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The book of Esther is one of the most challenging books in the Hebrew Bible/Old Testament, not only because of the difficulty of understanding the book itself in its time, place, and literary contexts, but also for the long and tortuous history of interpretation it has generated in both Jewish and Christian traditions. In this volume, Isaac Kalimi addresses both issues. He situates 'traditional' literary, textual, theological, and historical-critical discussion of Esther alongside comparative Jewish and Christian interpretive histories, showing how the former serves the latter. Kalimi also demonstrates how the various interpretations of the Book of Esther have had an impact on its reception history, as well as on Jewish-Christian relations. Based on meticulous and comprehensive analysis of all available sources, Kalimi's volume fills a gap in biblical, Jewish, and Christian studies and also shows how and why the Book of Esther became one of the central books of Judaism and one of the most neglected books in Christianity.
Global instabilities in swirling flows can significantly alter the flame and flow dynamics of swirl-stabilized flames, such as those in modern gas turbine engines. In this study, we characterize the interaction between the precessing vortex core (PVC), which is the consequence of a global hydrodynamic instability, and thermoacoustic instabilities, which are the result of a coupling between combustor acoustics and the unsteady heat release rate. This study is performed using experimental data obtained from a model gas turbine combustor employing two concentric swirling nozzles of air, separated by a ring of fuel injectors, operating at five bar pressure. The flow split between the two streams is systematically varied to observe the impact of flow structure variation on the system dynamics at both non-reacting and reacting conditions. High-speed stereoscopic particle image velocimetry, OH planar laser-induced fluorescence and acetone planar laser-induced fluorescence are used to obtain information about the velocity fields, flame and fuel flow behaviour, respectively. Spectral proper orthogonal decomposition and a complex network analysis are used to identify and characterize the dominant oscillation mechanisms driving the system. In the non-reacting data, a PVC is present in most cases and the amplitude of the oscillation increases with increasing flow through the centre nozzle. In the reacting data, three dominant modes are seen: two thermoacoustic modes and the PVC. Our results show that in the cases where the frequency of the PVC overlaps with either of the thermoacoustic modes, the thermoacoustic modes are suppressed. The complex network analysis coupled with a weakly nonlinear theoretical analysis suggests the mechanisms by which this coupling and suppression of the thermoacoustic mode occur.
“Context” has been increasingly featured and acknowledged in second language (L2) research because L2 teaching is recognised to be shaped by the environments in which it is situated. Numerous theoretical perspectives were introduced to L2 research that aim to capture the contextual forces at work in teaching and learning, including but not limited to Activity Theory, Complexity Theory, and Sociocultural Theory. Activity Theory holds that a learner's motives (human needs directed towards an object) are highly malleable, subject to the influence of such contextual variables as institutional rules, community, tools and artefacts available (see Leont'ev, 1978, 1981 who popularised Activity Theory from Sergei Rubenstein's founding and also Engeström's more current work in 1999). Complexity Theory, which has been widely adopted in both physical and social sciences, originates from physics (Martin et al., 2019). Complexity Theory was later introduced into L2 research by Diane Larsen-Freeman who posits that language learning is not only a process but a volatile and emerging system that is shaped by components of the system (e.g., learners, teachers, schools) engaging in constant and vibrant interactions (Larsen-Freeman, 2014). Sociocultural Theory highlights the sociocultural contexts where learning takes place (Lantolf, 2000; Vygotsky, 1978). Informed by a social constructivist view of learning, key concepts such as scaffolding (e.g., teachers’ support for learners) are put forward. In particular, Vygotsky argues that communication plays an indispensable role in language learning. Extrapolating Vygotsky's work to L2 research, Swain (2006) claims that languaging, dialogues among learners to discuss issues in L2 learning, is an important process of learning a L2.
We aimed to examine how public health policies influenced the dynamics of COVID-19 time-varying reproductive number (Rt) in South Carolina from February 26, 2020 to January 1, 2021.
Methods:
COVID-19 case series (March 6, 2020 - January 10, 2021) were shifted by 9 days to approximate the infection date. We analyzed the effects of state and county policies on Rt using EpiEstim. We performed linear regression to evaluate if per-capita cumulative case count varies across counties with different population size.
Results:
Rt shifted from 2-3 in March to <1 during April and May. Rt rose over the summer and stayed between 1.4 and 0.7. The introduction of statewide mask mandates was associated with a decline in Rt (-15.3%; 95% CrI, -13.6%, -16.8%), and school re-opening, an increase by 12.3% (95% CrI, 10.1%, 14.4%). Less densely populated counties had higher attack rate (p<0.0001).
