Faith, creative practice and facing injustice in counter-cultural music

Eilidh Harris’ contribution to our Arts and Culture section continues the theme of exploring deeper spiritual realities by rooting them in the struggle for justice through art. As a metal musician and a poet, Harris shares some insights into her own, as well as other artists’, creative practice as resistance and empowerment, particularly in relation to violence against women and girls. As someone who no longer subscribes to the Christian faith in God but remains in dialogue with theology and contemporary religious culture, Harris offers a thought-provoking reflection on the life-giving power of creative practice in the context of trauma

IL4Rα signaling abrogates hypoxic neutrophil survival and limits acute lung injury responses <i>in vivo</i>

Rationale: Acute respiratory distress syndrome is defined by the presence of systemic hypoxia and consequent on disordered neutrophilic inflammation. Local mechanisms limiting the duration and magnitude of this neutrophilic response remain poorly understood.  Objectives: To test the hypothesis that during acute lung inflammation tissue production of proresolution type 2 cytokines (IL-4 and IL-13) dampens the proinflammatory effects of hypoxia through suppression of HIF-1a (hypoxia-inducible factor-1a)mediated neutrophil adaptation, resulting in resolution of lung injury.  Methods: Neutrophil activation of IL4Ra (IL-4 receptor a) signaling pathways was explored ex vivo in human acute respiratory distress syndrome patient samples, in vitro after the culture of human peripheral blood neutrophils with recombinant IL-4 under conditions of hypoxia, and in vivo through the study of IL4Ra-deficient neutrophils in competitive chimera models and wild-type mice treated with IL-4.  Measurements and Main Results: IL-4 was elevated in human BAL from patients with acute respiratory distress syndrome, and its receptor was identified on patient blood neutrophils. Treatment of human neutrophils with IL-4 suppressed HIF-1a-dependent hypoxic survival and limited proinflammatory transcriptional responses. Increased neutrophil apoptosis in hypoxia, also observed with IL-13, required active STAT signaling, and was dependent on expression of the oxygen-sensing prolyl hydroxylase PHD2. In vivo, IL-4Ra-deficient neutrophils had a survival advantage within a hypoxic inflamed niche; in contrast, inflamed lung treatment with IL-4 accelerated resolution through increased neutrophil apoptosis.  Conclusions: We describe an important interaction whereby IL4Ra-dependent type 2 cytokine signaling can directly inhibit hypoxic neutrophil survival in tissues and promote resolution of neutrophil-mediated acute lung injury

The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study

Background The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is not known. In the COVID-19 in Older PEople (COPE) study we aimed to establish the prevalence of frailty in patients with COVID-19 who were admitted to hospital and investigate its association with mortality and duration of hospital stay. Methods This was an observational cohort study conducted at ten hospitals in the UK and one in Italy. All adults (≥18 years) admitted to participating hospitals with COVID-19 were included. Patients with incomplete hospital records were excluded. The study analysed routinely generated hospital data for patients with COVID-19. Frailty was assessed by specialist COVID-19 teams using the clinical frailty scale (CFS) and patients were grouped according to their score (1–2=fit; 3–4=vulnerable, but not frail; 5–6=initial signs of frailty but with some degree of independence; and 7–9=severe or very severe frailty). The primary outcome was in-hospital mortality (time from hospital admission to mortality and day-7 mortality). Findings Between Feb 27, and April 28, 2020, we enrolled 1564 patients with COVID-19. The median age was 74 years (IQR 61–83); 903 (57·7%) were men and 661 (42·3%) were women; 425 (27·2%) had died at data cutoff (April 28, 2020). 772 (49·4%) were classed as frail (CFS 5–8) and 27 (1·7%) were classed as terminally ill (CFS 9). Compared with CFS 1–2, the adjusted hazard ratios for time from hospital admission to death were 1·55 (95% CI 1·00–2·41) for CFS 3–4, 1·83 (1·15–2·91) for CFS 5–6, and 2·39 (1·50–3·81) for CFS 7–9, and adjusted odds ratios for day-7 mortality were 1·22 (95% CI 0·63–2·38) for CFS 3–4, 1·62 (0·81–3·26) for CFS 5–6, and 3·12 (1·56–6·24) for CFS 7–9. Interpretation In a large population of patients admitted to hospital with COVID-19, disease outcomes were better predicted by frailty than either age or comorbidity. Our results support the use of CFS to inform decision making about medical care in adult patients admitted to hospital with COVID-19

