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To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza.
US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011–2012 through 2018–2019 seasons.
Patients were identified through provider-initiated or facility-based testing. HA influenza was defined as a positive influenza test date and respiratory symptom onset >3 days after admission. Patients with positive test date >3 days after admission but missing respiratory symptom onset date were classified as possible HA influenza.
Among 94,158 influenza-associated hospitalizations, 353 (0.4%) had HA influenza. The overall adjusted rate of HA influenza was 0.4 per 100,000 persons. Among HA influenza cases, 50.7% were 65 years of age or older, and 52.0% of children and 95.7% of adults had underlying conditions; 44.9% overall had received influenza vaccine prior to hospitalization. Overall, 34.5% of HA cases received ICU care during hospitalization, 19.8% required mechanical ventilation, and 6.7% died. After including possible HA cases, prevalence among all influenza-associated hospitalizations increased to 1.3% and the adjusted rate increased to 1.5 per 100,000 persons.
Over 8 seasons, rates of HA influenza were low but were likely underestimated because testing was not systematic. A high proportion of patients with HA influenza were unvaccinated and had severe outcomes. Annual influenza vaccination and implementation of robust hospital infection control measures may help to prevent HA influenza and its impacts on patient outcomes and the healthcare system.
North-western Arabia is marked by thousands of prehistoric stone structures. Of these, the monumental, rectilinear type known as mustatils has received only limited attention. Recent fieldwork in AlUla and Khaybar Counties, Saudi Arabia, demonstrates that these monuments are architecturally more complex than previously supposed, featuring chambers, entranceways and orthostats. These structures can now be interpreted as ritual installations dating back to the late sixth millennium BC, with recent excavations revealing the earliest evidence for a cattle cult in the Arabian Peninsula. As such, mustatils are amongst the earliest stone monuments in Arabia and globally one of the oldest monumental building traditions yet identified.
Deleuze's notions of difference and repetition are developed within a project that has both a negative and a positive component. The negative or “critical” aspect is the argument that philosophy, in its very conception, has laboured under a “transcendental illusion”, which systematically subordinates the concepts of difference and repetition to that of identity, mostly within what Deleuze calls the “regime of representation”. The illusion is “transcendental” (the term comes from Kant) in so far as it is not simply an historical accident that can be corrected with the right information, but forms a necessary and inevitable part of the operation of thought, and thus requires a perpetual work of critique. Part of Deleuze's project consists in diagnosing this illusion, and showing how it falsifies the “true” movement of thought. In this movement, difference and repetition, in and for themselves, would be appreciated as the ultimate elements and agents of a thought “of the future”: not a historical future, but the future as the essential object of a vital and liberated philosophy, implicit even in philosophies of the past.
The positive component of Deleuze's project can already be glimpsed here, if only by default.
In his popular work, Modern French Philosophy, Vincent Descombes opens the section on Gilles Deleuze with the statement: ‘Gilles Deleuze is above all a post-Kantian.’ In justifying this claim he identifies three main areas of contention shared between Deleuze and ‘the great Chinaman of Künigsberg’, which will also form the main threads of the examination of the relationship presented here. The first is their rejection of the idea that thought requires a transcendent entity (the soul, the world, God) to serve as its foundation: ‘No experience can justify us in affirming a single substantial self, a totality of things and a first cause of this totality.’ The second is their emphasis on the active and autonomous nature of thought, substituting a practical ideal of thought as a form of determination for a speculative one based on representation: ‘Liberation of the will is the significance of the critical idea … Deleuze gives the name “philosophy of being” to the old, pre-Kantian metaphysics, and “philosophy of will” to the metaphysics born of the accomplished critique.’ Third, they identify the true problem of ‘difference’ as the difference between a conceptual order and a non-conceptual one rather than the difference between two concepts or identities: the one which obliges thought to introduce difference into its identities, particularity into its general representations, and precision into its concepts. The real difference is that which exists between concept and intuition, between the intelligible and the sensible, between the logical and the aesthetic.
Soulez's work focuses on the ethical dimension of philosophy manifested in the way in which thought engages and transforms an acting subject on a formal level, beyond what is “said” as such, including any explicitly ethical statements. Wittgenstein's injunction to “silence” on certain ethical matters does not, for Soulez, prevent his being a thinker of the ethical stakes of philosophy, contrary to more orthodox readings of the analytical tradition.
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