Conclusion:
The Rt dynamics over time indicated that public health interventions substantially slowed COVID-19 transmission in South Carolina, while their relaxation may have promoted further transmission. Policies encouraging people to stay home, such as closing non-essential businesses, were associated with Rt reduction, while policies that encouraged more movement, such as re-opening schools, were associated with Rt increase.
Across the range of African elephants Loxodonta spp., negative interactions with people are prevalent, and the impact of the resulting economic losses on farmers calls for solutions. The use of beehive fences, a mitigation method with ecological and socio-economic benefits, is gaining momentum in African savannah landscapes. We assessed the diurnal and nocturnal defensive behaviours of African honeybees Apis mellifera adansonii in response to visual and physical disturbances in the Campo–Ma'an conservation area, Cameroon. We examined six bee colonies, assessing their activity level, aggressive behaviour and ability to defend themselves when disturbed at different times of day. We found that activity levels varied between colonies and that colonies were more active during the day and inactive at night. The defensive perimeter around the hives also varied between the colonies and was generally greater during morning and evening periods. Bee colonies did not defend their hives around midday and at night. In response to a threat, bees were more likely to fly out from the hive during daytime than at night, with variation amongst colonies. Overall, as elephant intrusions occur mostly at night, beehive fences alone may not be an adequate mitigation method against crop damage caused by forest elephants Loxodonta cyclotis. We suggest combining beehive fences with other mitigation methods to improve crop protection.
In view of the limited number of acute inpatient beds relative to demand in England, a thorough assessment prior to referral is paramount in ascertaining clinical need. A comprehensive risk assessment is crucial in light of patient safety and assessing risk to others. Moreover, the appropriateness of an acute bed should be considered, and whether psychiatric intensive care or forensic services may be more appropriate for the patient. In line with this, the Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) admissions policy details standards of the assessment prior to referral to acute inpatient services. Pre-referral assessment should be carried out by a multidisciplinary team including a senior doctor. It should include rationale and plan of care for admission, risk assessment and section status on admission alongside type of bed being requested. Referrals are accepted from multiple teams including Home Treatment, the Place of Safety and Liaison Psychiatry. Aim: To audit adherence to the pre-referral policy for acute inpatient admissions to a male and female ward in BSMHFT, including comprehensive assessment, plan of care and consideration of appropriate bed type.
Methods
A retrospective audit of pre-referral documentation for all admissions from April to September 2019 to a male and separate female acute inpatient unit at the Zinnia Centre, Birmingham was carried out. This included 83 male admissions and 82 female admissions. Documentation was reviewed on the clinical system Rio. Parameters reviewed included assessing clinician, assessment summary, capacity assessment, consideration of bed type, plan of care and section details.
Results
Overall, almost half of admissions (49%) were assessed by a full Mental Health Act team, 34% by a senior psychiatric doctor and the remainder by psychiatric nurses in the referring department. An up-to-date assessment summary was completed in the majority of cases (67%) prior to referral. Risk assessments were completed in 82% of cases. 35% of cases included a detailed plan of care which met audit standards. Capacity assessment alongside outcome was documented in 13% of cases. The type of bed was only considered in 13% of cases.
Conclusion
Whilst assessment and risk documentation was completed in the majority of cases, few cases had a clear plan of care and appropriateness of bed type was rarely considered in assessment. Greater adherence to the pre-referral process could facilitate treatment decisions during admission and seek to ensure a safer inpatient environment.
A “Zanzibar” is an island of measurement values that internally cohere, but are detached from independent contact with reality. One manifestation of Zanzibars is through “bandwagon effects,” the tendency of contemporaneous measurements to agree. Bandwagons illustrate how the otherwise virtuous drive towards coherence can have negative epistemic consequences. I argue that precision is an epistemic virtue that mitigates against bandwagon effects and illustrate this claim with a case study from the history of measurements of c. This precision-first reasoning motivates the practice of blind data analysis in bleeding edge precision measurement, where outcomes can point the way to new physics.
According to Plato’s Timaeus, a benevolent divine craftsman creates the cosmos, guided by his intellect’s reasoning and his ‘forethought’ or ‘providence’ (pronoia, Tim. 30b) about how to make it as good as possible. Similarly, in Laws 10, a wise god is said to exercise oversight over the cosmos, and to have devised laws of fate that promote virtue by assigning souls to positions in the cosmos according to their deserts. These and other Platonic texts were important sources for later Platonist theories of providence, according to which beneficent divine thought ensures the best possible arrangement and management of the cosmos.
From Strangers to Neighbors: Post-disaster Resettlement and Community Building in Honduras. By Ryan Alaniz. Austin: University of Texas Press, 2017. Pp. xv + 216. $29.95 paperback. ISBN: 9781477314098.
The Migrant Passage: Clandestine Journeys from Central America. By Noelle Kateri Brigden. Ithaca, NY: Cornell University Press, 2018. Pp. 264. $24.95 paperback. ISBN: 9781501730559.
