25 research outputs found

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    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

    Measurement of the charge asymmetry in top-quark pair production in the lepton-plus-jets final state in pp collision data at s=8TeV\sqrt{s}=8\,\mathrm TeV{} with the ATLAS detector

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    ATLAS Run 1 searches for direct pair production of third-generation squarks at the Large Hadron Collider

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    Interrupting discourses around gender through collective memory work and collaborative curriculum research in middle school

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    Many schools in recent years have implemented curricular projects to 'deal with' homophobia and sexism as problems that affect adolescent students and make schools unsafe. The ways in which we, as teachers and researchers, confront such problems, however, depends upon how we view their power within schools. When viewed as discursive elements of a generally heteronormative school environment, gender and sexuality norms become more complicated and subtle, as they are a part of systems of language, actions, and expectations that can be difficult to problematize with students and teachers. Drawing on feminist post-structuralist theory related to normativity and discourse analysis, our research looks at two middle-school projects aimed at interrupting heteronormative thinking by including students in the process of analyzing and re-creating school discourse. In one project, a whole class looks at gender identity formation through analyzing collective memory works collaboratively with the teacher. In the second project, a smaller group of girls works to re-think ways that the science/math curriculum could be more responsive to girls, in the end also analyzing the work that comes out of the collaboration. Together, the projects raise important questions about the effectiveness of such curricular projects, the power of school language around 'adolescence', and the potential for addressing gender normativity on the level of discourse, especially in the face of such powerful ideas of gender/sexuality in the middle grades

    Response to Bettina Fabos

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    We thank the Pedagogies editors for publishing Fabos’s response and offering us a chance to reflect in kind on her reading of our article. We agree with many of her observations. Perhaps some brief clarifications are in order before we take up the substantive issues she raises in her critique. We hope to contribute some interesting lines of speculation and inquiry for readers of this issue and to justify the editors’ invitation to have this dialogue

    Hybridity, globalisation and literacy education in the context of New York City

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    Although multiliteracies have been well theorised in recent years, few studies have researched the practical aspects of developing a curriculum of multiliteracies. This article examines multiliteracies as a crossdisciplinary curriculum practice, drawing on data from a 3-year study in an urban middle school. The data show possibilities for students to engage in critique and to move toward designing multimodal texts. Using Bourdieusian concepts of social capital and academic field, we explore the struggles around learning to inhabit certain school discourses. <br /

    Hybridity, globalization and literacy education in the context of NYC's Chinatown

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    Although multiliteracies have been well theorised in recent years, few studies have researched the practical aspects of developing a curriculum of multiliteracies. This article examines multiliteracies as a crossdisciplinary curriculum practice, drawing on data from a 3-year study in an urban middle school. The data show possibilities for students to engage in critique and to move toward designing multimodal texts. Using Bourdieusian concepts of social capital and academic field, we explore the struggles around learning to inhabit certain school discourses
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