Prognostic value of estimated glomerular filtration rate in hospitalised older patients (over 65) with COVID-19: a multicentre, European, observational cohort study

Background: The reduced renal function has prognostic significance in COVID-19 and it has been linked to mortality in the general population. Reduced renal function is prevalent in older age and thus we set out to better understand its effect on mortality. Methods: Patient clinical and demographic data was taken from the COVID-19 in Older People (COPE) study during two periods (February–June 2020 and October 2020–March 2021, respectively). Kidney function on admission was measured using estimated glomerular filtration rate (eGFR). The primary outcomes were time to mortality and 28-day mortality. Secondary outcome was length of hospital stay. Data were analysed with multilevel Cox proportional hazards regression, and multilevel logistic regression and adjusted for individual patient clinical and demographic characteristics. Results: One thousand eight hundred two patients (55.0% male; median [IQR] 80 [73–86] years) were included in the study. 28-day mortality was 42.3% (n = 742). 48% (n = 801) had evidence of renal impairment on admission. Using a time-to-event analysis, reduced renal function was associated with increased in-hospital mortality (compared to eGFR ≥ 60 [Stage 1&2]): eGFR 45–59 [Stage 3a] aHR = 1.26 (95%CI 1.02–1.55); eGFR 30–44 [Stage 3b] aHR = 1.41 (95%CI 1.14–1.73); eGFR 1–29 [Stage 4&5] aHR = 1.42 (95%CI 1.13–1.80). In the co-primary outcome of 28-day mortality, mortality was associated with: Stage 3a adjusted odds ratio (aOR) = 1.18 (95%CI 0.88–1.58), Stage 3b aOR = 1.40 (95%CI 1.03–1.89); and Stage 4&5 aOR = 1.65 (95%CI 1.16–2.35). Conclusion: eGFR on admission is a good independent predictor of mortality in hospitalised older patients with COVID-19 population. We found evidence of a dose-response between reduced renal function and increased mortality

Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial

Background Neutrophil serine proteases are involved in the pathogenesis of COVID-19 and increased serine protease activity has been reported in severe and fatal infection. We investigated whether brensocatib, an inhibitor of dipeptidyl peptidase-1 (DPP-1; an enzyme responsible for the activation of neutrophil serine proteases), would improve outcomes in patients hospitalised with COVID-19. Methods In a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial, across 14 hospitals in the UK, patients aged 16 years and older who were hospitalised with COVID-19 and had at least one risk factor for severe disease were randomly assigned 1:1, within 96 h of hospital admission, to once-daily brensocatib 25 mg or placebo orally for 28 days. Patients were randomly assigned via a central web-based randomisation system (TruST). Randomisation was stratified by site and age (65 years or ≥65 years), and within each stratum, blocks were of random sizes of two, four, or six patients. Participants in both groups continued to receive other therapies required to manage their condition. Participants, study staff, and investigators were masked to the study assignment. The primary outcome was the 7-point WHO ordinal scale for clinical status at day 29 after random assignment. The intention-to-treat population included all patients who were randomly assigned and met the enrolment criteria. The safety population included all participants who received at least one dose of study medication. This study was registered with the ISRCTN registry, ISRCTN30564012. Findings Between June 5, 2020, and Jan 25, 2021, 406 patients were randomly assigned to brensocatib or placebo; 192 (47·3%) to the brensocatib group and 214 (52·7%) to the placebo group. Two participants were excluded after being randomly assigned in the brensocatib group (214 patients included in the placebo group and 190 included in the brensocatib group in the intention-to-treat population). Primary outcome data was unavailable for six patients (three in the brensocatib group and three in the placebo group). Patients in the brensocatib group had worse clinical status at day 29 after being randomly assigned than those in the placebo group (adjusted odds ratio 0·72 [95% CI 0·57–0·92]). Prespecified subgroup analyses of the primary outcome supported the primary results. 185 participants reported at least one adverse event; 99 (46%) in the placebo group and 86 (45%) in the brensocatib group. The most common adverse events were gastrointestinal disorders and infections. One death in the placebo group was judged as possibly related to study drug. Interpretation Brensocatib treatment did not improve clinical status at day 29 in patients hospitalised with COVID-19

