From acceptera to Vällingby: The Discourse on Individuality and Community in Sweden (1931-54)

The Swedish suburb of Vällingby, completed in 1954, culminated an investigation into the housing problem which can be traced back to the functionalist manifesto acceptera of 1931, where the issue of finding a ‘Middle Way’ between the individual and the mass, the personal and the universal was presented as being as central to the project of modern architecture as it was to Social Democracy as a whole.The ebb and flow of discourse on housing and policy during the 30s and early 40s engaged directly with the binary of private individualism/public collectivism, drawing on the thinking of figures such as Ellen Key, Torgny T. Segerstedt and Lewis Mumford to arrive at neighbourhood planning as a suitable foil to both the laissez-faire of the capitalist system and the monotonous and alienating results of early attempts at mass social housing.While Vällingby provided improved dwellings and amenity, setting new standards in terms of efficiency, economy and convenience, these very qualities, it is suggested in conclusion, also mask the ‘unfreedoms’ of the modern welfare state, which in the case of Vällingby might be seen as the Social Democratic bias towards a ‘group society’ at the expense of true self-determination.

Crop Updates 2003 - -Katanning

This session covers sixteen papers from different authors Breeding Cereals for Rust Resistance – are we losing the battle? Robert F. Park, University of Sydney Stripe rust – where to now for the WA wheat industry? Robert Loughman, Department of Agriculture, Colin Wellings, University of Sydney, Greg Shea, Department of Agriculture Oaten hay production, Jocelyn Ball, Natasha Littlewood and Lucy Creagh, Department of Agriculture Don’t rely on ‘Spray and Pray’ Alex Douglas, Department of Agriculture Seasonal outlook: What is in store for 2003, David Stephens, Department of Agriculture No-till copper, phosphorus and zinc experiments, Ross Brennan and Mike Bolland, Department of Agriculture Wheat nutrition in the high rainfall zone, Narelle Hill, Department of Agriculture Aphid damage to cereal grain crops, Phil Michael, Department of Agriculture Aphid damage to canola – not all cultivars are equal, Francoise A. Berlandier and Christiaan Valentine, Department of Agriculture Overcropping Lucerne, Roy Latta, Department of Agriculture Future direction of field pea varieties, M. Rodger Beermier, Department of Agriculture Selecting the right pasture for the job, Keith Devenish, Department of Agriculture Topping up pasture seedbanks, Keith Devenish, Department of Agriculture Baudin and Hamlin New generation of malting barleys, Blakely Paynter, Roslyn Jettner and Kevin Young, Department of Agriculture Wheat variety performance in 2002 compared to the long term, Robin Wilson, Ian Barclay Robyn McLean, Robert Loughman, Jenny Garlinge, Bill Lambe, Neil Venn and Peter Clarke, Department of Agriculture The role of green manure crops in renovating poor performing paddocks: What’s it worth? Francis Hoyle, Leanne Schulz and Judith Devenish, Department of Agricultur

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

De grenzen van architectuur

In 1930, the Stockholm Exhibition took place in Sweden. In addition to utensils and applied arts, the exposition included complete dwellings. Attracting 4 million visitors in five months, it is widely considered a breakthrough for functionalism in Swedish architecture and design. The exhibition was initiated by Svenska Slöjdföreningen or the Swedish Arts and Crafts Society. The leader of this designer’s association, Gregor Paulsson, was partly inspired by his 1927 visit to the Weissenhof Siedlungen. The exhibition pavilions, in most cases designed by Gunnar Asplund, radiated hope and optimism, despite the fact that Sweden was facing high unemployment and poor living conditions at the time. In 1931, some of the architects involved in the Housing Section published their controversial manifesto acceptera propagating functionalism as the inevitable solution to the problems of the times. In the following article, Lucy Creagh takes a closer look at their exhibition contributions. – The EditorsIn 1930 vond in Zweden de Stockholm-tentoonstelling plaats. Naast gebruiksvoorwerpen en toegepaste kunst werden hier ook complete woningen getoond. De tentoonstelling trok in vijf maanden tijd 4 miljoen bezoekers en wordt algemeen gezien als de doorbraak van het functionalisme in de Zweedse architectuur en design. Het initiatief voor de tentoonstelling werd genomen door de Svenska Slöjdföreningen. De leider van deze groep ontwerpers, Gregor Paulsson, was mede geïnspireerd door zijn bezoek in 1927 aan de Weissenhofsiedlung. De tentoonstellingspaviljoens, voornamelijk ontworpen door Gunnar Asplund, straalden een hoopvol optimisme uit, juist in een tijd waarin veel Zweden te maken hadden met werkloosheid en slechte woonomstandigheden. Sommige van de architecten die betrokken waren bij de Woningbouwsectie, publiceerden in 1931 het spraakmakende manifest acceptera, waarin het functionalisme gepropageerd wordt als onontkoombare oplossing voor de problemen van de moderne tijd. In onderstaand artikel gaat Lucy Creagh nader in op hun bijdrage aan de tentoonstelling. – De redacti

Open Publishing Case Studies released

A set of open publishing case studies supported by Australian university libraries has been released