The Tsar's Happy Occasion shows how the vast, ornate affairs that were royal weddings in early modern Russia were choreographed to broadcast powerful images of monarchy and dynasty. Processions and ...speeches emphasized dynastic continuity and legitimacy. Fertility rites blended Christian and pre-Christian symbols to assure the birth of heirs. Gift exchanges created and affirmed social solidarity among the elite. The bride performed rituals that integrated herself and her family into the inner circle of the court. Using an array of archival sources, Russell E. Martin demonstrates how royal weddings reflected and shaped court politics during a time of dramatic cultural and dynastic change. As Martin shows, the rites of passage in these ceremonies were dazzling displays of monarchical power unlike any other ritual at the Muscovite court. And as dynasties came and went and the political culture evolved, so too did wedding rituals. Martin relates how Peter the Great first mocked, then remade wedding rituals to symbolize and empower his efforts to westernize Russia. After Peter, the two branches of the Romanov dynasty used weddings to solidify their claims to the throne. The Tsar's Happy Occasion offers a sweeping, yet penetrating cultural history of the power of rituals and the rituals of power in early modern Russia.
Highly porous metal-organic frameworks (MOFs), which have undergone exciting developments over the past few decades, show promise for a wide range of applications. However, many studies indicate that ...they suffer from significant stability issues, especially with respect to their interactions with water, which severely limits their practical potential. Here we demonstrate how the presence of 'sacrificial' bonds in the coordination environment of its metal centres (referred to as hemilability) endows a dehydrated copper-based MOF with good hydrolytic stability. On exposure to water, in contrast to the indiscriminate breaking of coordination bonds that typically results in structure degradation, it is non-structural weak interactions between the MOF's copper paddlewheel clusters that are broken and the framework recovers its as-synthesized, hydrated structure. This MOF retained its structural integrity even after contact with water for one year, whereas HKUST-1, a compositionally similar material that lacks these sacrificial bonds, loses its crystallinity in less than a day under the same conditions.
God, Tsar, and People brings together in one volume essays written over a period of fifty years, using a wide variety of evidence—texts, icons, architecture, and ritual—to reveal how early modern ...Russians (1450–1700) imagined their rapidly changing political world. This volume presents a more nuanced picture of Russian political thought during the two centuries before Peter the Great came to power than is typically available. The state was expanding at a dizzying rate, and atop Russia's traditional political structure sat a ruler who supposedly reflected God's will. The problem facing Russians was that actual rulers seldom—or never—exhibited the required perfection. Daniel Rowland argues that this contradictory set of ideas was far less autocratic in both theory and practice than modern stereotypes would have us believe. In comparing and contrasting Russian history with that of Western European states, Rowland is also questioning the notion that Russia has always been, and always viewed itself as, an authoritarian country. God, Tsar, and People explores how the Russian state in this period kept its vast lands and diverse subjects united in a common view of a Christian polity, defending its long frontier against powerful enemies from the East and from the West.
Metal–organic frameworks (MOFs) are a class of porous materials that show promise in the removal of toxic industrial chemicals (TICs) from contaminated airstreams, though their development for this ...application has so far been hindered by issues of water stability and the wide availability and low cost of traditionally used activated carbons. Here a series of three MOF‐activated carbon composite materials with different MOF to carbon ratios are prepared by growing STAM‐17‐OEt crystals inside the commercially available BPL activated carbon. The composite materials display excellent water stability and increased uptake of ammonia gas when compared to unimpregnated carbon. Such properties make these composites very promising in the fields of air purification and personal protective equipment.
Crystals in coal: A new series of MOF‐activated carbon composite materials are synthesised, using the copper MOF: STAM‐17‐OEt and commercially available BPL activated carbon. STAM‐17‐OEt is grown inside BPL carbon at three loadings to provide a series of granular materials that display excellent gas adsorption properties and water stability.