Depictions of sainthood in the Latin saints' lives of twelfth-century England

This thesis examines the depiction of saintly figures within the Latin vitae of twelfth-century England (1066–c.1215). It tests the extent to which these depictions are homogeneous and examines what factors may have shaped representations. Analysis focuses on vitae of twelfth-century saints, a sample of texts that have not previously been examined as a corpus in this way. By encompassing a range of different types of saint, authors and contexts, utilising this corpus allows a comparative examination of how different facets of sainthood could be expressed in hagiography. The textual analysis at the heart of this study aims to unpick individual texts’ ideals of saintly behaviour. Whilst hagiographers functioned within a well-established genre, considering a wide range of saints’ vitae allows scrutiny of the impact of context in shaping depictions. It will be argued that these portrayals of saintly figures demonstrate thematic harmony which is tempered by individuality and context to form recognisable and yet distinctive depictions of sainthood. The analysis is structured around four common hagiographical themes, each worthy of detailed examination: Outer Appearance, Sexuality and Chastity, Food and Fasting, and Death. Chapter 1 investigates how saintly figures are described in terms of physical appearance, deportment and demeanour, and clothing. Chapter 2 focuses upon sexuality, exploring the manifestations of chastity and virginity within the Lives and testing how this might vary from saint to saint and between the sexes. Chapter 3 examines food and food abstention, previously under-represented in secondary literature on twelfth-century hagiography and on male saints. The thesis ends with a consideration of death, a surprisingly understudied theme in Anglophone scholarship. By examining the process of dying and the moment of mortality, this chapter will fill an important analytical vacuum between lived sanctity and sanctity in death

Breaking down barriers: creating a community of learning development at the University of St Andrews

This presentation outlined a collaboration that delivered an integrated in-sessional academic and learning development provision for students at the University of St Andrews. Staff from the student learning development team in the Centre for Educational Enhancement and Development, and the Academic English Service, situated in the International Education Institute, partnered to bring previously segregated provisions together for academic year 2023/24.Historically both units have provided separate in-sessional one-to-one tutorials dictated by students’ first language or stage of study, but with overlap in some skills areas such as writing development. Each service had different parameters in terms of who could access the tutorials and how often they could do so. Due to the restrictions of each provision, and the siloed nature of the services, we identified that students were often not accessing the most appropriate form of tutorial, and that some tutorials were not being used to best effect.The provision has been reimagined to proffer a new Academic Development Community with the aim of creating a more effective and inclusive resource. This presentation unpicks motivations for pursuing a unified service and reflects on the changes made. The session shared the results of qualitative and quantitative student feedback on the newly aligned provision, and the perceptions of focus group participants on the unified service and relationship with contributing units. Combining the feedback collected thus far with our own professional reflections we explored the outcomes of these changes, as well as the challenges encountered in our collaborative approach. We concluded by sharing the future directions of this collaboration.<br/

Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

In response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19

The Future of Cancer and Collective Intelligence in the Post-Covid World

The Future of Cancer and Collective Intelligence in the Post-Covid World project was jointly conceived by the Innovation School at Glasgow School of Art and the Institute of Cancer Sciences at the University of Glasgow. Graduating year Product Design students from the Innovation School were presented with a challenge-based project to produce a vision of the future based on current trends that relate to the Future of Cancer and Collective Intelligence in the Post-Covid World. Currently, cancer research and development occur in isolated pockets within stages across the cancer care continuum, which often negatively impacts on the potential for cancer professionals to exchange, integrate and share data, insights and knowledge across the framework. One of the most significant societal shifts currently taking place within Cancer and Collective Intelligence is the transformation from the siloed clinic point of care model to a seamless continuum of care with greater focus on prevention and early intervention, changing what it means to be someone living with cancer and a professional working within this context. From this new dynamic, emerges the concept of living-labs; transdisciplinary communities of practice involving people working within and living with cancer, capable, through collective intelligence-enabled systems and services, of generating knowledge which can be used locally, and shared globally, to deliver focused innovations across the whole cancer ecosystem. If collective intelligence holds the potential to truly connect people to people, and people to data, across diverse communities, linking peoples’ lived experiences locally and globally, what kinds of new health and care services might emerge to improve cancer control across the continuum from prevention, detection, treatment and survivorship, and what types of new roles might emerge for citizens, patients and community groups to collaboratively drive these forward with health professionals? In order to address this challenge, the GSA Innovation School’s final year Product Design students and faculty formed a dynamic community of practice with cancer practitioners and researchers from the Institute of Cancer Sciences at The University of Glasgow and beyond to envisage a 2030 cancer blueprint as a series of future world exhibits, and create the designed products, services and experiences for the people who might live and work within this ecosystem. This project involved the students working in partnership with an Expert Faculty composed of Cancer Physicians, Cancer Researchers, Social Scientists, Biomedical Engineers, Health Research Specialists, Past Patients, Digital Health Specialists, Design Experts and Government Agencies. The Expert Faculty was assembled from a range of local to global organisations including the University of Glasgow, the Beatson West of Scotland Cancer Centre, the Malawi Ministry of Health and the International Agency for Research on Cancer (IARC is part of the World Health Organization). This project asked the students to embark on a speculative design exploration into future experiences of working and living with cancer ten years from now, where advances in collective intelligence have evolved to the extent that new forms and ecosystems of medical practice, cancer care and experiences of living with, through and beyond cancer transform how we interact with each other, with health professionals and the communities around us. This project was conceived and carried out during the global COVID-19 pandemic. Throughout the project the students positively used this situation to creatively embrace a digital studio practice and innovate around digital and remote access platforms and forums for collaboration, development and engagement. Thus, the designed products, services and experiences for the people who might live and work within the cancer ecosystem are presented as innovative, highly creative, fully immersive, experiential exhibits. The project was divided into two sections: The first was a collaborative stage based on Future Worlds. The worlds are groups of students working together on specific topics, to establish the context for their project and collaborate on research and development. These were clustered together around ‘Future Working’ and ‘Future Living’ but also joined up across these groups to create pairs of worlds, and in the process generate collective intelligence between the groups. The worlds clustered around ‘Future Working’ are Education, Care and Treatment, Prevention and Detection. Future Worlds clustered around ‘Future Living’ are Personal Wellbeing, Communicating Cancer, Beyond Cancer. The second stage saw students explore their individual response to their assigned Future World that had been created in the first stage. Each student developed their own research by iteratively creating a design outcome that was appropriate to the Future cancer World. This culminated in each student producing designed products, services or systems and a communication of the future experiences created. Throughout the project, the results were presented as a series live interactive digitally curated, virtual work-in-progress exhibitions for specific audiences including a special global event to participate in World Cancer Day on the 4th February 2021. An event which allowed the students to actively interact and discuss the project with a global audience of cancer community leaders. The deposited materials are arranged as follows: 1. Readme files - two readme files relate to tage one and stage two of the project as outlined above. 2. Project overview document - gives a visual overview of the structure and timeline of the project. 3. Stage one data folders - the data folders for stage one of the project are named by the six Future Worlds through which each group explored possible futures. 4. Stage two data folders - the data folders for stage two of the project are named for the individual students who conducted the work and organised by the Future World cluster they worked within

Large-scale migration into Britain during the Middle to Late Bronze Age

Present-day people from England and Wales harbour more ancestry derived from Early European Farmers (EEF) than people of the Early Bronze Age . To understand this, we generated genome-wide data from 793 individuals, increasing data from the Middle to Late Bronze and Iron Age in Britain by 12-fold, and Western and Central Europe by 3.5-fold. Between 1000 and 875 BC, EEF ancestry increased in southern Britain (England and Wales) but not northern Britain (Scotland) due to incorporation of migrants who arrived at this time and over previous centuries, and who were genetically most similar to ancient individuals from France. These migrants contributed about half the ancestry of Iron Age people of England and Wales, thereby creating a plausible vector for the spread of early Celtic languages into Britain. These patterns are part of a broader trend of EEF ancestry becoming more similar across central and western Europe in the Middle to Late Bronze Age, coincident with archaeological evidence of intensified cultural exchange . There was comparatively less gene flow from continental Europe during the Iron Age, and Britain's independent genetic trajectory is also reflected in the rise of the allele conferring lactase persistence to ~50% by this time compared to ~7% in central Europe where it rose rapidly in frequency only a millennium later. This suggests that dairy products were used in qualitatively different ways in Britain and in central Europe over this period. [Abstract copyright: © 2021. The Author(s), under exclusive licence to Springer Nature Limited.