Language in a world of plurality:the tree, the bot and the octopus teacher

Abstract. Language has been considered proof of human exceptionalism in the Western European culture since the Enlightenment era. As a result, a rigid hierarchy placing human on the top emerged. Due to human’s capacity to rationalize thought and materialize it using language as a tool, it entitled itself to possess and dispose of anything deemed as less- or non-human. Once the fixed idea of language is destabilized, its accuracy as a tool fit enough to represent the world and human thought comes into question. Once language, a pillar of Humanism, is damaged, the collapse of human exceptionalism is imminent. Post-humanism and ontological pluralism are offering the grounds for exploring a paradigm without the hierarchy. A flattened reality in which the relationships between ways of being are far more complex than mere hierarchies, food chains, or concentric circles. They are entangled, mangled. They are plugging-in and unplugging in an assemblage. For inquiring into an assemblage, tools such as qualitative methodologies, representational logic and data become useless. Meanwhile, post-qualitative inquiries do not pretend to ascend the ultimate, pure knowledge or truth but simply offer a brief, incomplete glimpse into the assemblage. The results of such destabilizations consist of more care and attention being offered to negotiating language and languaging, empty spaces and howls, communication outside the higher senses of sight and hearing. In education, it translates into alternative teachers and teachings. The learners are entangled into an assemblage with which they are inter-acting by forming relationships. They are learning to co-live with rather than to make sense of the ways of being

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study.

BACKGROUND Despite concerns that patients with liver transplants might be at increased risk of adverse outcomes from COVID-19 because of coexisting comorbidities and use of immunosuppressants, the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on this patient group remains unclear. We aimed to assess the clinical outcomes in these patients. METHODS In this multicentre cohort study, we collected data on patients with laboratory-confirmed SARS-CoV-2 infection, who were older than 18 years, who had previously received a liver transplant, and for whom data had been submitted by clinicians to one of two international registries (COVID-Hep and SECURE-Cirrhosis) at the end of the patient's disease course. Patients without a known hospitalisation status or mortality outcome were excluded. For comparison, data from a contemporaneous cohort of consecutive patients with SARS-CoV-2 infection who had not received a liver transplant were collected from the electronic patient records of the Oxford University Hospitals National Health Service Foundation Trust. We compared the cohorts with regard to several outcomes (including death, hospitalisation, intensive care unit [ICU] admission, requirement for intensive care, and need for invasive ventilation). A propensity score-matched analysis was done to test for an association between liver transplant and death. FINDINGS Between March 25 and June 26, 2020, data were collected for 151 adult liver transplant recipients from 18 countries (median age 60 years [IQR 47-66], 102 [68%] men, 49 [32%] women) and 627 patients who had not undergone liver transplantation (median age 73 years [44-84], 329 [52%] men, 298 [48%] women). The groups did not differ with regard to the proportion of patients hospitalised (124 [82%] patients in the liver transplant cohort vs 474 [76%] in the comparison cohort, p=0·106), or who required intensive care (47 [31%] vs 185 [30%], p=0·837). However, ICU admission (43 [28%] vs 52 [8%], p<0·0001) and invasive ventilation (30 [20%] vs 32 [5%], p<0·0001) were more frequent in the liver transplant cohort. 28 (19%) patients in the liver transplant cohort died, compared with 167 (27%) in the comparison cohort (p=0·046). In the propensity score-matched analysis (adjusting for age, sex, creatinine concentration, obesity, hypertension, diabetes, and ethnicity), liver transplantation did not significantly increase the risk of death in patients with SARS-CoV-2 infection (absolute risk difference 1·4% [95% CI -7·7 to 10·4]). Multivariable logistic regression analysis showed that age (odds ratio 1·06 [95% CI 1·01 to 1·11] per 1 year increase), serum creatinine concentration (1·57 [1·05 to 2·36] per 1 mg/dL increase), and non-liver cancer (18·30 [1·96 to 170·75]) were associated with death among liver transplant recipients. INTERPRETATION Liver transplantation was not independently associated with death, whereas increased age and presence of comorbidities were. Factors other than transplantation should be preferentially considered in relation to physical distancing and provision of medical care for patients with liver transplants during the COVID-19 pandemic. FUNDING European Association for the Study of the Liver, US National Institutes of Health, UK National Institute for Health Research

The effect of solid-phase composition on the drying behavior of Markermeer sediment

We studied the drying behavior of slurries of Markermeer sediments in the Netherlands having different solid compositions. Natural processes such as sand–mud segregation and oxidation of organic matter were mimicked to analyze the effect of changes in sediment composition. Evaporation experiments were performed with soft slurry samples using the Hyprop setup. Soil water retention curves (SWRCs) and hydraulic conductivity curves (HCCs) were determined as a function of the water ratio (WR, defined as volume of water/volume of solids). The sediment remained close to saturation until the end of the experiments. The Atterberg limits reduced significantly after sediment treatment involving drying at 50 °C, rewetting, and chemical oxidation. Furthermore, the oxidized sediment lost capacity to retain water. The SWRCs of sandy and oxidized clays were steeper, and fine-textured sediments showed large water ratios. At low matric suctions, the water retention capacity of the upper sediment samples containing more labile organic matter was larger than that of the sediment underneath. Clear correlations were found between van Genuchten parameters and the degree of degradation of the organic matter. The hydraulic conductivity of fine-textured samples with less labile organics was larger. The results give insight into the drying behavior of Markermeer sediment, currently used to build wetlands.Environmental Fluid Mechanic

Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: an international registry study.

