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To describe an outbreak of bacteremia caused by vancomycin-sensitive Enterococcus faecalis (VSEfe).
An investigation by retrospective case control and molecular typing by whole-genome sequencing (WGS).
A tertiary-care neonatal unit in Melbourne, Australia.
Risk factors for 30 consecutive neonates with VSEfe bacteremia from June 2011 to December 2014 were analyzed using a case control study. Controls were neonates matched for gestational age, birth weight, and year of birth. Isolates were typed using WGS, and multilocus sequence typing (MLST) was determined.
Bacteremia for case patients occurred at a median time after delivery of 23.5 days (interquartile range, 14.9–35.8). Previous described risk factors for nosocomial bacteremia did not contribute to excess risk for VSEfe. WGS typing results designated 43% ST179 as well as 14 other sequence types, indicating a polyclonal outbreak. A multimodal intervention that included education, insertion checklists, guidelines on maintenance and access of central lines, adjustments to the late onset sepsis antibiotic treatment, and the introduction of diaper bags for disposal of soiled diapers after being handled inside the bed, led to termination of the outbreak.
Typing using WGS identified this outbreak as predominately nonclonal and therefore not due to cross transmission. A multimodal approach was then sought to reduce the incidence of VSEfe bacteremia.
Within the growing field of publications on El Sistema and Sistema-inspired programmes around the world, a marked divide can be observed between the findings of critical academic studies and commissioned evaluations. Using evaluations of El Sistema in Venezuela and Aotearoa New Zealand as our principal case studies, we argue that this gulf can be explained at least partly by methodological problems in the way that some evaluations are carried out. We conclude that many Sistema evaluations display an alignment with advocacy rather than explorative research, and that the foundation for El Sistema's claims of social transformation is thus weak.
A model of a High Voltage CMOS (HV-CMOS) Monolithic Active Pixel Sensor (MAPS) has been modelled using Technology Computer Aided Design (TCAD). The model has incorporated both the active region and the on-pixel readout circuits which were comprised of a source follower amplifier and an integrated charge amplifier. The simulation has examined the electrical characteristics and response output of a HV-CMOS MAPS sensor using typical dimensions, levels of doping in the structural layers and bias conditions for this sensor. The performance of two alternate designs of amplifier have been examined as a function of the operating parameters. The response of the sensor to the incidence of Minimum Ionizing Particles (MIPs) at different energies has been included in the model.
This study tests novel methods for automatically identifying annual layers in a shallow Antarctic ice core (WDC05Q) using images that were collected with an optical scanner at the US National Ice Core Laboratory. A new method of optimized variance maximization (OVM) modeled the density-related changes in annual layer thickness directly from image variance. This was done by using multi-objective complex (MOCOM) parameter optimization to drive a low-pass filtering scheme. The OVM-derived changes in annual layer thickness corresponded well with the results of an independent glaciochemical interpretation of the core. Individual annual cycles in image brightness were then identified by using OVM results to apply a depth-varying low-pass filter and fitting a second-order polynomial to a locally detrended neighborhood. The resulting map of annual cycles agreed to within 1% of the overall annual count of the glaciochemical interpretation. Agreement on the presence of specific annual layer features was 96%. It was also shown that the MOCOM parameter optimization could calibrate the image-based results to match directly the date of a specific volcanic marker.
On 1 December 2011 the West Antarctic Ice Sheet (WAIS) Divide ice-core project reached its final depth of 3405 m. The WAIS Divide ice core is not only the longest US ice core to date, but is also the highest-quality deep ice core, including ice from the brittle ice zone, that the US has ever recovered. The methods used at WAIS Divide to handle and log the drilled ice, the procedures used to safely retrograde the ice back to the US National Ice Core Laboratory (NICL) and the methods used to process and sample the ice at the NICL are described and discussed.
To determine trends, patient characteristics, and outcome of patients with healthcare-associated influenza in Canadian hospitals.
