Lydia Hayward

Lydia Hayward—born in the last quarter of the nineteenth century in Sheffield, England, to a father in the entertainment business—started her career as a stage actress, but in her early forties switched careers to become a leading scriptwriter in the British film industry. Her theatrical career has yet to be researched; however, in 1914, according to the website Theatricalia, she was taking roles at the Shakespeare Memorial Theatre in Stratford-upon-Avon (n.p.). By 1920 she had become a sufficiently spirited and dependable character actor to be cast as the convention-challenging Lona Hessel in Rex Wilson’s film adaptation of Ibsen’s Pillars of Society (1920), giving a performance that Kinematograph Weekly found “probably the best all-round piece of work” in a well-regarded film (1920, 82). However, thereafter she deserted both stage and film acting, to go behind the scenes as a scenarist, working in the British film industry between 1920 and 1942, where she achieved frequent recognition in the trade press: on May 12, 1927, The Bioscope declared her “the finest scenario writer we have” (33). Indeed, her aim in joining the cast of Pillars of Society may have been to learn the film business, since in her only known interview—made in Australia on April 12, 1939 with The Sydney Morning Herald—she cites as her inspiration a shilling guide on the art of scenario writing, loaned to her when visiting the office of Frank Benson’s Shakespearean company (6)

An Ephemeral History: Women and British Cinema Culture in the Silent Era

This essay examines select examples of British trade, fan and news press of the 1910s and 1920s in order to explore how the new visibility of women in cinema—both as audiences and in films—was registered. My focus is less how women themselves responded to cinema, than how these materials, in marking the relationship between women and cinema, reveal conflicts around shifting gender relations and identities. Starting by outlining some of the problems of using such material, I will highlight some key themes that emerged in British cultural discourses and imaginings across a range of print media circulating around cinema in this formative period. These include: women and cinema work; the English “girl” and “Americanitis”; sentimentality and “sob-stuff”; acting, “it” and sex-appeal; trans-valuation of the “true woman” in the new cinematic public sphere; femininity, class and representation; and gender contest

“Be patient, dear mother … wait for me”: the neo-infirmity film, female illness and contemporary cinema

In social reality, illness and death occur in myriad ways, yet Hollywood films have historically preferred spectacular, violent death over realist depictions of the terminal stages of life. Yet an ever-growing number of popular films, which I term neo-infirmity films, incorporate episodes of women characters debilitated by illness or injury. Operating at the intersection of melodrama and realism, the scenes are instrumental in staging contemporary cinema's gender politics. I argue that women's deathbed and hospital-bed scenes in contemporary cinema validate anew the maternal role and the figure of the mother, transporting the woman-centered discursive space of melodrama into narrative terrain often hostile to women's presence. Through this relocation, the films emphasize her importance to sons in particular (and less often to daughters, husbands, and the larger family unit). Many such scenes simultaneously undermine women's agency, reducing mothers to principally symbolic, literally immobile roles. Ailing women can become catalysts for male psychological transformation occurring through grief, action, or both in combination. In all, such scenes speak to continued ambivalence surrounding women's representation in popular cinema, and to continued patrolling of the boundaries of female power. This essay compares selected texts from contemporary Hollywood cinema, alongside three parallel discourses that also deploy melodramatic modes of articulation: nonfiction amateur video as relayed via television news programs, international art cinema, and US independent cinema. Arguing for homologies across multiple fields of textual production, I seek through this comparison to generate insights into the cultural work done by filmic representation

Elinor Glyn's British Talkies: Voice, Nationality and the Author On-Screen

Existing accounts of Elinor Glyn's career have emphasized her substantial impact on early Hollywood. In contrast, relatively little attention has been paid to her less successful efforts to break into the UK film industry in the early sound period. This article addresses this underexplored period, focusing on Glyn's use of sound in her two 1930 British films, Knowing Men and The Price of Things. The article argues that Glyn's British production practices reveal a unique strategy for reformulating her authorial stardom through the medium of the ‘talkie’. It explores how Glyn sought to exploit the specifically national qualities of the recorded English voice amidst a turbulent period in UK film production. The article contextualizes this strategy in relation to Glyn's business and personal archives, which evidence her attempts to refine her own speaking voice, alongside those of the screen stars whose careers she sought to develop for recorded sound. It suggests that the sound film was marked out as an important, exploitable new tool for Glyn within a broader context of debates about voice, recorded sound and nationality in UK culture at this time. This enabled her to portray a distinctively national brand identity through her new film work and surrounding publicity, in contrast to her appearances in American silent films. The article will show that recorded sound further allowed Glyn performatively to foreground her role as author-director through speaking cameos. This is analysed in relation to wider evidence of her practice, where she reflected on the performative qualities of the spoken voice in her writing and interviews, and made use of radio, newsreel and live performance to perfect and refine her own skills in recitation and oration

Creativity and commerce: Michael Klinger and new film history

The crisis in film studies and history concerning their legitimacy and objectives has provoked a reinvigoration of scholarly energy in historical enquiry. 'New film history' attempts to address the concerns of historians and film scholars by working self-reflexively with an expanded range of sources and a wider conception of 'film' as a dynamic set of processes rather than a series of texts. The practice of new film history is here exemplified through a detailed case study of the independent British producer Michael Klinger (active 1961-87) with a specific focus on his unsuccessful attempt to produce a war film, Green Beach, based on a memoir of the Dieppe raid (August 1942). This case study demonstrates the importance of analysing the producer's role in understanding the complexities of film-making, the continual struggle to balance the competing demands of creativity and commerce. In addition, its subject matter - an undercover raid and a Jewish hero - disturbed the dominant myths concerning the Second World War, creating what turned out to be intractable ideological as well as financial problems. The paper concludes that the concerns of film historians need to engage with broader cultural and social histories. © 2010 Taylor & Francis

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

Whole-genome sequencing reveals host factors underlying critical COVID-19

Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care1 or hospitalization2–4 after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes—including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)—in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease

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