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Anticoagulation Among Patients Hospitalized for COVID-19:A Systematic Review and Prospective Meta-analysis
No full textBackground: Reported results of clinical trials assessing higher-dose anticoagulation in patients hospitalized for COVID-19 have been inconsistent.Purpose: To estimate the association of higher- versus lower-dose anticoagulation with clinical outcomes.Data Sources: Randomized trials were identified from the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov with no restriction by trial status or language.Study Selection: Eligible randomized trials assigned patients hospitalized for COVID-19 to higher- versus lower-dose anticoagulation.Data Extraction: 20 eligible trials provided data in a prospectively agreed format. Two further studies were included based on published data. The primary outcome was all-cause mortality 28 days after randomization. Secondary outcomes were progression to invasive mechanical ventilation or death, thromboembolic events, and major bleeding.Data Synthesis: Therapeutic- compared with prophylactic-dose anticoagulation with heparins reduced 28-day mortality (OR, 0.77 [95% CI, 0.64 to 0.93]; I 2 = 29%; 11 trials, 6297 patients, of whom 5456 required low or no oxygen at randomization). The ORs for 28-day mortality were 1.21 (CI, 0.93 to 1.58; I 2 = 0%) for therapeutic-dose compared with intermediate-dose anticoagulation (6 trials, 1803 patients, 843 receiving noninvasive ventilation at randomization) and 0.95 (CI, 0.76 to 1.19; I 2 = 0%; 10 trials, 3897 patients, 2935 receiving no or low oxygen at randomization) for intermediate- versus prophylactic-dose anticoagulation. Treatment effects appeared broadly consistent across predefined patient subgroups, although some analyses were limited in power. Higher- compared with lower-dose anticoagulation was associated with fewer thromboembolic events, but a greater risk for major bleeding.Conclusion: Therapeutic-dose compared with prophylactic-dose anticoagulation reduced 28-day mortality. Mortality was similar for intermediate-dose compared with prophylactic-dose anticoagulation and higher for therapeutic-dose compared with intermediate-dose anticoagulation, although this comparison was not estimated precisely
Hydrological vs. mechanical impacts of soil water repellency on erosion
Get PDFSoil erosion is a major concern for both agricultural and natural resources. Soil water repellency (SWR) is known to hinder wetting of soils, decreasing infiltration of water and thus increasing overland flow—the driving force for erosion. These hydrological impacts of SWR on erosion, are quite well established. In contrast, the mechanical impacts of SWR, namely on the resistance to erosion, are poorly understood. Here, we provide a critical review of the current understanding of both the hydrological and mechanical impacts of SWR on erosion. Analysis of compiled experimental data provides contradictory evidence: an increase in erosion with increasing SWR in some cases, versus a decrease in others, with a strong dependency on the mechanism (weather, fire, or pollution-induced SWR). We offer a plausible explanation for this contradiction—that the net erosional impacts of SWR depend on the balance between its hydrological and mechanical effects on erosion, and exemplify this in a simple 1D slope model. Our simulations illustrate the dual nature of SWR's influence on soil erosion, and explain the diversity of published data. Finally, we identify research gaps and suggest ways to address them
Fuzzy Logic-based Enhanced Edge Server Selection for Hierarchical Federated Learning
No full text—In the rapidly evolving landscape of federated learning (FL), hierarchical architectures are pivotal for improving computational efficiency and safeguarding data privacy. A key challenge in this research area is the optimal selection of edge servers, crucial for executing distributed learning tasks across multiple clients and servers efficiently. Traditional selection methods falter due to their inability to dynamically handle the uncertainties in network conditions and server capabilities. To addressing this weakness, we propose a fuzzy logic based approach that optimizes edge server selection in a novel smart way, thus enhancing resource allocation by efficiently handling the unpredictable nature of network environments and servers performance. This method is integrated with a previously developed scheme for selecting an optimal subset of clients,thereby establishing a comprehensive framework that significantly boosts the performance and reliability of FL networks.The performance of our approach is validated through real world experiments and the results demonstrate its superiority over existing methods in terms of accuracy and processing tim
Trust and public sector work:How public service motivation helps explain multi-level trust relations
No full textThis chapter explores the relationship between Public Service Motivation (PSM) and trust within public organisations. It provides an overview of the existing literature, structuring this around the interpersonal, intergroup, and organisational levels of analysis. The review points to a reciprocal relationship between trust and PSM, highlighting shared theoretical foundations and empirical insights across these two concepts, such as the importance of aligned values and common ground. The challenges and barriers in cultivating PSM and trust are considered within the context of contemporary public sector work, and avenues for further research outlined, namely that of cross-level trickle effects
The Time Machine Stops
