Rising incidence, progression and changing patterns of liver disease in Wales 1999-2019

BACKGROUND Liver disease incidence and hence demand on hepatology services is increasing. AIM To describe trends in incidence and natural history of liver diseases in Wales to inform effective provision of hepatology services. METHODS The registry is populated by International Classification of Diseases-10 (ICD-10) code diagnoses for residents derived from mortality data and inpatient/day case activity between 1999-2019. Pseudo-anonymised linkage of: (1) Causative diagnoses; (2) Cirrhosis; (3) Portal hypertension; (4) Decompensation; and (5) Liver cancer diagnoses enabled tracking liver disease progression. RESULTS The population of Wales in 2019 was 3.1 million. Between 1999 and 2019 73054 individuals were diagnosed with a hepatic disorder, including 18633 diagnosed with cirrhosis, 10965 with liver decompensation and 2316 with hepatocellular carcinoma (HCC). Over 21 years the incidence of liver diseases increased 3.6 fold, predominantly driven by a 10 fold increase in non-alcoholic fatty liver disease (NAFLD); the leading cause of liver disease from 2014. The incidence of cirrhosis, decompensation, HCC, and allcause mortality tripled. Liver-related mortality doubled. Alcohol-related liver disease (ArLD), autoimmune liver disease and congestive hepatopathy were associated with the highest rates of decompensation and all-cause mortality. CONCLUSION A 10 fold increase in NAFLD incidence is driving a 3.6 fold increase in liver disease in Wales over 21 years. Liver-related morbidity and mortality rose more slowly reflecting the lower progression rate in NAFLD. Incidence of ArLD remained stable but was associated with the highest rates of liver-related and all-cause mortality

Urban semiosis: Creative industries and the clash of systems

© The Author(s) 2014. This article has two aims. The first is to make the case that the ‘universe of the mind’ imagined by Yuri Lotman may be considered as a foundational model for cultural evolution (population-wide, dynamic, autopoietic, self-organising adaptation to changing environments). The second aim is to take forward a model of culture derived from Lotman’s work – a model I call ‘the clash of systems’ – in order to apply it to creative industries research. Such a move has the salutary effect of putting the ‘universe of the mind’ literally in its place. That place, now, predominantly, is in the city. Thus, the article uses Lotman’s model of the semiosphere to link different complex systems, principally the semiosphere with that of the city, in order to explore the productive potential of encounters – clashes – between different systems. Applying these insights to the field of creative industries research, the article proposes that creative culture in the globalised, urban and web-connected era can be characterised as ‘urban semiosis’

Intermedial Relationships of Radio Features with Denis Mitchell’s and Philip Donnellan’s Early Television Documentaries

Writing of the closure in early 1965 of the Radio Features Department, Asa Briggs identifies one of the reasons for the controversial decision as ‘the incursion of television, which was developing its own features.’ ‘[Laurence] Gilliam and his closest colleagues believed in the unique merits of “pure radio”. The screen seemed a barrier’ (The History of Broadcasting in the United Kingdom, Vol. 5, p. 348). Rather than the screen being ‘a barrier’ for them, a number of the creators of the emerging television documentary were from the late 1950s onwards able to transfer and transform distinctive techniques of ‘pure radio’ into highly effective visual forms. Two key figures were the producers of ‘poetic’ documentaries Denis Mitchell and Philip Donnellan, who employed layered voices, imaginative deployments of music and effects, and allusive juxtapositions of sound and image, to develop an alternative (although always marginal) tradition to the supposedly objective approaches of current affairs and, later, verité filmmakers. And a dozen years after the dismemberment of the Features Department, Donnellan paid tribute to it in his glorious but little-seen film Pure Radio (BBC1, 3 November 1977). Taking important early films by Mitchell and Donnellan as case studies, this paper explores the impact of radio features on television documentaries in the 1950s and early 1960s, and assesses the extent to which the screen in its intermedial relationships with ‘pure radio’ was a barrier or, in the work of certain creators, an augmentation

History of the Antarctic sovereignty dispute between Britain, Argentina, and Chile, 1939-1959

textThis dissertation investigates the causes, development, and the partial resolution of the Antarctic sovereignty dispute that took place between Britain, Argentina, and Chile between 1939 and 1959. It has two interconnected arguments. The first argument is that the dispute had its roots in a clash between British imperialism and South American nationalism, and, as a consequence, ought to be seen as part of the wider history of European decolonization in the years during and after the Second World War. The second argument is that the history of the sovereignty dispute offers an excellent opportunity for "doing environmental history" due to the relative simplicity of human-nature-culture interactions in Antarctica. By putting these two arguments together, it becomes possible to write an "environmental history of decolonization." Within the context of the sovereignty dispute, this dissertation asks the question: what happened to British imperial claims to "dominion over nature" during the decolonization of the British Empire in the mid-twentieth century? Over the course of the sovereignty dispute, Argentina and Chile sought to challenge Britain's claims to "environmental authority" in Antarctica with their own "environmental nationalism." Rather than conceding to the South American challenge, Britain initially responded by redoubling its efforts to maintain Antarctic sovereignty. However, as the three countries learned more about the reality of the Antarctic environment, their political perceptions of the region changed. The British, in particular, became less attached to exclusive sovereignty and successfully negotiated a limited international regime that would retain their political influence without the need for formal control. The Antarctic Treaty of 1959 brought a partial end to the sovereignty dispute by "freezing" all sovereignty claims for its duration.Histor

Shaw's textbook of gyn ecology

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