BACKGROUND Chronic liver disease (CLD) and cirrhosis are associated with immune dysregulation leading to concerns that these patients may be at risk of adverse outcomes following SARS-CoV-2 infection. However, the impact of COVID-19 among patients with pre-existing liver disease remains ill-defined. METHODS Data for CLD patients with SARS-CoV-2 were collected by two international registries. Comparisons were made with non-CLD patients with SARS-CoV-2 from a UK hospital network. RESULTS Between 25th March and 8th July 2020, 745 CLD patients were reported from 29 countries including 386 with cirrhosis and 359 without. Mortality was 32% in patients with cirrhosis compared with 8% in those without (p<0.001). Mortality in cirrhosis patients increased according to Child-Turcotte-Pugh class (CTP-A (19%), CTP-B (35%), CTP-C (51%)) and the main cause of death was respiratory failure (71%). After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (OR 1.02; 1.01-1.04), CTP-A (OR 1.90; 1.03-3.52), CTP-B (OR 4.14; 2.4-7.65), CTP-C cirrhosis (OR 9.32; 4.80-18.08) and alcohol related liver disease (ALD) (OR 1.79; 1.03-3.13). When comparing CLD versus non-CLD (n=620) in propensity-score-matched analysis there were significant increases in mortality with CTP-B +20.0% (8.8%-31.3%) and CTP-C cirrhosis +38.1% (27.1%-49.2%). Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of which 21% had no respiratory symptoms. 50% of those with hepatic decompensation had acute-on-chronic liver failure. CONCLUSIONS This is the largest reported cohort of CLD and cirrhosis patients with SARS-CoV-2 infection to date. We demonstrate that baseline liver disease stage and ALD are independent risk factor for death from COVID-19. These data have important implications for the risk stratification of patients with CLD across the globe during the COVID-19 pandemic

Long-term clinical outcomes of patients with COVID-19 and chronic liver disease: US multicenter COLD study.

BackgroundCOVID-19 is associated with higher morbidity and mortality in patients with chronic liver diseases (CLDs). However, our understanding of the long-term outcomes of COVID-19 in patients with CLD is limited.MethodsWe conducted a multicenter, observational cohort study of adult patients with CLD who were diagnosed with COVID-19 before May 30, 2020, to determine long-term clinical outcomes. We used a control group of patients with CLD confirmed negative for COVID-19.ResultsWe followed 666 patients with CLD (median age 58 years, 52.8% male) for a median of 384 (interquartile range: 31-462) days. The long-term mortality was 8.1%; with 3.6% experiencing delayed COVID-19-related mortality. Compared to a propensity-matched control group of patients with CLD without COVID-19 (n=1332), patients with CLD with COVID-19 had worse long-term survival [p&lt;0.001; hazards ratio (HR): 1.69; 95% CI: 1.19-2.41] and higher rate of hospitalization (p&lt;0.001, HR: 2.00, 1.62-2.48) over a 1-year follow-up period. Overall, 29.9% of patients reported symptoms of long-COVID-19. On multivariable analysis, female sex (p=0.05, HR: 2.45, 1.01-2.11), Hispanic ethnicity (p=0.003, HR: 1.94, 1.26-2.99), and severe COVID-19 requiring mechanical ventilation (p=0.028, HR: 1.74, 1.06-2.86) predicted long-COVID-19. In survivors, liver-related laboratory parameters showed significant improvement after COVID-19 resolution. COVID-19 vaccine status was available for 72% (n=470) of patients with CLD and history of COVID-19, of whom, 70% (n=326) had received the COVID-19 vaccine.ConclusionsOur large, longitudinal, multicenter study demonstrates a high burden of long-term mortality and morbidity in patients with CLD and COVID-19. Symptoms consistent with long-COVID-19 were present in 30% of patients with CLD. These results illustrate the prolonged implications of COVID-19 both for recovering patients and for health care systems

PET/MR in invasive ductal breast cancer. Correlation between imaging markers and histological phenotype

Background:Differences in genetics and receptor expression (phenotypes) of invasive ductal breast cancer (IDC) impact on prognosis and treatment response. Immunohistochemistry (IHC), the most used technique for IDC phenotyping, has some limitations including its invasiveness. We explored the possibility of contrast-enhanced positron emission tomography magnetic resonance (CE-FDG PET/MR) to discriminate IDC phenotypes.Methods:21 IDC patients with IHC assessment of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor-2 (HER2), and antigen Ki-67 (Ki67) underwent CE-FDG PET/MR. Magnetic resonance-perfusion biomarkers, apparent diffusion coefficient (ADC), and standard uptake value (SUV) were compared with IHC markers and phenotypes, using a Student's t-test and one-way ANOVA.Results:ER/PR-tumours demonstrated higher Kep mean and SUV max than ER or PR+ tumours. HER2-tumours displayed higher ADC mean, Kep mean, and SUV max than HER2+tumours. Only ADC mean discriminated Ki67≤14% tumours (lower ADC mean) from Ki67&gt;14% tumours. PET/MR biomarkers correlated with IHC phenotype in 13 out of 21 patients (62%; P=0.001).Conclusions:Positron emission tomography magnetic resonance might non-invasively help discriminate IDC phenotypes, helping to optimise individual therapy options