No full textAs of this writing, 1653744144847 milliseconds have elapsed since midnight on January 1, 1970, the start of the “Unix Epoch,” so named for the operating system upon which the internet is based. While that date was chosen arbitrarily, it also denotes the onset of “computime,” which Jeremy Rifkin calls “the final abstraction of time and its complete separation from human experience and rhythms of nature.” This chapter explores this notion of computime from within the computer in the form of a dialogue set in the future, which takes place inside of a game that simulates nature. The religious scholar James Carse divided games into two types: “A finite game is played for the purpose of winning, an infinite game for the purpose of continuing the play.” One has temporal boundaries, the other eliminates them; one is defined externally by “world time,” the other defines time internally through the gameplay. Now the world outside of the computer begins to look finite: the passage of time appears as a form of energy that is progressively being dispersed, and when it has been exhausted, the game is over
Assessing the determinants of participation in the circular plastic economy by Nigerian students
No full textPurpose: This study aims to address the critical subject of building capacity for the circular economy in the global south. It complements the literature by providing information on the role of higher education institutions in developing skills for the circular plastic economy. Design/methodology/approach: This study used a mixed method approach drawing on reflective analysis on qualitative data from 5 focus groups and 12 semi-structured interviews, and structural equation modelling of quantitative data from 151 students across 4 Nigerian Universities. Findings: The results indicate that Nigerian university students are more likely to participate in the circular plastic economy through a high prominence of soft power features such as increased awareness, inspiration, idea generation, encouragement and capacity building. Research limitations/implications: The main limitation of this study is with the sample. A larger data set, including other tertiary institutions such as private universities, polytechnics and schools of vocational studies, would strengthen the results. Practical implications: The study underlines the importance of targeted policy interventions and pedagogic innovations to drive awareness and knowledge building among Nigeria’s youth population. Originality/value: This study makes a novel contribution by using empirical evidence to determine the predictors of student participation in the circular plastic economy. This understanding is important for the development and implementation of appropriate policies that promote participation in the circular plastic economy. Furthermore, given the typical youthful age bracket of university students, any plans to achieve a systemic shift in the plastic value chain must involve the young generation.</p
Life on the Breadline:The Role of Christians in Tackling Poverty in the UK
No full textThis chapter examines Christian engagement in tackling poverty in the UK over the last decade. We draw on three years of research which included interviews with 16 national UK Church leaders, an online survey with over 100 regional Church leaders, and six ethnographic case studies in Birmingham, London, and Manchester. We examine the different ways that Christians are responding to poverty in the UK—including caring, campaigning and advocacy, enterprise, and self-reliance—and explore the theological and ethical values that underpin their social action. We show that a key challenge facing both society and the Church is whether the Church is willing to use its social capital to resource campaigns seeking to transform structural injustice, rather than confining itself to welfare-based responses to poverty
Promoting the Well-Being of Asylum-Seeking and Refugee Children Within and Beyond the School Gates: Insights from the United Kingdom
No full textThis chapter provides a narrative synthesis of the research findings on the well-being of asylum-seeking and refugee children in the United Kingdom. The authors identified 36 research articles published in peer-review journals and thematically analyzed them to document these children’s negative experiences that could impact their well-being. The reported studies also explained the support mechanisms and interventions needed to sustain and improve child welfare and the challenges encountered in supporting their well-being. The research findings suggest that asylum-seeking and refugee children have diverse socioemotional and behavioral challenges, needs, expectations, psychological resources, and coping mechanisms that require schools to develop socioemotionally, culturally, or/and religiously sensitive responses for a more inclusive school environment
Strange/r/ness: (Post)digital Intimacies in Uncanny Worlds
No full textIn this article, we interrogate strange intimacies in digital culture by engaging with the multiplicity and ambiguities of the strange, the stranger, and strangeness. We situate our accounts in critical intimacies research, and those that apply this in context of digital, mediated, data, and postdigital cultures. We argue for a foregrounding of the strange, and recognise the parallels between intimacy’s resistance to singularity and the way the strange can only be approached as plurality and multiplicity. Experimenting with strange/r/ness, we then draw on a heteroglossic framework to explore four examples that differently position the strange, exploring how the strange is found, what it does, and what feelings of belonging or non-belonging it creates. Our examples broadly map onto bodily intimacies, our intimate knowledge of ourselves, belonging in communities, and the relationship between intimacy, society, and politics. They run from the micro to the macro, while the distinctions between these elements always remain permeable. We finish with a discussion of the value of bringing the intimate and the strange together, revealing their relationship to one another, and highlighting the critical capacity that developing these two concepts together permits