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Sixty-day consequences of COVID-19 in patients discharged from hospital: an electronic health records study
No full textData on patients discharged following COVID-19 hospitalization is scarce. We conducted an electronic health records study of community-acquired COVID-19 patients discharged between 15 March and 14 July 2020 from hospitals in Oxfordshire, UK. Of 403 discharged patients, 114 (28%) were readmitted or died within 60 days (incidence rate 18/100 person-months). Rates of readmission or death were twice as high among those ≥ 65 years as those < 65 years [standardized rate ratio: 2.21 (95% CI: 1.45–3.56)] and among women than men [2.25 (1.05–4.18)]. These findings suggest important sex differences in 60-day outcomes following COVID-19 hospitalization that have not previously been well described
Ring-opening polymerisation of l- and rac-lactide using group 4 permethylpentalene aryloxides and alkoxides
No full textA new family of group 4 permethylpentalene (C8Me62−; Pn*) aryloxide and alkoxide complexes have been synthesised and fully characterised by multinuclear NMR spectroscopy and single-crystal X-ray diffraction; (η8-C8Me6)Zr(OR)2 (R = tBu (1), 2,6-Me-C6H3 (2), 2,6-iPr-C6H3 (3) and 4-OMe-C6H4 (4)), (η8-C8Me6)Zr (OR) (R = 2,6-tBu-C6H3 (5) and 2,6-tBu-4-Me-C6H2 (6)), (η8-C8Me6)ZrCp(OR) (R = tBu (7), 2,6-Me-C6H3 (8) and 2,6-iPr-C6H3 (9)), (η8-C8Me6)TiCp(O-2,6-Me-C6H3) (10) and (η8-C8Me6)ZrCpMe(OR) (R = 2,6-Me-C6H3 (11), 2,6-iPr-C6H3 (12) and 2,4-tBu-C6H3 (13)). 2, 3, 6, 7, 9, 10 and 12 were studied as initiators for the ring-opening polymerisation (ROP) of L-lactide, and 2, 3, 6, 7 and 10 were studied as initiators for the ROP of rac-lactide. 3 was found to be the most active initiator for the ROP of L-lactide (kobs = 0.35 h−1) and 2 for the ROP of rac-lactide (kobs = 0.21 h−1). These initiators produced isotactic PLA for the ROP of L-lactide and moderately heterotactic enriched (maximum Pr of 0.69) or atactic PLA for the ROP of rac-lactide with polymer chains consisting of polylactic acid repeat units with –OR and –OH end groups
The unclothed body on and off stage in the Comedia Nueva
No full textThis article examines the presence of the unclothed body in the comedia nueva, both when it appears on stage and when it is referred to off stage. It begins with a brief examination of what desnudez actually meant in practical terms in the corral theaters (and moralists' responses to states of undress). The study goes on to analyze in more detail some of the main implications and resonances of nakedness in the minds of Golden Age audiences. These are important for characterization, including the establishment of a character's poverty, madness, or vulnerability; for dramatists' attempts to establish time and place; and, above all, because of the eroticism of the unclothed body which is linked to pictorial traditions. Examples are taken from full-length comedias by a variety of playwrights, supplemented with the exploration of analogous motifs in seventeenth-century visual culture, to highlight its role in helping the audience imagine these scenes
Getting the message right on nature‐based solutions to climate change
No full textNature‐based solutions (NbS)—solutions to societal challenges that involve working with nature—have recently gained popularity as an integrated approach that can address climate change and biodiversity loss, while supporting sustainable development. Although well‐designed NbS can deliver multiple benefits for people and nature, much of the recent limelight has been on tree planting for carbon sequestration. There are serious concerns that this is distracting from the need to rapidly phase out use of fossil fuels and protect existing intact ecosystems. There are also concerns that the expansion of forestry framed as a climate change mitigation solution is coming at the cost of carbon rich and biodiverse native ecosystems and local resource rights. Here, we discuss the promise and pitfalls of the NbS framing and its current political traction, and we present recommendations on how to get the message right. We urge policymakers, practitioners and researchers to consider the synergies and trade‐offs associated with NbS and to follow four guiding principles to enable NbS to provide sustainable benefits to society: (1) NbS are not a substitute for the rapid phase out of fossil fuels; (2) NbS involve a wide range of ecosystems on land and in the sea, not just forests; (3) NbS are implemented with the full engagement and consent of Indigenous Peoples and local communities in a way that respects their cultural and ecological rights; and (4) NbS should be explicitly designed to provide measurable benefits for biodiversity. Only by following these guidelines will we design robust and resilient NbS that address the urgent challenges of climate change and biodiversity loss, sustaining nature and people together, now and into the future
Multilevel and Quasi Monte Carlo methods for the calculation of the Expected Value of Partial Perfect Information
No full textThe expected value of partial perfect information (EVPPI) provides an upper bound
on the value of collecting further evidence on a set of inputs to a cost-effectiveness decision model. Standard Monte Carlo (MC) estimation of EVPPI is computationally
expensive as it requires nested simulation. Alternatives based on regression approximations to the model have been developed, but are not practicable when the number
of uncertain parameters of interest is large and when parameter estimates are highly
correlated. The error associated with the regression approximation is difficult to determine, while MC allows the bias and precision to be controlled. In this paper, we explore