Extracellular vesicles (EVs) are an important intercellular communication system facilitating the transfer of macromolecules between cells. Delivery of exogenous cargo tethered to the EV surface or ...packaged inside the lumen are key strategies for generating therapeutic EVs. We identified two “scaffold” proteins, PTGFRN and BASP1, that are preferentially sorted into EVs and enable high-density surface display and luminal loading of a wide range of molecules, including cytokines, antibody fragments, RNA binding proteins, vaccine antigens, Cas9, and members of the TNF superfamily. Molecules were loaded into EVs at high density and exhibited potent in vitro activity when fused to full-length or truncated forms of PTGFRN or BASP1. Furthermore, these engineered EVs retained pharmacodynamic activity in a variety of animal models. This engineering platform provides a simple approach to functionalize EVs with topologically diverse macromolecules and represents a significant advance toward unlocking the therapeutic potential of EVs.
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Extracellular vesicles (EVs) are natural mediators of cell-cell communication and thus potential vehicles for drug delivery. Dooley et al. describe an EV engineering platform based on two scaffold proteins, PTGFRN and BASP1, which enable high-density EV surface display and luminal loading of therapeutic cargo, leading to potent, pharmacodynamic activity in vitro and in vivo.
Purpose
Invasive pulmonary aspergillosis is increasingly reported in patients with influenza admitted to the intensive care unit (ICU). Classification of patients with influenza-associated pulmonary ...aspergillosis (IAPA) using the current definitions for invasive fungal diseases has proven difficult, and our aim was to develop case definitions for IAPA that can facilitate clinical studies.
Methods
A group of 29 international experts reviewed current insights into the epidemiology, diagnosis and management of IAPA and proposed a case definition of IAPA through a process of informal consensus.
Results
Since IAPA may develop in a wide range of hosts, an entry criterion was proposed and not host factors. The entry criterion was defined as a patient requiring ICU admission for respiratory distress with a positive influenza test temporally related to ICU admission. In addition, proven IAPA required histological evidence of invasive septate hyphae and mycological evidence for
Aspergillus
. Probable IAPA required the detection of galactomannan or positive
Aspergillus
culture in bronchoalveolar lavage (BAL) or serum with pulmonary infiltrates or a positive culture in upper respiratory samples with bronchoscopic evidence for tracheobronchitis or cavitating pulmonary infiltrates of recent onset. The IAPA case definitions may be useful to classify patients with COVID-19-associated pulmonary aspergillosis (CAPA), while awaiting further studies that provide more insight into the interaction between
Aspergillus
and the SARS-CoV-2-infected lung.
Conclusion
A consensus case definition of IAPA is proposed, which will facilitate research into the epidemiology, diagnosis and management of this emerging acute and severe
Aspergillus
disease, and may be of use to study CAPA.
OBJECTIVES:Administrative claims data are commonly used for sepsis surveillance, research, and quality improvement. However, variations in diagnosis, documentation, and coding practices for sepsis ...and organ dysfunction may confound efforts to estimate sepsis rates, compare outcomes, and perform risk adjustment. We evaluated hospital variation in the sensitivity of claims data relative to clinical data from electronic health records and its impact on outcome comparisons.
DESIGN, SETTING, AND PATIENTS:Retrospective cohort study of 4.3 million adult encounters at 193 U.S. hospitals in 2013–2014.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:Sepsis was defined using electronic health record–derived clinical indicators of presumed infection (blood culture draws and antibiotic administrations) and concurrent organ dysfunction (vasopressors, mechanical ventilation, doubling in creatinine, doubling in bilirubin to ≥ 2.0 mg/dL, decrease in platelets to < 100 cells/µL, or lactate ≥ 2.0 mmol/L). We compared claims for sepsis prevalence and mortality rates between both methods. All estimates were reliability adjusted to account for random variation using hierarchical logistic regression modeling. The sensitivity of hospitals’ claims data was low and variablemedian 30% (range, 5–54%) for sepsis, 66% (range, 26–84%) for acute kidney injury, 39% (range, 16–60%) for thrombocytopenia, 36% (range, 29–44%) for hepatic injury, and 66% (range, 29–84%) for shock. Correlation between claims and clinical data was moderate for sepsis prevalence (Pearson coefficient, 0.64) and mortality (0.61). Among hospitals in the lowest sepsis mortality quartile by claims, 46% shifted to higher mortality quartiles using clinical data. Using implicit sepsis criteria based on infection and organ dysfunction codes also yielded major differences versus clinical data.
