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Newcastle disease (ND) is a notifiable disease affecting chickens and other avian species caused by virulent strains of Avian paramyxovirus type 1 (APMV-1). While outbreaks of ND can have devastating consequences, avirulent strains of APMV-1 generally cause subclinical infections or mild disease. However, viruses can cause different levels of disease in different species and virulence can evolve following cross-species transmission events. This report describes the detection of three cases of avirulent APMV-1 infection in Great Britain (GB). Case 1 emerged from the ‘testing to exclude’ scheme in chickens in Shropshire while cases 2 and 3 were made directly from notifiable avian disease investigations in chicken broilers in Herefordshire and on premises in Wiltshire containing ducks and mixed species, respectively). Class II/genotype I.1.1 APMV-1 from case 1 shared 99.94% identity to the Queensland V4 strain of APMV-1. Class II/genotype II APMV-1 was detected from case 2 while the class II/genotype I.2 virus from case 3 aligned closely with strains isolated from Anseriformes. Exclusion of ND through rapid detection of avirulent APMV-1 is important where clinical signs caused by avirulent or virulent APMV-1s could be ambiguous. Understanding the diversity of APMV-1s circulating in GB is critical to understanding disease threat from these adaptable viruses.
We present the case of a 4-month-old, former 23-week premature baby who underwent patent ductus arteriosus device closure in the cardiac catheterisation lab with an Amplatzer Piccolo™ device at 12 weeks of life. This was complicated by late migration of the device into the aorta resulting in severe obstruction and requiring surgical intervention.
The pregnant patient may present for fetal intervention at any time from the second trimester until near delivery. Physiological changes of pregnancy occur in every organ system in a dynamic fashion, with changes occurring to different degrees at specific periods during gestation. The maternal-fetal anesthesiologist must be familiar with expected changes. The decrease in diastolic pressure and mean arterial pressure, which nadir in the second trimester, often need to be addressed during mid-gestation fetal interventions. Other changes may need to be addressed earlier than typically expected during pregnancy. For example, the pregnant patient’s airway is characterized by mucosal edema and the need for a smaller than expected endotracheal tube. This is typically of concern at the time of delivery or non-obstetric surgery if endotracheal intubation is required. As the majority of fetal intervention procedures are performed during the mid-gestation period, the maternal-fetal anesthesiologist is often faced with managing the pregnant airway, not uncommonly in rapidly changing situations as planned sedation may be converted to general anesthesia for a variety of reasons during the procedure. All the physiologic changes of pregnancy are important to keep in mind as one approaches the clinical care of the pregnant patient.
Like any respectable modern organization, the Ford Foundation has computer printouts showing in fat volumes of lists and tables what it has done. Some of these compilations trace the record from the beginning of the Foundation’s national and international programs in 1950. An international interest was there from the start, because the study group that in the late forties advised the Foundation’s trustees on what they ought to do successfully urged that they should devote major attention to world problems of peace and international understanding. The first specific attention to Africa south of the Sahara came in 1954 with a half-dozen grants and a series of what were then called “foreign study and research fellowships.” Fellowships for Asian and Near Eastern studies had started earlier, in 1952, and some of them went to young scholars working on the Maghreb, Egypt, and places down as far as Sudan and Ethiopia.
Radiology in the austere environment is an evolving entity. The extent to which the anesthesiologist will have to be aware of issues related to radiology is highly dependent upon the environment in which he or she will work. Capabilities may be limited to a portable ultrasound (US) carried by the provider in a backpack with an imaging screen the size of a modern smartphone to full magnetic resonance imaging (MRI) capabilities that may be seen in higher echelons of care, typically in a military setting. Each modality has its uses and limitations for the anesthesiologist and awareness of the capabilities, safety issues, and limitations of each modality allows maximal extraction of imaging in providing quality care in the “disaster” or austere environment. This chapter will focus on issues related to radiation safety in plain radiography (X-ray) and fluoroscopy, radiation protection, US familiarization, and image quality, and some issues surrounding computed tomography (CT) and MRI.
We evaluated whether a diagnostic stewardship initiative consisting of ASP preauthorization paired with education could reduce false-positive hospital-onset (HO) Clostridioides difficile infection (CDI).
Single center, quasi-experimental study.
Tertiary academic medical center in Chicago, Illinois.
Adult inpatients were included in the intervention if they were admitted between October 1, 2016, and April 30, 2018, and were eligible for C. difficile preauthorization review. Patients admitted to the stem cell transplant (SCT) unit were not included in the intervention and were therefore considered a contemporaneous noninterventional control group.
The intervention consisted of requiring prescriber attestation that diarrhea has met CDI clinical criteria, ASP preauthorization, and verbal clinician feedback. Data were compared 33 months before and 19 months after implementation. Facility-wide HO-CDI incidence rates (IR) per 10,000 patient days (PD) and standardized infection ratios (SIR) were extracted from hospital infection prevention reports.
During the entire 52 month period, the mean facility-wide HO-CDI-IR was 7.8 per 10,000 PD and the SIR was 0.9 overall. The mean ± SD HO-CDI-IR (8.5 ± 2.0 vs 6.5 ± 2.3; P < .001) and SIR (0.97 ± 0.23 vs 0.78 ± 0.26; P = .015) decreased from baseline during the intervention. Segmented regression models identified significant decreases in HO-CDI-IR (Pstep = .06; Ptrend = .008) and SIR (Pstep = .1; Ptrend = .017) trends concurrent with decreases in oral vancomycin (Pstep < .001; Ptrend < .001). HO-CDI-IR within a noninterventional control unit did not change (Pstep = .125; Ptrend = .115).
A multidisciplinary, multifaceted intervention leveraging clinician education and feedback reduced the HO-CDI-IR and the SIR in select populations. Institutions may consider interventions like ours to reduce false-positive C. difficile NAAT tests.
