Border crossings in the African travel narratives of Ibn Battuta, Richard Burton and Paul Theroux

This article compares the representation of African borders in the 14th-century travelogue of Ibn Battuta, the 19th-century travel narrative of Richard Burton and the 21st-century travel writing of Paul Theroux. It examines the mutually constitutive relationship between conceptions of literal territorial boundaries and the figurative boundaries of the subject that ventures across borders in Africa. The border is seen as a liminal zone which paradoxically separates and joins spaces. Accounts of border crossings in travel writing from different periods suggest the historicity and cultural specificity of conceptions of geographical borders, and the way they index the “boundaries” of the subjects who cross them. Tracing the transformations in these conceptions of literal and metaphorical borders allows one to chart the emergence of the dominant contemporary idea of “Africa” as the inscrutable, savage continent

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

Accounts of China and India

Cover -- ACCOUNTS OF CHINA AND INDIA -- Title -- Copyright -- Dedication -- CONTENTS -- Letter from the General Editor -- Foreword -- Acknowledgments -- Introduction -- Notes to the Introduction -- Map: The Lands and Seas of Abu Zāyd's Accounts -- ACCOUNTS OF CHINA AND INDIA -- Accounts of China and India: The First Book -- The Sea of Harkand -- Maritime Commerce between the Arabs and the Chinese -- The Sea Route from Sīrāf to Khānfū -- On Tides, and Unusual Phenomena of the Seas -- The Chinese and Some of Their Customs -- Accounts of the Lands of India and China and of Their Rulers -- China, and the Customs of Its Inhabitants -- India, and Some of the Customs of Its People -- Chinese and Indian Customs Compared -- Accounts of China and India: The Second Book -- The Changed Situation in China, and the Cause of It -- Various Practices and Manufactures of the Chinese -- The Visit of Ibn Wahb al-Qurashī to the King of China -- How the Seas Are Connected One to Another -- The Kingdom of al-Mihrāj -- The Land of al-Qamār and the Stupidity of Its King -- The Belief of the Eastern Kings in the Transmigration of Souls -- Accounts of China Continued -- Further Accounts of India -- Accounts of the Island of Sarandīb and of the Region of al-Aghbāb, Which Faces It -- General Accounts of India Continued -- The Land of the Zanj -- The Island of Socotra -- Seas and Lands Lying West of the Gulf of Oman -- Ambergris and Whales -- An Account of Pearls -- Further Accounts of Indian Customs -- Afterword to the Second Book -- Notes -- Glossary of Names and Terms -- Bibliography -- Index -- About the NYU Abu Dhabi Institute -- About the Translator -- The Library of Arabic LiteratureDescription based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries