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An unprecedented outbreak of Ebola virus diseases (EVD) occurred in West Africa from March 2014 to January 2016. The French Institute for Public Health implemented strengthened surveillance to early identify any imported case and avoid secondary cases.
Febrile travellers returning from an affected country had to report to the national emergency healthcare hotline. Patients reporting at-risk exposures and fever during the 21st following day from the last at-risk exposure were defined as possible cases, hospitalised in isolation and tested by real-time polymerase chain reaction. Asymptomatic travellers reporting at-risk exposures were considered as contact and included in a follow-up protocol until the 21st day after the last at-risk exposure.
From March 2014 to January 2016, 1087 patients were notified: 1053 were immediately excluded because they did not match the notification criteria or did not have at-risk exposures; 34 possible cases were tested and excluded following a reliable negative result. Two confirmed cases diagnosed in West Africa were evacuated to France under stringent isolation conditions. Patients returning from Guinea (n = 531; 49%) and Mali (n = 113; 10%) accounted for the highest number of notifications.
No imported case of EVD was detected in France. We are confident that our surveillance system was able to classify patients properly during the outbreak period.
Infants in the neonatal intensive care unit (NICU) are at increased risk for methicillin-resistant Staphylococcus aureus (MRSA) acquisition. Outbreaks may be difficult to identify due in part to limitations in current molecular genotyping available in clinical practice. Comparison of genome-wide single nucleotide polymorphisms (SNPs) may identify epidemiologically distinct isolates among a population sample that appears homogenous when evaluated using conventional typing methods.
To investigate a putative MRSA outbreak in a NICU utilizing whole-genome sequencing and phylogenetic analysis to identify recent transmission events.
Clinical and surveillance specimens collected during clinical care and outbreak investigation.
A total of 17 neonates hospitalized in a 43-bed level III NICU in northeastern Florida from December 2010 to October 2011 were included in this study.
We assessed epidemiological data in conjunction with 4 typing methods: antibiograms, PFGE, spa types, and phylogenetic analysis of genome-wide SNPs.
Among the 17 type USA300 isolates, 4 different spa types were identified using pulsed-field gel electrophoresis. Phylogenetic analysis identified 5 infants as belonging to 2 clusters of epidemiologically linked cases and excluded 10 unlinked cases from putative transmission events. The availability of these results during the initial investigation would have improved infection control interventions.
Whole-genome sequencing and phylogenetic analysis are invaluable tools for epidemic investigation; they identify transmission events and exclude cases mistakenly implicated by traditional typing methods. When routinely applied to surveillance and investigation in the clinical setting, this approach may provide actionable intelligence for measured, appropriate, and effective interventions.
Infect. Control Hosp. Epidemiol. 2015;36(7):777–785
Although playing a key role in the understanding of the supernova phenomenon, the evolution of massive stars still suffers from uncertainties in their structure, even during their “quiet” main sequence phase and later on during their subgiant and helium burning phases. What is the extent of the mixed central region? In the local mixing length theory (LMLT) frame, are there structural differences using Schwarzschild or Ledoux convection criterion? Where are located the convective zone boundaries? Are there intermediate convection zones during MS and post-MS phase, and what is their extent and location? We discuss these points and show how asteroseismology could bring some light on these questions.
A mixed finite element method for the Navier–Stokes equations is introduced in which the
stress is a primary variable. The variational formulation retains the mathematical
structure of the Navier–Stokes equations and the classical theory extends naturally to
this setting. Finite element spaces satisfying the associated inf–sup conditions are
Ensembles of indium phosphide nanowires were grown on amorphous quartz substrates and their optical properties were examined at various cryogenic temperatures. Complex dynamics result from the large areal densities, random orientation, combination of both zincblende and wurtzite phases, and the geometries of the nanowires. Those complex dynamics are discussed in relation to their effect on the temperature dependence of photoluminescence and Raman spectroscopy. Five peaks are found to exist in the photoluminescence spectra at low temperatures which are attributed to radiative recombinations associated with quantum confined zinc blende, quantum confined excitons in zinc blende, quantum confined wurtzite, excitons in bulk zinc blende and impurity states. An energy transfer mechanism between two types of radiative recombinations among the five is proposed to explain intensity variations and the temperature dependence of the PL peaks is discussed. The Raman spectra is observed to have peaks created by a combination of zinc blende and wurtzite vibrational modes which is explained by folding the phonon dispersion.
Mexico has experienced significant changes in social welfare policy since the early 1990s. The administrations of Ernesto Zedillo Ponce de León (1994–2000) and Vicente Fox Quesada (2000–2006) redesigned programs providing basic health care, housing, education, and retirement pensions in order to broaden access to these services. In some instances (particularly the partial privatization of health care and the creation of privately managed retirement pensions), meeting the goal of expanded program access in the context of continuing revenue shortages required the government to shift part of the responsibility for welfare provision from the public sector to individuals and families. The Zedillo and Fox administrations also adopted more selectively targeted programs aimed at reducing poverty in Mexico.