The Democracy Development Machine: Neoliberalism, Radical Pessimism, and Authoritarian Populism in Mayan Guatemala. By Nicholas Copeland. Ithaca, NY: Cornell University Press, 2019. Pp. 282. $24.95 paperback. ISBN: 9781501736063.
The Long Honduran Night: Resistance, Terror, and the United States in the Aftermath of the Coup. By Dana Frank. Chicago: Haymarket Books, 2018. Pp. 344. $17.95 paperback. ISBN: 9781608469604.
Caravana: Cómo el éxodo Centroamericano salió de la clandestinidad. By Alberto Pradilla. Mexico City: Penguin Random House, 2019. Paperback. Pp. 293. ISBN: 9786073180511.
A House of One’s Own: The Moral Economy of Post-disaster Aid in El Salvador. By Alicia Sliwinski. Montreal: McGill-Queen’s University Press, 2018. Pp. x + 264. $29.95 paperback. ISBN: 9780773552920.
Background: Proteogenomics, the integration of proteomics and RNASeq expands the discovery landscape for candidate expressed gene networks to obtain novel insights into host response in post-infectious hydrocephalus (PIH). We examined the cerebrospinal fluid (CSF) of infants with PIH, and case controlled against age-matched infants with non-postinfectious hydrocephalus (NPIH) to probe the molecular mechanisms of PIH, leveraging molecular identification of bacterial and viral pathogens. Methods: Ventricular CSF samples of 100 infants ≤ 3 months of age with PIH (n=64) and NPIH (n=36) were analyzed with proteomics and RNASeq. 16S rRNA/DNA sequencing and virome capture identified Paenibacillus spp. and cytomegalovirus as dominant pathogenetic bacteria implicated in our PIH cohort. Proteogenomics assessed differential expression, gene set enrichment and activated gene pathways. Results: Of 616 proteins and 11,114 genes, there was enrichment for the immune system, cell-cell junction signaling and response to oxidative stress. Proteogenomics yielded 33 functionally and genetically associated gene sets related to neutrophil activation, platelet activation, and cytokines (interleukins and interferon) signaling. Conclusions: We identified PIH patients with severe disease at time of hydrocephalus surgery, to have differential expression of proteins/genes involved in neuroinflammation, ependymal barrier integrity and reaction to oxidative stress. Further studies are needed to examine those proteins/genes as biomarkers for PIH.
We describe a large outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) involving an acute-care hospital emergency department during December 2020 and January 2021, in which 27 healthcare personnel worked while infectious, resulting in multiple opportunities for SARS-CoV-2 transmission to patients and other healthcare personnel. We provide recommendations for improving infection prevention and control.
Background: The National University Hospital (NUH) is a 1,200 bed tertiary-care hospital with no documented nosocomial transmission of COVID-19 among patients for the first year and a half of the pandemic, despite 65% of the patients being housed in 4- to 8-bedded open cubicles with shared bathrooms. However, this arrangement changed in late September 2021 with large community clusters including in healthcare institutions nationally associated with the spread of the δ (delta) variant of SARS-CoV-2. We conducted a retrospective review of hospital epidemiology data to determine risk factors for SARS-COV-2 transmission during this period. Methods: Index patients were defined as the first patient in an open cubicle with a confirmed positive SARS-CoV-2 PCR test. Contacts were defined as being in the same cubicle as a patient before isolation from 2 days before symptom onset, up to 7 days from positive test if asymptomatic. Clinical and patient movement data were obtained manually from routine clinical records. Proximity of the contact from the index was classified as within, or more than, 2 m away, according to the prevailing definition from the Singapore Ministry of Health. A univariate analysis was performed to identify risk factors for nosocomial acquisition of SARS-CoV-2. The analysis was deemed exempt from ethics review (reference no. NHG-DSRB-2021/01026). Results: From October 1 to November 30, 2021, 30 index cases occurred in open cubicles identified (median, 9 days after admission; IQR, 19 days). Contact tracing yielded 211 contacts, of whom 10 (4.7%) were infected. Linear regression analysis found the duration of contact for each hour spent in the same room as the index case was the only statistically significant risk variable for contracting COVID-19, with an odds ratio 1.02 (Table 1). Conclusions: Patients in open cubicles are at risk for nosocomial transmission of COVID-19 and other infections. The duration of contact appeared to be more important than vaccination status of index or ward ventilation status. Larger multicentered studies are needed to validate this finding, which has significant implications for infection prevention strategies and pandemic planning.