1. Rationale. Authors’ literary papers are precious to cultural heritage and to scholarship, and many have wider popular appeal. They inform literary and biographical studies, textual studies, cognitive studies, and many areas of research. Above all, they are precious because of the information they provide about the creative process and what influences this, recording successive versions, drafts and variations. The preservation of these papers in public institutions will be welcomed by a wide range of users, in various fields of education, lifelong learning, biographical and cultural research and the creative arts, and the wider public. Authors are encouraged to think in terms of each literary work as passing through several archival stages of development and to seek to preserve each stage. When this guidance refers to “papers” this means all of the materials relating to an author's working life, in whatever format— paper or digital, or audiovisual.
2. What to keep. Authors may often be tempted to destroy early plans and discarded drafts. These should be kept wherever possible. Libraries and archives are interested in collecting early drafts, notebooks, handwritten and typescript versions, working notes, study notes, and research material in any format. In addition, there is an interest which extends beyond literary research:
in correspondence: both incoming mail and drafts and copies of outgoing mail; both personal and professional correspondence;
in emails, audio-visual materials (literary and personal), diaries, journals, and commonplace books;
in disks, memory-sticks, and computer drives;
authors’ personal libraries are also of great interest, especially where books and journals are annotated.
All kinds of materials and correspondence relating to literary festivals, reading tours, conferences, seminars and literary organizations should be regarded as an integral part of any author's archive. In determining what to keep, authors should bear in mind that, in addition to illustrating the creative literary process, their papers are likely to have a wider cultural and historical interest. If the literary work has been influenced by visual arts, music, or other forms of expressive culture then the author's information on these, programmes of concerts, exhibitions, and events would also constitute a vital part of a full “author's archive.” In short, all the raw material relating to a writer's life and work is likely to be of interest to an archive service and to researchers.
The chapters in this book combine a wide variety of subject matter with consistency of theme, bound together by the notion of literary archives as characteristically “diasporic.” Most of the authors of the chapters participated and discussed together during the workshops of the Diasporic Literary Archives Network, so, although they did not have the opportunity to read each other's contributions as the book took shape, it is perhaps not surprising that there is a notable consistency and a natural inter-relationship between the points of view expressed in the different essays.
The essays by André Derval, Alison Donnell, Maureen Roberts, and Jennifer Toews all lay stress on the diasporic lives lived by many literary authors, especially but not exclusively in a postcolonial and post-imperialist context. Authors from poorer countries, with fewer job opportunities and a less developed publishing industry at home, often gravitated towards richer countries, when they could. Authors whose origins lie in the former colonies of the Caribbean region or North and West Africa, for example, or in the “protectorates” of the Arab countries and southern Africa, would tend to move between the countries of their birth and the countries of the colonial rulers— for economic, financial, political, and sometimes literary reasons. Many of these diasporic lives were, of necessity, quiet and cautious in the new locations in richer countries, although Maureen Roberts gives us the quite exceptional story of Eric and Jessica Huntley, who, forced out of the then British Guiana because of their political and community activism, became unrelenting political and community activists in London. In many and varied situations, the archival collections have come to reside in the new diasporic destination, in the country of wealth and power and, sometimes, safety. The attitudes of Adonis towards France, C. L. R. James and Una Marson towards Britain, and Octavio Paz towards the USA combine a keen awareness of imperialist imposition with a sense of financial, literary, and even archival necessity. The archives of Octavio Paz are in the Harry Ransom Center of the University of Texas perhaps primarily for financial reasons whereas the archives of Adonis are in the Institut Mémoires de l’édition contemporaine for reasons of a more geopolitical nature, but both archival placements form part of the same wider diasporic pattern.
The essays collected in this book all derive or continue from the recent work of the Diasporic Literary Archives Network and illustrate the innovative and exciting range of programmes and actions which it generated. The Network was conceived and planned by a team of archivists, researchers and scholars in the University of Reading during 2010– 2011, and came into existence on January 1, 2012, funded by a generous grant from the Leverhulme Trust. Although the Leverhulme Trust's financial support came to an end in 2015, the Network has continued many of its projects and activities in the subsequent years and retains a clear identity through ongoing cooperation between its members and through regular updating of its website.
From the beginning, the Network proposed to take a comparative, transnational and internationalist approach to studying literary manuscripts, their uses and their significance. It took as its prime starting point the notion that literary archives differ from most other types of archival papers in that their locations are more diverse and difficult to predict; they may have a higher financial value which will lead to their more frequently being purchased— as opposed to being deposited or donated; and acquiring institutions for literary papers have historically had very little by way of collecting policies. Consequently, the collecting of literary papers has often been opportunistic, unexplained and serendipitous.
The first points of comparison for this defining view of the unpredictable mobility of literary papers were the existing sections and the proposed future sections within the International Council on Archives. Using these benchmarks, assessments could be made in contrast with national and regional official papers; archives of local, municipal and territorial government; architectural archives; religious and faith tradition archives; archives of sports and games; political, business, and trade union archives; archives of educational institutions, hospitals, prisons, museums, and palaces; legal, notarial, and judicial papers; parliamentary and political papers; and the archives of international organizations. The comparisons confirmed that no category of archival material was more subject to uncertainty of location and to haphazardness of acquisition.
Literary archives differ from most other types of archival papers in that their locations are more diverse and difficult to predict. The essays collected in this book derive from the recent work of the Diasporic Literary Archives Network, whose focus on diaspora provides a philosophical framework which gives a highly original set of points of reference for the study of literary archives, including concepts such as the natural home, the appropriate location, exile, dissidence, fugitive existence, cultural hegemony, patrimony, heritage, and economic migration.