CONCLUSIONS:Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals’ sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital comparisons.
The Tsar's Happy Occasion
shows how the vast, ornate affairs that were royal weddings
in early modern Russia were choreographed to broadcast powerful
images of monarchy and dynasty. Processions and ...speeches
emphasized dynastic continuity and legitimacy. Fertility rites
blended Christian and pre-Christian symbols to assure the birth of
heirs. Gift exchanges created and affirmed social solidarity among
the elite. The bride performed rituals that integrated herself and
her family into the inner circle of the court.
Using an array of archival sources, Russell E. Martin
demonstrates how royal weddings reflected and shaped court politics
during a time of dramatic cultural and dynastic change. As Martin
shows, the rites of passage in these ceremonies were dazzling
displays of monarchical power unlike any other ritual at the
Muscovite court. And as dynasties came and went and the political
culture evolved, so too did wedding rituals. Martin relates how
Peter the Great first mocked, then remade wedding rituals to
symbolize and empower his efforts to westernize Russia. After
Peter, the two branches of the Romanov dynasty used weddings to
solidify their claims to the throne.
The Tsar's Happy Occasion offers a sweeping, yet
penetrating cultural history of the power of rituals and the
rituals of power in early modern Russia.
Positron emission tomography (PET) and magnetic resonance imaging (MRI) are widely used in vivo imaging technologies with both clinical and biomedical research applications. The strengths of MRI ...include high-resolution, high-contrast morphologic imaging of soft tissues; the ability to image physiologic parameters such as diffusion and changes in oxygenation level resulting from neuronal stimulation; and the measurement of metabolites using chemical shift imaging. PET images the distribution of biologically targeted radiotracers with high sensitivity, but images generally lack anatomic context and are of lower spatial resolution. Integration of these technologies permits the acquisition of temporally correlated data showing the distribution of PET radiotracers and MRI contrast agents or MR-detectable metabolites, with registration to the underlying anatomy. An MRI-compatible PET scanner has been built for biomedical research applications that allows data from both modalities to be acquired simultaneously. Experiments demonstrate no effect of the MRI system on the spatial resolution of the PET system and <10% reduction in the fraction of radioactive decay events detected by the PET scanner inside the MRI. The signal-to-noise ratio and uniformity of the MR images, with the exception of one particular pulse sequence, were little affected by the presence of the PET scanner. In vivo simultaneous PET and MRI studies were performed in mice. Proof-of-principle in vivo MR spectroscopy and functional MRI experiments were also demonstrated with the combined scanner.
Purpose
Invasive pulmonary aspergillosis (IPA) is increasingly reported in patients with severe coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU). Diagnosis and management ...of COVID-19 associated pulmonary aspergillosis (CAPA) are challenging and our aim was to develop practical guidance.
Methods
A group of 28 international experts reviewed current insights in the epidemiology, diagnosis and management of CAPA and developed recommendations using GRADE methodology.
Results
The prevalence of CAPA varied between 0 and 33%, which may be partly due to variable case definitions, but likely represents true variation. Bronchoscopy and bronchoalveolar lavage (BAL) remain the cornerstone of CAPA diagnosis, allowing for diagnosis of invasive
Aspergillus
tracheobronchitis and collection of the best validated specimen for
Aspergillus
diagnostics. Most patients diagnosed with CAPA lack traditional host factors, but pre-existing structural lung disease and immunomodulating therapy may predispose to CAPA risk. Computed tomography seems to be of limited value to rule CAPA in or out, and serum biomarkers are negative in 85% of patients. As the mortality of CAPA is around 50%, antifungal therapy is recommended for BAL positive patients, but the decision to treat depends on the patients’ clinical condition and the institutional incidence of CAPA. We recommend against routinely stopping concomitant corticosteroid or IL-6 blocking therapy in CAPA patients.
Conclusion
CAPA is a complex disease involving a continuum of respiratory colonization, tissue invasion and angioinvasive disease. Knowledge gaps including true epidemiology, optimal diagnostic work-up, management strategies and role of host-directed therapy require further study.
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