construction of Dutch national and cultural identity vis-à-vis converts is related to sex and gender. Veiled Muslimas in particular express that they cannot longer be 'real Dutch'. Veiling is subordination and oppressed women are the 'ultimate others' of Dutch self-perception.keywords Converts, Islam, the Netherlands, cultural racism, national identity D uring the 1980s and 1990s, several social scientists and anti-racists discerned the growing presence of a 'new racism' or 'cultural racism' in Europe. This means that exclusion and discrimination are primarily based on cultural rather than physical difference. In the current xenophobia, Islamophobia is prominent. The present discourse on Islam can be regarded as a kind of cultural racism. Islam is not only perceived as the 'ultimate cultural other' but Islam as a cultural system and Muslims as believers are also constructed as an immutable category.The construction of Muslims as the 'Other' necessarily implies constructing a 'Self'. By reifying the Muslims, also the 'Self's' cultural and national identity is reified. Yet, this latter process has received less attention. In this article, I will discuss the dialectical process of reification by studying a specific group of Muslim women: the growing group of Dutch female converts to Islam. Converts are an interesting group positioned betwixt and between the discourse

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The public sphere in the Middle East and elsewhere is changing rapidly due to the global availability of new technologies of mass media. As a result of the growing influence of Islamist and pietistic movements in the Muslim world and in Muslim communities in the West, an increasing Islamization or 'pietization' (Turner 2008) of the public sphere is discernable. Also with regard to the cultural sphere attempts are made to bring art, leisure and entertainment in accordance with religious commitments. Pious sensibilities seem to be a moving but not necessarily dominating force in the creation of new forms of artistic expressions and leisure activities. Secularism, in particular, and 'the grand project of nationalist progress' (Schielke, this issue) are still very influential in the field of art. In much of the Arab world, mass culture is still one of the few remaining bastions of secularism (Salamandra, this issue). Secularist regimes perceive art and entertainment as important strongholds that are in need of defence. For that reason religious notions of art, leisure and entertainment are highly contested. Journalists, Islamists, artists and art consumers redefine the relationship between religion, art and leisure activities. The debates are raging within and between the secularists and the Islamist groups and profoundly discuss the place of religion in the public sphere.This special issue is the outcome of a panel organised on this topic at the MESA conference in 2007. We will highlight several examples of the ways piety is creatively merged with art and sketch the development towards a pious cultural sphere. Yet equally important is how these projects are debated, consumed and contested by diverse actors inside and outside the piety movement.