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To characterize nontuberculous mycobacteria (NTM) associated with case clusters at 3 medical facilities.
Retrospective cohort study using molecular typing of patient and water isolates.
Veterans Affairs Medical Centers (VAMCs).
Isolation and identification of NTM from clinical and water samples using culture, MALDI-TOF, and gene population sequencing to determine species and genetic relatedness. Clinical data were abstracted from electronic health records.
An identical strain of Mycobacterium conceptionense was isolated from 41 patients at VA Medical Centers (VAMCs A, B, and D), and from VAMC A’s ICU ice machine. Isolates were initially identified as other NTM species within the M. fortuitum clade. Sequencing analyses revealed that they were identical M. conceptionense strains. Overall, 7 patients (17%) met the criteria for pulmonary or nonpulmonary infection with NTM, and 13 of 41 (32%) were treated with effective antimicrobials regardless of infection or colonization status. Separately, a M. mucogenicum patient strain from VAMC A matched a strain isolated from a VAMC B ICU ice machine. VAMC C, in a different state, had a 4-patient cluster with Mycobacterium porcinum. Strains were identical to those isolated from sink-water samples at this facility.
NTM from hospital water systems are found in hospitalized patients, often during workup for other infections, making attribution of NTM infection problematic. Variable NTM identification methods and changing taxonomy create challenges for epidemiologic investigation and linkage to environmental sources.
Vertically aligned graphene was grown by plasma-enhanced chemical vapor deposition using methane feedstock. Optical emission spectroscopy (OES) was used to monitor the plasma species, and Raman spectroscopy was used for characterizing the properties of as-grown vertically aligned graphene. OES-derived information on plasma species, such as C, C2, CH, and H, are correlated with the properties of the vertically aligned graphene. Graphene grown at 250 W and 15 sccm exhibited the lowest amount of defects. Although OES peak intensities occurred at the highest power and lowest flow conditions, the OES peak ratios of plasma species had a greater dependence on flow rate and exhibited a saddle point in the atomic C/H ratio corresponding to optimal growth involving the lowest amount of overall defects. Plasma diagnostics provides a valuable approach to optimize growth characteristics and material properties.
When they process sentences, language comprehenders activate perceptual and motor representations of described scenes. On the “immersed experiencer” account, comprehenders engage motor and perceptual systems to create experiences that someone participating in the described scene would have. We tested two predictions of this view. First, the distance of mentioned objects from the protagonist of a described scene should produce perceptual correlates in mental simulations. And second, mental simulation of perceptual features should be multimodal, like actual perception of such features. In Experiment 1, we found that language about objects at different distances modulated the size of visually simulated objects. In Experiment 2, we found a similar effect for volume in the auditory modality. These experiments lend support to the view that language-driven mental simulation encodes experiencer-specific spatial details. The fact that we obtained similar simulation effects for two different modalities—audition and vision—confirms the multimodal nature of mental simulations during language understanding.
We explore the possibility that the US political system can usefully be characterized as oligarchic. Using a material-based definition drawn from Aristotle, we argue that oligarchy is not inconsistent with democracy; that oligarchs need not occupy formal office or conspire together or even engage extensively in politics in order to prevail; that great wealth can provide both the resources and the motivation to exert potent political influence. Data on the US distributions of income and wealth are used to construct several Material Power Indices, which suggest that the wealthiest Americans may exert vastly greater political influence than average citizens and that a very small group of the wealthiest (perhaps the top tenth of 1 percent) may have sufficient power to dominate policy in certain key areas. A brief review of the literature suggests possible mechanisms by which such influence could occur, through lobbying, the electoral process, opinion shaping, and the US Constitution itself.
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