One key element underpinning these changes was a marked shift in the political logic shaping welfare policy making. In the social welfare model that developed during the period of Institutional Revolutionary Party (PRI) hegemony from the late 1930s through the 1980s, select constituencies gained access to public services as a form of patronage. Indeed, there was a wide gap between an official rhetoric proclaiming the federal government's constitutionally mandated responsibility to cover the basic welfare needs of all Mexican citizens, and actual policy practice. Programs such as President Carlos Salinas de Gortari's (1988–1994) main poverty-alleviation initiative, the National Solidarity Program (PRONASOL), were notably politicized.
In Chapter Three we discussed the surprisingly slow growth of the Mexican economy once it opened up to foreign trade and investment. We noted that one of the causes of Mexico's sluggish economic performance since the mid-1990s has been the scarcity of credit for firms and households. Indeed, whether we compare Mexico with other members of the Organisation for Economic Co-operation and Development (OECD) or with other Latin American countries, Mexico has an extraordinarily small banking system. As Figure 4.1 demonstrates, in 2005 the ratio of private credit to gross domestic product (GDP) in Mexico was the smallest of any OECD country. Moreover, it was the smallest by a very wide margin, even when compared with the economies of Southern and Eastern Europe. Mexico also does not fare well when compared with other Latin American countries. As Figure 4.2 shows, in 2005 Mexico's banking system, as a percentage of GDP, was dwarfed by those of Chile, Honduras, Uruguay, Bolivia, Costa Rica, Brazil, and even Nicaragua. It was even small by the standards of Ecuador, Peru, Colombia, and Guatemala. In fact, in 2005 there were only two countries in the region with banking systems that were appreciably smaller than Mexico's: Argentina and Venezuela.
Perhaps even more surprising is the fact that Mexico's banking system has been shrinking over time. As Figure 4.3 makes clear, the ratio of bank loans to GDP in Mexico declined drastically between 1994 and 2005.
Since the early 1980s Mexico has experienced momentous economic, political, and social change. Of the various transformations examined in the preceding chapters of this book, the consolidation of a competitive electoral democracy was particularly important because it ended well over a century of authoritarian rule and established essential (albeit insufficient) bases for a liberal-democratic order. The combination of free and fair elections, intense multiparty competition for power, and heightened media scrutiny of political developments has significantly increased Mexican citizens' capacity to hold government officials accountable for their public actions. Partisan alternation in power at the national level and assertive actions by federal legislators and judicial authorities in a more effective system of checks and balances have also greatly constrained what was once an all-powerful presidency. Moreover, nongovernmental organizations and other civil society groups with widely divergent goals and partisan loyalties play an important role in what is an increasingly pluralistic public policy-making process.
Nevertheless, Mexico is burdened by multiple legacies of authoritarianism and the rent-seeking coalitions that ruled the country until the end of the twentieth century. For instance, the persistence of public monopolies and private oligopolies in key economic sectors, and the weakness of government regulatory authorities charged with promoting competition and protecting consumer rights, are direct legacies of the concentrated political and economic power that characterized Mexico under the Institutional Revolutionary Party (PRI) and the fact that the privatization of many state-owned firms during the 1980s and early 1990s occurred while that regime still held sway.
This book is about a revolution – albeit an incomplete one. It had none of the features that political analysts typically associate with revolutions: no organized violence, no overturning of the social class structure, and no defeated dictator fleeing into exile. Nevertheless, if by “revolution” we mean a dramatic change in the institutions that organize economic, political, and social life, then Mexico has undoubtedly been in the midst of a revolution since the early 1980s.
In 1980, Mexico was largely closed to foreign trade and investment; government-owned firms controlled a substantial portion of the economy. An “official” party, the Institutional Revolutionary Party (PRI), held a virtual monopoly on political power. Since its creation in 1929, Mexico's government-supported party had won every presidential, gubernatorial, and senatorial election. To maintain a façade of democracy, PRI-led administrations crafted a complex set of electoral rules that allowed other parties, some of which were actually subsidized by the government, to win seats in the federal Chamber of Deputies (Mexico's lower house of congress). The PRI, however, always dominated this chamber by an overwhelming majority. The PRI used its electoral dominance to maintain control over Mexico's regulatory and legal systems: PRI-affiliated government officials named state and federal judges and the directors of government-owned firms as well as making appointments in the federal bureaucracy.
The Institutional Revolutionary Party (PRI) was fortunate that the presidential election held in July 1982 took place before the government announced a debt moratorium in August and nationalized private banks in September. For several decades the party had sought to legitimate its monopoly on power on the basis of Mexico's record of sustained economic growth and rising living standards for urban and industrial workers and other key constituencies. Those claims to legitimacy were, however, now difficult to sustain. The value of the peso had collapsed. In 1981 the peso–U.S. dollar exchange rate was 26:1; by 1983 it was 144:1, and by 1985 it was 372:1. Inflation skyrocketed. Investment contracted, with the ratio of gross fixed capital formation to gross domestic product (GDP) falling from 27 percent in 1980 to 18 percent in 1983 (see Figure 3.1). The wages of Mexican workers went into a free fall. Hourly wages in the manufacturing sector, adjusted for inflation, fell by 26 percent from 1981 to 1983 – and then kept falling. By 1986 they were only 51 percent of their 1981 level (see Figure 3.2).
The government needed to find ways of protecting the interests of its principal constituencies or the party risked losing its hold on power. The immediate challenge was to rekindle growth, which required that the government devise some means of inducing investment.