The Heritage Buddhist Manuscripts of Ladakh Tibetan Buddhist Canons and the Perfection of Wisdom Sutra

The history of the earliest transmission of Indian Buddhism to Tibet in the 7th– 8thcenturies is in essence the story of the transmission of its scriptures. Tibetan translations of Sanskrit texts from the early imperial period, along with manuscripts translated from the 11thcentury onwards, contributed to the formation of Buddhist scriptural collections. Today different versions of the Tibetan Kangyur survive in the interior and at the margins of the Tibetan cultural world. This Perspectives piece serves as a modest introduction to the illustrated Prajñāpāramitā manuscripts and handwritten Buddhist canons preserved in the Indian north-western Himalayas. Their further study will undoubtedly advance our knowledge of Ladakh’s cultural and religious heritage and offer critical insights in the formation of Tibetan canonical literature. The purpose of this overview is to highlight the results of initial findings, explain how they relate to existing knowledge, and raise important themes for additional enquiries

The Heritage Buddhist Manuscripts of Ladakh Tibetan Buddhist Canons and the Perfection of Wisdom Sutra

The history of the earliest transmission of Indian Buddhism to Tibet in the 7th– 8thcenturies is in essence the story of the transmission of its scriptures. Tibetan translations of Sanskrit texts from the early imperial period, along with manuscripts translated from the 11thcentury onwards, contributed to the formation of Buddhist scriptural collections. Today different versions of the Tibetan Kangyur survive in the interior and at the margins of the Tibetan cultural world. This Perspectives piece serves as a modest introduction to the illustrated Prajñāpāramitā manuscripts and handwritten Buddhist canons preserved in the Indian north-western Himalayas. Their further study will undoubtedly advance our knowledge of Ladakh’s cultural and religious heritage and offer critical insights in the formation of Tibetan canonical literature. The purpose of this overview is to highlight the results of initial findings, explain how they relate to existing knowledge, and raise important themes for additional enquiries

Chamchung Lhakang, Basgo Fort (Ladakh)

Images of the exterior and interior of the Chamchung temple in Basgo fort

The overriding influence of hedonism in driving consumer happiness

The experience recommendation prescribes a disadvantage to material purchases, suggesting that spending on experiential rather than material purchases makes people happier. This study challenges this idea by examining the hedonic/utilitarian nature of purchases. The results of a qualitative study and four experiments (one preregistered) show that the happiness advantage of experiential (vs. material) purchases is contingent on pronounced hedonic properties. Our results indicate that hedonism asymmetries override the distinction between purchase type, such that there is no happiness advantage in buying experiences over material objects when purchases are equally (non)hedonic. Importantly, we find that hedonism is more instrumental for material purchases and that hedonic materials are equally effective as experiential purchases, altogether, and even outperform utilitarian experiences in eliciting happiness. Our findings encourage consumers to focus on the properties, rather than the type, of purchases to increase purchase-related happiness. Our results further suggest that marketers of material goods, in particular, can considerably increase customer value by using design components, product features, and brand imagery that leverage hedonic qualities.publishersversionpublishe

Warmth and competence perceptions of key protagonists are associated with containment measures during the COVID-19 pandemic: Evidence from 35 countries

It is crucial to understand why people comply with measures to contain viruses and their effects during pandemics. We provide evidence from 35 countries (Ntotal = 12,553) from 6 continents during the COVID-19 pandemic (between 2021 and 2022) obtained via cross-sectional surveys that the social perception of key protagonists on two basic dimensions—warmth and competence—plays a crucial role in shaping pandemic-related behaviors. Firstly, when asked in an open question format, heads of state, physicians, and protest movements were universally identified as key protagonists across countries. Secondly, multiple-group confirmatory factor analyses revealed that warmth and competence perceptions of these and other protagonists differed significantly within and between countries. Thirdly, internal meta-analyses showed that warmth and competence perceptions of heads of state, physicians, and protest movements were associated with support and opposition intentions, containment and prevention behaviors, as well as vaccination uptake. Our results have important implications for designing effective interventions to motivate desirable health outcomes and coping with future health crises and other global challenges.publishedVersio

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans.

BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. METHODS: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. RESULTS: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. CONCLUSION: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research