Velocity profiles and turbulence in the aorta : a study by hot-film anemometry

Imperial Users onl

Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses

To understand neurological complications of COVID-19 better both acutely and for recovery, we measured markers of brain injury, inflammatory mediators, and autoantibodies in 203 hospitalised participants; 111 with acute sera (1–11 days post-admission) and 92 convalescent sera (56 with COVID-19-associated neurological diagnoses). Here we show that compared to 60 uninfected controls, tTau, GFAP, NfL, and UCH-L1 are increased with COVID-19 infection at acute timepoints and NfL and GFAP are significantly higher in participants with neurological complications. Inflammatory mediators (IL-6, IL-12p40, HGF, M-CSF, CCL2, and IL-1RA) are associated with both altered consciousness and markers of brain injury. Autoantibodies are more common in COVID-19 than controls and some (including against MYL7, UCH-L1, and GRIN3B) are more frequent with altered consciousness. Additionally, convalescent participants with neurological complications show elevated GFAP and NfL, unrelated to attenuated systemic inflammatory mediators and to autoantibody responses. Overall, neurological complications of COVID-19 are associated with evidence of neuroglial injury in both acute and late disease and these correlate with dysregulated innate and adaptive immune responses acutely

El papel del Derecho en el cambio material y simbólico del paisaje colombiano 1850-1930* The role of Law in the material and symbolic change of the Colombian landscape 1850-1930

Este artículo entrelaza diferentes aspectos de la transformación del paisaje de Colombia, simbólico y material, desde mediados del siglo XIX hasta las primeras tres décadas del siglo XX. Para ello, describe, evalúa y analiza el sistema jurídico, particularmente, asociado a la regulación y codificación de la propiedad privada de la tierra, así como los aspectos públicos de las leyes de baldíos. No presenta un listado exhaustivo de la normatividad promulgada en la época sino la forma cómo en la realidad colombiana - territorialmente fragmentada y heterogéneamente apropiada - el Derecho contribuye a la transformación del paisaje. El Derecho del Estado tendió a construir una especie de monismo jurídico sobre la pluralidad de órdenes jurídicos que heredó de la colonia y las primeras décadas republicanas. De este modo, cuestiona tanto las visones que se basan en el derecho formalista y positivo, como las posiciones de la sociología jurídica que consideran que sólo hay un abismo entre la realidad social y la jurídica. Apunta a mostrar el papel simbólico, más que ideológico, del Derecho en el cambio ambiental pero, a su vez reconoce los cambios materiales que el proyecto de Derecho basado en el predominio de la propiedad privada como Derecho absoluto engendró en esta época.<br>Este artigo entrelaça diferentes aspectos da transformação da paisagem da Colômbia, simbólica e material, desde meados do século XIX até as primeiras três décadas do século XX. Para tanto, descreve, avalia e analisa o sistema jurídico, particularmente associado à regulamentação e codificação da propriedade privada da terra, assim como os aspectos públicos das leis de terras devolutas. Não apresenta uma lista exaustiva da normatividade promulgada na época, mas a forma como - na realidade colombiana, territorialmente fragmentada e heterogeneamente apropriada - o Direito contribui para a transformação da paisagem. O Direito de Estado tendeu a construir uma espécie de monismo jurídico sobre a pluralidade de ordens jurídicas herdadas da colônia e das primeiras décadas republicanas. Deste modo, questionam-se tanto as visões baseadas no direito formalista e positivo, como as posições da sociologia jurídica, que consideram tão somente um abismo entre a realidade social e a jurídica. Sublinha-se o papel simbólico, mais que ideológico, do direito na transformação ambiental mas, por sua vez, reconhece as transformações materiais então engendradas no projeto de direito baseado no predomínio da propriedade privada como Direito absoluto.<br>This article entangles several aspects of the transformation of the Colombian landscape in both, its material and symbolic faces, since the middle of the nineteenth until the third decade of the twentieth century. Consequently, it describes, and analyses the legal system, particularly those aspects related to the private and the public property of land. It argues first, about the importance of the Civil Code to understand the whole nineteenth century project; and second, about "waste lands" (baldíos: public lands without legal proprietors) which are of crucial interest to understand the whole process. It thinks about Law, not simply as a written norm, but in its environmental interaction. It also goes beyond the apparent chasm posed by sociology of Law as "law in books and law in action". It concludes that the dualistic "Law of the State" tended - unfolded as private and public Law - to monopolize the legal phenomenon engendering symbolic and material changes of a landscape that was territorially fragmented and heterogeneously appropriated

Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study

Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear. Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.</p