Prospective surveillance of laboratory-confirmed influenza among hospitalized adults was conducted from 2006 to 2012. Adults with positive test results at or after admission to the hospital were assessed. Influenza was considered to be healthcare associated if symptom onset was equal to or more than 96 hours after admission to a facility or if a patient was readmitted less than 96 hours after discharge or admitted less than 96 hours after transfer from another facility. Baseline characteristics of influenza patients were collected. Patients were reassessed at 30 days to determine the outcome.
Acute care hospitals participating in the Canadian Nosocomial Infection Surveillance Program.
A total of 570 (17.3%) of 3,299 influenza cases were healthcare associated; 345 (60.5%) were acquired in a long-term care facility (LTCF), and 225 (39.5%) were acquired in an acute care facility (ACF). There was year-to-year variability in the rate and proportion of cases that were healthcare associated and variability in the proportion that were acquired in a LTCF versus an ACF. Patients with LTCF-associated cases were older, had a higher proportion of chronic heart disease, and were less likely to be immunocompromised compared with patients with ACF-associated cases; there was no significant difference in 30-day all-cause and influenza-specific mortality.
Healthcare-associated influenza is a major component of the burden of disease from influenza in hospitals, but the proportion of cases that are healthcare associated varies markedly from year to year, as does the proportion of healthcare-associated infections that are acquired in an ACF versus an LTCF.
In this chapter I address the meaning and representativity of the term ‘Cuban popular culture’ through two rather different test-cases, the first of which is the film Aventuras de Juan Quinquín (1967) by the Cuban film director Julio García-Espinosa (b. 1926), and the second the religious social phenomenon of santería. In each case I ask the question of the extent to which the energy of popular culture is co-opted into a new (revolutionary) value-system or whether, ultimately, it escapes that hermeneutic net. It is legitimate to argue that García-Espinosa's films as much as santería as we nowadays understand the phenomenon came into being as a result of the Cuban Revolution. The experience of a revolution in Cuba in 1959 was as decisive for its generation as the French Revolution had been for European intellectuals in the 1790s. As Hobsbawm puts it: ‘It was now known that social revolution was possible; that nationals existed as something independent of states, peoples as something independent of their rulers, and even that the poor existed as something independent of the ruling classes’ (1962: 91). Hobsbawm's last point about the ‘poor’ existing ‘as something independent of the ruling classes’ is particularly relevant to the Cuban context. Hugh Thomas provides a sense of Fidel Castro's particular personal impact among the popular sectors of Cuban society soon after the Revolution:
A month after Batista's flight, Castro had established a personal hold over the Cuban masses such as no Latin American leader had ever had. […] Castro appeared so often on the television screen (the State Department was already beginning to curse the salesmen of those 400,000 sets) that he resembled less a De Gaulle or a Kennedy (others who used television to effect) than a kind of permanent confessor or a resident revolutionary medicine man. (1971: 1193)
Unannounced transitions, ellipses, openings in medias res, truncated dénouements: examples from Lucrecia Martel's films would fill a textbook on the subject of the disruption of narrative linearity. Their apparent rejection of the codes of storytelling creates an uncertainty and an ambiguity that confound conventional modes of critical interpretation. This has certainly been the experience of many of Martel's critics, who have found her films – in particular, La ciénaga (The Swamp, 2001) and La niña santa (The Holy Girl, 2004) – stubbornly resistant to attempts to tease out deeper meanings or to place them within their socio-political context (see, for example, Aguilar 2006: 24; Varas and Dash 2007: 198; Gundermann 2005: 241; Page 2009: 182–94). To add to the confusion, at different times Martel has variously sanctioned or rejected allegorical readings of her films. She has been more consistent in describing La mujer sin cabeza (The Headless Woman, 2008) as an allegory of society's complicity in Argentina's most recent military regime (Enriquez 2008); however, as I will argue below, this reading may occlude a more radical understanding of the film's politics.
Martel's films steer us unequivocally away from transcendental modes of criticism which would seek an ideological or political ‘meaning’ for the text, and towards the immanent approaches advocated and practised by Deleuze, which refer us always to relations rather than essences, construction rather than interpretation, and to the text as assemblage rather than a set of signifying codes to be cracked.