the potential of Quasi Monte-Carlo (QMC) and Multilevel Monte-Carlo (MLMC) estimation to reduce computational cost of estimating EVPPI by reducing the variance
compared with MC, while preserving accuracy. In this paper, we develop methods to
apply QMC and MLMC to EVPPI, addressing particular challenges that arise where
Markov Chain Monte Carlo (MCMC) has been used to estimate input parameter distributions. We illustrate the methods using a two examples: a simplified decision tree
model for treatments for depression, and a complex Markov model for treatments to
prevent stroke in atrial fibrillation, both of which use MCMC inputs. We compare
the performance of QMC and MLMC with MC and the approximation techniques of
Generalised Additive Model regression (GAM), Gaussian process regression (GP), and
Integrated Nested Laplace Approximations (INLA-GP). We found QMC and MLMC to
offer substantial computational savings when parameter sets are large and correlated,
and when the EVPPI is large. We also find GP and INLA-GP to be biased in those
situations, while GAM cannot estimate EVPPI for large parameter sets
Transnational universities and English medium instruction in China: how admissions, language support and language use differ in Chinese universities
No full textThis article reports on a study of policymaking at transnational and local universities in China concerning English Medium Instruction (EMI) provision, and the impact this has on stakeholder experiences. It explores policymaking at two transnational universities, which are compared and contrasted with data collected at six other Chinese universities that offer EMI programmes. Data were collected via individual and group interviews with 26 key policy stakeholders during fieldwork at the eight universities and centred on language-related policy diffusion surrounding admissions, language support, and language use. Findings revealed a reliance on foundation year studies at transnational universities versus the Gaokao (national college entrance examination) at other universities to ensure students had the requisite proficiency upon admissions. Findings also revealed transnational universities were more likely to offer language support to their students and have language policies governing language use. Overall, the findings reveal a range of affordances and caveats associated with each institution’s contextualized policy making, causing ease and conflict for EMI stakeholders
The neoliberal age? Britain since the 1970s
No full textThe late twentieth and early twenty-first centuries are commonly characterised as an age of ‘neoliberalism’ in which individualism, competition, free markets and privatisation came to dominate Britain’s politics, economy and society. This historical framing has proven highly controversial, within both academia and contemporary political and public debate. Standard accounts of neoliberalism generally focus on the influence of political ideas in reshaping British politics; according to this narrative, neoliberalism was a right-wing ideology, peddled by political economists, think-tanks and politicians from the 1930s onwards, which finally triumphed in the 1970s and 1980s. The Neoliberal Age? suggests this narrative is too simplistic. Where the standard story sees neoliberalism as right-wing, this book points to some left-wing origins, too; where the standard story emphasises the agency of think-tanks and politicians, this book shows that other actors from the business world were also highly significant. Where the standard story can suggest that neoliberalism transformed subjectivities and social lives, this book illuminates other forces which helped make Britain more individualistic in the late twentieth century. The analysis thus takes neoliberalism seriously but also shows that it cannot be the only explanatory framework for understanding contemporary Britain. The book showcases cutting-edge research, making it useful to researchers and students, as well as to those interested in understanding the forces that have shaped our recent past
The impact of recipient demographics on outcomes from living donor kidneys: systematic review and meta-analysis
No full textBackground and Aims: Recipient demographics affect outcomes after kidney transplantation. The aim of this study was to assess, for kidneys retrieved from living donors, the effect of recipient sex, ethnicity, and body mass index (BMI) on delayed graft function (DGF) and one-year graft function, incidence of acute rejection (AR), and recipient and graft survivals.
Methods: A systematic review and meta-analysis was performed. EMBASE and MEDLINE databases were searched using algorithms through Ovid. Web of Science collection, BIOSIS, CABI, Korean Journal database, Russian Science Citation Index, and SciELO were searched through Web of Science. Cochrane database was also searched. Risk of bias was assessed using the NHBLI tools. Data analysis was performed using Revman 5.4. Mean difference (MD) and risk ratio (RR) were used in analysis.
Results: A total of 5129 studies were identified; 24 studies met the inclusion criteria and were analysed. Female recipients were found to have a significantly lower serum creatinine 1-year-post renal transplantation (MD: −0.24 mg/dL 95%CI: −0.18 to −0.29 p 30) was found to have no effect on 1-year recipient (p = 0.28) and graft survival (p = 0.93) compared to non-obese recipients although non-obese recipients had a lower rate of DGF (RR = 0.65 p < 0.01) and AR (RR = 0.81 p < 0.01) compared to obese recipients.
Conclusions: Gender mismatch between male recipients and female donors has negative impact on graft survival. African ethnicity and obesity do not to influence recipient and graft survival but negatively affect DGF and AR rates