Virtual spaces, virtual subjects : anxiety and modernity

Wissenschaftliches Kolloquium vom 24. bis 27. April 2003 in Weimar an der Bauhaus-Universität zum Thema: ‚MediumArchitektur - Zur Krise der Vermittlung

The Scarlet Letter: A critical review

Nathaniel Hawthorn’s 19th century romance The Scarlet Letter centres on the simple transgression of adultery and its social consequences. Hawthorn’s narrative and story-telling skill, however, is far from simple; the author manages to subtly and cleverly set the tale within a framework of other transgressions. Ideas of space and other social constructions such including language and belief systems are tested and subverted in this description of a 17th century Puritan settlement. In this paper David Littlefield and Rachel Sara set out the transgressive qualities of this classic American text, putting it into the context of the theme Body + Space and demonstrating how the book pre-figures much 20th century thinking on the subject

Monstrous Domesticity – Home as a Site of Oppression in Crimson Peak

This paper begins by offering a brief overview of the popular culture narrative Crimson Peak (2015), directed by Guillermo del Toro. The analysis focuses on the most compelling Gothic trope del Toro reintroduces, the proverbial mansion, simultaneously displaying Freud’s heimlich and unheimlich elements, oppressing and liberating its inhabitants. Since the narrative revolves around two female protagonists, Lucille Sharpe and Edith Cushing, the paper also refers to feminist socio-cultural perspectives on space, primarily Gillian Rose’s and Shelley Mallett’s, in order to understand the position of the two protagonists within the decidedly Gothic space. This paper aims to emphasize that Lucille’s liberation as the mistress of the house is illusory regardless of the fact that she is represented as the embodiment of domestic corruption. It is precisely because she is a sexually active woman and a disruptor of the patriarchal order that she must ultimately be punished. Even though del Toro subverts the traditional image of the madwoman in the attic by positioning her at the center of the narrative, Allerdale Hall does not reveal itself as a space of female empowerment

Exposing the unconscious through the para-architectural photo-essay and prose

Para-architecture as a method of design exploits the creative potential within interdisciplinary practices such as philosophy, sculpture, cartoons, as a supplement to conventional design methodologies. This photo essay expands upon such methods originally highlighted within Bernard Tschumi’s Manhattan Transcripts (1976), in a parallel to unconscious principles of psychoanalytic “site-writing”, as proposed by Jane Rendell. Responding to the Hepworth Wakefield, United Kingdom, as the architectural object, photography and intuitive prose are explored as para-architectural tools of interrogation. Through an original series of photographs and developed prose, a diagnosis and analysis takes place – harnessing the potential of utilizing para-architectural methods to explore the unconscious of cultural architectural interventions. The future potential in subscribing to para-architectural inquiry affords for design ideologies and pedagogy within the discipline to advance the dimensions of prescriptive architecture; encouraging creative responses, whilst also considering the unseen cognitive burdens architecture often places onto communities, cultures, and cities.N/

The stories we tell: uncanny encounters in Mr Straw’s house

During my first visit to Mr Straw’s House, a National Trust Property in the North of England, I was intrigued by the discrepancies between the narrative framework provided by the National Trust – its exclusions, silences and invisibilities – and the far more complex stories the house seemed to tantalisingly hint at. As a scholar I am drawn to certain sites and affectively engage with them and yet I usually keep silent about my investment which informs not only my interest but also how I read these heritage sites. My aim here is not primarily to interrogate my own investment, but to ask how productive it is, what it enables me to see and to describe and where its limits are. This case study explores a particular tourist attraction from the perspective of storytelling and asks what narratives can be constructed around, and generated through, the spatial-emotional dimensions of this heritage site. I am interested in the hold sites have over people, why and how they provoke imaginative and empathic investment that generates a network of stories and triggers processes of unravelling which have the potential to transform silences and unmetabolised affect into empathy and emotional thought

The Australasian Resuscitation In Sepsis Evaluation : fluids or vasopressors in emergency department sepsis (ARISE FLUIDS), a multi-centre observational study describing current practice in Australia and New Zealand

Objectives: To describe haemodynamic resuscitation practices in ED patients with suspected sepsis and hypotension. Methods: This was a prospective, multicentre, observational study conducted in 70 hospitals in Australia and New Zealand between September 2018 and January 2019. Consecutive adults presenting to the ED during a 30-day period at each site, with suspected sepsis and hypotension (systolic blood pressure <100 mmHg) despite at least 1000 mL fluid resuscitation, were eligible. Data included baseline demographics, clinical and laboratory variables and intravenous fluid volume administered, vasopressor administration at baseline and 6- and 24-h post-enrolment, time to antimicrobial administration, intensive care admission, organ support and in-hospital mortality. Results: A total of 4477 patients were screened and 591 were included with a mean (standard deviation) age of 62 (19) years, Acute Physiology and Chronic Health Evaluation II score 15.2 (6.6) and a median (interquartile range) systolic blood pressure of 94 mmHg (87–100). Median time to first intravenous antimicrobials was 77 min (42–148). A vasopressor infusion was commenced within 24 h in 177 (30.2%) patients, with noradrenaline the most frequently used (n = 138, 78%). A median of 2000 mL (1500–3000) of intravenous fluids was administered prior to commencing vasopressors. The total volume of fluid administered from pre-enrolment to 24 h was 4200 mL (3000–5661), with a range from 1000 to 12 200 mL. Two hundred and eighteen patients (37.1%) were admitted to an intensive care unit. Overall in-hospital mortality was 6.2% (95% confidence interval 4.4–8.5%). Conclusion: Current resuscitation practice in patients with sepsis and hypotension varies widely and occupies the spectrum between a restricted volume/earlier vasopressor and liberal fluid/later vasopressor strategy

Corridor Gothic

This article investigates the role of the corridor in Gothic fiction and horror film from the late eighteenth century to the present day. It seeks to establish this transitional space as a crucial locus, by tracing the rise of the corridor as a distinct mode of architectural distribution in domestic and public buildings since the eighteenth century. The article tracks pivotal appearances of the corridor in fiction and film, and in the final phase argues that it has become associated with a specific emotional tenor, less to do with amplified fear and horror and more with emotions of Angst or dread

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research