Adopting city surfaces as their open canvas, Brazilian street artists inscribe São Paulo's built environment with a chaotic flow of colourful imagery and typographic scripts. Their cumulative input to the urban visual sphere constructs an alternative mediation of the cityscape based in mediatic excess, which disorients (or rather, reorients) the experience and expectations of urban conditions negotiated by city inhabitants on a daily basis. While paulistano street art practitioners frequently envision their creative endeavours as an ‘arte pro povo’ – a ‘popular’ public art located between the margins and the masses – because of their nonconformist (often unauthorized) use of public space, these amendments to urban content are routinely positioned as an excessive and disorderly social text which disrupts the appearance of prescribed visual order, seemingly beyond the control of the city authorities. Threatening formalized efforts (particularly by the state) to enforce orderly city planning or to maintain intended architectural aesthetics, such street art transgressions can subsequently become maligned as a contaminating presence, a ‘visual pollution’ which mars the cityscape.
Playing on this sense of pollution – at once evoking ecological, societal and aesthetic connotations – multiple street artists visually articulate their concern for the conditions of São Paulo's physical and social environments by engaging a ‘garbage’ framework within their art. Specifically, these eco-ethical discourses are achieved through the incorporation of waste management mechanisms (especially recycling and cleaning) into the construction of their artistic productions in order to highlight polluting behaviours habitually performed within the urban environment and social body.
This chapter discusses the work of internationally acclaimed, influential mixed-and multimedia artists who may be situated between the introduction in the 1990s in Cuba of the policy that granted artists the right to receive payment in convertible currency as well as to promote their work abroad freely, the introduction of a parallel currency for foreign visitors and investors (peso cubano convertible) and the ironic taking stock of the effects that such liberalization and commerce had on visual art practice referenced by the exhibition Cubanos convertibles in 2008. Its reflections play on the slippage between ‘convertible’ currency and convertible vehicles in relation to the value assigned to convertibility in aesthetic and cultural paradigms. These artists' deconstructivist strategies have sought to critique globalization while dismantling the complicitous ‘impurities’ and incongruities of their own productivity, seen through the distorting mirror of frustrated consumerism at home and the voracity of the free market paragons abroad that promote and consume their wares. The twisted skein of the analysis aims to discuss an interestingly impersonal (although archival) reflexive trend in contemporary art that, fibred by notions of social responsibility, participatory spectatorship and dissent, has explored the notion of ‘recycling’ as broadly inclusive of material disjecta with attendant ideas of ingestion and reconversion. Pieces have been predicated on the shift of emphasis from the phenomenology of ‘beholding’ to the involvement of the public as recipient, correspondent, interlocutor or user, with attention focused on the body of the observer and on experience.
In this chapter I would like to reflect on the ways in which the Magdalena river has figured both in the imaginary production of a Colombian national-popular body, and in its dissolution, and at key moments in Colombian history from the mid-nineteenth century to the beginning of the twenty-first. I do so not to reclaim the river and its landscape, in a Romantic vein, as the wellspring of some authentic national ‘spirit’. Instead I am more interested in how instances of the articulation of such a thing occur in both real and imagined spaces where the nation's integrity is most questionable and the porosity of its borders most conspicuous.
As the principal route for the traffic of people, ideas and capital between colonial times and the early twentieth century, the Magdalena was for a long time central to the construction of the nation. Even today, as flows of global capital and information have displaced the organic motif of the river as an index of historical time and of the nation's temporal unfolding (see Appadurai 1996; Castells 2000), the Magdalena retains an affectively loaded presence in works of Colombian art and literature. Thus, in texts such as Fernando Vallejo's El río del tiempo (1998), where nature's collapse mirrors the entropy of Colombian public life, or films such as Bolívar soy yo (Jorge Alí Triana 2002), where history dissolves into the two dimensionality of the spectacle, the Magdalena continues to perform a labour of figuration, albeit of the nation's destiny as pipedream or curse.