Background: Incidence of methicillin-sensitive Staphylococcus aureus (MSSA) bloodstream infections (BSIs) in the United States during 2012–2017 has been reported to have been stable for hospital-onset BSIs and to have increased 3.9% per year for community-onset BSIs. We sought to determine whether these trends continued in more recent years and whether there were further differences within subgroups of community-onset BSIs. Methods: We analyzed CDC Emerging Infections Program active, population- and laboratory-based surveillance data during 2016–2019 for MSSA BSIs from 8 counties in 5 states. BSI cases were defined as isolation of MSSA from blood in a surveillance area resident. Cases were considered hospital onset (HO) if culture was obtained >3 days after hospital admission and healthcare-associated community-onset (HACO) if culture was obtained on or after day 3 of hospitalization and was associated with dialysis, hospitalization, surgery, or long-term care facility residence within 1 year prior or if a central venous catheter was present ≤2 days prior. Cases were otherwise considered community-associated (CA). Annual rates per 100,000 census population were calculated for each epidemiologic classification; rates of HACO cases among chronic dialysis patients per 100,000 dialysis patients were calculated using US Renal Data System data. Annual increases were modeled using negative binomial or Poisson regression and accounting for changes in the overall population age group, and sex. Descriptive analyses were performed. Results: Overall, 8,344 MSSA BSI cases were reported. From 2016–2019 total MSSA BSI rates increased from 23.9 per 100,000 to 28.5 per 100,000 (6.6% per year; P < .01). MSSA BSI rates also increased significantly among all epidemiologic classes. HO cases increased from 2.5 per 100,000 to 3.2 per 100,000 (7.9% per year; P = .01). HACO cases increased from 12.7 per 100,000 to 14.7 per 100,000 (7.0% per year; P = .01). CA cases increased from 8.4 per 100,000 to 10.4 per 100,000 (6.7% per year; P < .01) (Fig. 1). Significant increases in MSSA BSI rates were also observed for nondialysis HACO cases (9.3 per 100,000 to 11.1 per 100,000; 7.8% per year; P < .01) but not dialysis HACO cases (1,823.2 per 100,000 to 1,857.4 per 100,000; 1.4% per year; P = .59). Healthcare risk factors for HACO cases were hospitalization in the previous year (82%), surgery (31%), dialysis (27%), and long-term care facility residence (19%). Conclusions: MSSA BSI rates increased from 2016–2019 overall, among all epidemiologic classes, and among nondialysis HACO cases. Efforts to prevent MSSA BSIs among individuals with healthcare risk factors, particularly those related to hospitalization, might have an impact on MSSA BSI rates.
Background: In March–April 2021, 23 patients at a 906-bed hospital in Delaware had surgical implantation of a bone graft product contaminated with Mycobacterium tuberculosis; 17 patients were rehospitalized for surgical site infections and 6 developed pulmonary tuberculosis. In May 2021, we investigated this tuberculosis outbreak and conducted a large, multidisciplinary, contact investigation among healthcare personnel (HCP) and patients potentially exposed over an extended period in multiple departments. Methods: Exposed HCP were those identified by their managers as present, without the use of airborne precautions, in operating rooms (ORs) during index spine surgeries or subsequent procedures, the postanesthesia care unit (PACU) when patients had draining wounds, inpatient rooms when wound care was performed, and the sterile processing department (SPD) on the days repeated surgeries were performed. We created and assigned an online education module and symptom screening questionnaire to exposed HCP. Employee health services (EHS) instituted a dedicated phlebotomy station to provide interferon-γ release assay (IGRA) testing for HCP at ≥8 weeks after last known exposure. EHS managed all exposed HCP, including nonemployees (eg, private surgeons) via automated e-mail reminders, which were escalated through supervisory chains as needed until follow-up completion. The infection prevention team notified exposed patients, defined as those who shared semiprivate rooms with case patients with transmissible tuberculosis. The Delaware Division of Public Health performed IGRA testing. Results: There were 506 exposed HCP in ORs (n = 100), the PACU (n = 87), inpatient units (n = 140), the SPD (n = 54), and other locations (n = 122); 83% were employed by the health system. Surgical masks and eye protection were routinely used during patient care. All exposed HCP completed screening by December 17, 2021. Furthermore, 2 HCP had positive IGRAs without symptoms or chest radiograph abnormalities, indicating latent tuberculosis infection, but after further review of records and interviews, we discovered that they had previously tested positive and had been treated for latent tuberculosis infection. In addition, 5 exposed patients tested negative and 2 remain pending. Conclusions: This large investigation demonstrated the need for a systematic process that encompassed all exposed HCP including nonemployees and incorporated administrative controls to ensure complete follow-up. We did not identify any conversions related to this outbreak despite high burden of disease in case patients and multiple exposures to contaminated bone-graft material and infectious bodily fluids without respirator use. Transmission risk was likely reduced by baseline surgical mask use and rapid institution of airborne precautions after outbreak recognition.