The Malthusian Paradox: performance in an alternate reality game

The Malthusian Paradox is a transmedia alternate reality game (ARG) created by artists Dominic Shaw and Adam Sporne played by 300 participants over three months. We explore the design of the game, which cast players as agents of a radical organisation attempting to uncover the truth behind a kidnapping and a sinister biotech corporation, and highlight how it redefined performative frames by blurring conventional performer and spectator roles in sometimes discomforting ways. Players participated in the game via a broad spectrum of interaction channels, including performative group spectacles and 1-to-1 engagements with game characters in public settings, making use of low- and high-tech physical and online artefacts including bespoke and third party websites. Players and game characters communicated via telephony and social media in both a designed and an ad-hoc manner. We reflect on the production and orchestration of the game, including the dynamic nature of the strong episodic narrative driven by professionally produced short films that attempted to respond to the actions of players; and the difficulty of designing for engagement across hybrid and temporally expansive performance space. We suggest that an ARG whose boundaries are necessarily unclear affords rich and emergent, but potentially unsanctioned and uncontrolled, opportunities for interactive performance, which raises significant challenges for design

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Excited-State Aromatic Interactions in the Aggregation-Induced Emission of Molecular Rotors

Small, apolar aromatic groups, such as phenyl rings, are commonly included in the structures of fluorophores in order to impart hindered intramolecular rotations, leading to desirable solid-state luminescence properties. However, they are not normally considered to take part in through-space interactions that influence the fluorescent output. Here, we report on the photoluminescence properties of a series of phenyl-ring molecular rotors bearing three, five, six, and seven phenyl groups. The fluorescent emissions from two of the rotors are found to originate, not from the localized excited state as one might ex-pect, but from unanticipated through-space aromatic dimer states. We demonstrate that these relaxed dimer states can form as a result of intra- or intermolecular interactions across a range of environments in solution and solid samples, including conditions that promote aggregation-induced emission. Computational modeling also suggests that the formation of aro-matic-dimer excited states may account for the photophysical properties of a previously reported luminogen. These results imply, therefore, that this is a general phenomenon that should be taken into account when designing and interpreting the fluorescent outputs of luminescent probes and optoelectronic devices based on fluorescent molecular rotors