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To determine the utility of the Sofia® SARS rapid antigen fluorescent immunoassay (FIA) to guide hospital bed placement of patients being admitted through the emergency department (ED).
Cross-sectional analysis of a clinical quality improvement study.
Two community hospitals in Maryland. From 9/21/2020 to 12/3/2020, 2887 patients simultaneously received the Sofia® SARS rapid antigen FIA and SARS-CoV-2 RT-PCR assays on admission through the ED.
Rapid antigen results and symptom assessment guided initial patient placement while confirmatory RT-PCR was pending. The sensitivity, specificity, positive and negative predictive values of the rapid antigen assay were calculated relative to RT-PCR, overall and separately for symptomatic and asymptomatic patients. Assay sensitivity was compared to RT-PCR cycle threshold (Ct) values. Assay turnaround times were compared. Clinical characteristics of RT-PCR positive patients and potential exposures from false-negative antigen assays were evaluated.
Overall agreement, sensitivity, and specificity for all patients was 97.9%, 76.6% (95% confidence interval (CI): 71%, 82%), and 99.7% (95% CI: 99%, 100%), respectively. No differences in performance were seen between asymptomatic and symptomatic individuals. As RT-PCR Ct increased, sensitivity of the antigen assay decreased. Mean turnaround time for the antigen assay and RT-PCR was 1.2 (95% CI: 1.0, 1.3) and 20.1 (95% CI: 18.9, 40.3) hours, respectively (p<0.001). No transmission from antigen-negative/RT-PCR-positive patients was identified.
While not a replacement for RT-PCR for detection of all SARS-CoV-2 infections, the Sofia® SARS antigen FIA has clinical utility for potential initial timely patient placement.
Episodic memory impairment and hippocampal pathology are hallmark features of both temporal lobe epilepsy (TLE) and amnestic mild cognitive impairment (aMCI). Pattern separation (PS), which enables the distinction between similar but unique experiences, is thought to contribute to successful encoding and retrieval of episodic memories. Impaired PS has been proposed as a potential mechanism underling episodic memory impairment in aMCI, but this association is less established in TLE. In this study, we examined behavioral PS in patients with TLE and explored whether profiles of performance in TLE are similar to aMCI.
Patients with TLE, aMCI, and age-matched, healthy controls (HCs) completed a modified recognition task that relies on PS for the discrimination of highly similar lure items, the Mnemonic Similarity Task (MST). Group differences were evaluated and relationships between clinical characteristics, California Verbal Learning Test—Second Edition scores, and MST performance were tested in the TLE group.
Patients with TLE and aMCI demonstrated poorer PS performance relative to the HCs, but performance did not differ between the two patient groups. Neither the side of seizure focus nor having hippocampal sclerosis affected performance in TLE. However, TLE patients with clinically defined memory impairment showed the poorest performance.
Memory performance on a task that relies on PS was disrupted to a similar extent in TLE and aMCI. The MST could provide a clinically useful tool for measuring hippocampus-dependent memory impairments in TLE and other neurological disorders associated with hippocampal damage.
This book is published in the new series Tamesis Studies in Popular and Digital Cultures, edited by Thea Pitman and Stephanie Dennison, scholars known for their pioneering publications on Latin American digital culture and transnational cinema (Dennison, Contemporary Hispanic Cinema; Pitman, Latin American Identity). I am most grateful to professors Pitman and Dennison for their valuable initiative, and to the anonymous readers for their acute comments. I thank Dr. Megan Milan, commissioning editor at Tamesis, for her exceptional kindness and efficiency in the whole production process. Finally, I thank Patricia Arriaga Jordán, executive producer of Canal Once's Malinche, for permission to use an image from her miniseries on the cover of this book. One note is sadly necessary: although I refer briefly in the third and the final chapters to COVID-19, the rest of the book was written before the pandemic so gravely affected the audiovisual scene, and indeed life in general, in Mexico.
In a chapter of a previous book, I identified a trend that I called “post-homophobic” comedy in Mexico: mainstream feature films, such as Macho (Antonio Serrano, 2016) and Hazlo como hombre (“Do It Like an Hombre,” Nicolás López, 2017), in which it is not homosexuality but homophobia that is presented as humorous; and it is not the gay character but the macho man who is the butt of the joke (Smith, Multiplatform 45–60). In this first chapter I will suggest that a parallel phenomenon is what we might call “post-patriarchal” comedy. Just as the post-homophobic films assume a progressive society (and commercial movie audience) for whom homophobia is a ridiculous anomaly and gayness universally acceptable, so these post-patriarchal films are based on the premise that in modern Mexico (as in Spain) the old-school patriarch is a figure of fun; and women, especially working women, are deserving of not just gender equality but full autonomy.
My two trans-Atlantic texts here, both given wide and successful commercial releases at home in 2018 and thus too recent to have received academic attention, are versions of a Chilean original by Nicolás López once more, Sin filtro (“No Filter,” 2016). Currently available on streaming services, the Mexican remake is called Una mujer sin filtro (“A Woman with No Filter,” Luis Eduardo Reyes), and the near simultaneous Spanish version is Sin rodeos (“Empowered,” Santiago Segura). The shared protagonist of the trans-Atlantic franchise is a troubled and submissive woman named with transparent irony “Paz” (“Peace”), a creative executive at an advertising agency, who is exploited by a deadbeat husband and ungrateful stepson at home and an insulting boss and asinine digital media rival at work.
The two films’ shared premise is that, after drinking a supposedly magic potion, Paz is suddenly compelled to speak the unvarnished truth to all those she has previously suffered in silence. Strikingly, in both versions female acquaintances are almost as abusive as the males: Paz's selfish sister offloads her beloved cat on to the harassed heroine (inevitably it dies); her best friend is a gym- and cell-phone-addict (the phone will end up at the bottom of a swimming pool).
Malinche is a series created by Patricia Arriaga Jordán for Mexico's public TV channel Canal Once. It premiered in 2018 and was acclaimed by the Mexican press as the most anticipated show of the year (Cueva, “La serie”). The five hour-long episodes (supplemented by a full-length “making-of “ that serves as a sixth installment) track the Spanish Conquest of Mexico and destruction of the Mexica (Aztec) Empire from the perspective of the conquistador Cortés's interpreter. While little is known historically about Malinche, who is generally condemned as a traitor by modern Mexicans (“malinchismo” means to put the interests of another country above one's own), contemporary Spanish sources describe her respectfully as a noblewoman, lending her the honorific title “Doña.” Her Nahuatl name of “Malinzin” equally pays tribute to her high social position. This was in spite of the fact that when Malinche first encountered Cortés she was reduced to the status of a slave. Arriaga intends, then, to reinvest her subject with the respect that she once managed to achieve against all the odds.
Malinche is a real-life figure who was a major actor in history. Indeed, she is often depicted in contemporary drawings as larger in size than Cortés and even lent her name to her supposed master, who was dubbed by the Mexica “El Malinche.” Eye-witness chronicler Bernal Díaz del Castillo, a minor character in the series, wrote at the time that the woman he called “Doña Marina” was the “absolute ruler of the Indians in all of New Spain” and compares her story, of slavery and redemption, to that of Joseph in the Bible (Díaz del Castillo 130). Yet, the legacy of Cortés's translator (described appropriately enough in primary sources as his “lengua” or “tongue”) remains much contested, not least by feminists and nationalists, who have viewed her alternately as either a collaborator or a resistor to a patriarchal and colonial regime. And beyond her role as interpreter, Malinche can also be seen in different lights as being either an honored consort or a victim of rape, bearing Cortés as she did an illegitimate son. Her legacy has also long been explored in the USA by Chicanas.
In 2019 a fiction feature premiered at Morelia that became known as the “anti-Roma.” Xquipi’ Guie’dani / El ombligo de Guie’dani (“Guie’dani's Navel”) tells the story of a modern-day mother and daughter who travel to Mexico City from their village in Oaxaca to live and work as domestic laborers in a rich family's home. It was said by the Mexican press to be the “antithesis” of Cuarón's much-heralded masterpiece that had been released by Netflix just months earlier (Ramírez).
El ombligo de Guie’dani was on the same subject as Roma and engaged the same fraught intersection of gender, class, and ethnicity. It also featured dialogue in an indigenous language (in this case Zapotec, not Mixtec). But now the domestic worker protagonist was openly rebellious, reflecting what the director, Xavi Sala, called “the warlike spirit” of the women of her community (Ramírez). In presenting the film at Morelia, where it was described as a “mirror of Mexican society,” the Alicante-born director went further, suggesting a kinship between his experience as a native Catalan speaker and that of indigenous people, who are likewise socially excluded by a hegemonic Spanish language that is not their own (Aranza Flores). Meanwhile, back in Spain, El ombligo de Guie’dani would win an award at the Huelva festival, acclaimed as the film that best captured the “reality” of Latin America today (Ramírez).
Clearly, whatever its intrinsic merits, El ombligo de Guie’dani raises thorny institutional or ideological questions that I treated in my chapter on festivals: the problem of Europeans who serve as gatekeepers to what counts as Latin American cinema at home and abroad; and that of individual films that, when they circulate in the North, are made to stand in for complex countries and lengthy cinematic traditions. Yet the evident common ground between festival film El ombligo de Guie’dani and Netflix original Roma must make us question the status of a feature that is generally experienced as an exceptional title by a unique director. The aim of this final chapter, or coda, is similarly to recontextualize Cuarón's film, habitually isolated as an Oscar-winning sensation, within Mexican cinema and Mexican multimedia.
On December 30, 2019, Mexican national daily El Universal reported on Netflix's most successful projects of the year in feature film and series. The headline translates as “Entertainment Made in Mexico: The Most Popular on Netflix.” Although, as journalist Ariel León Luna notes, the streaming giant releases few figures or details of its audiences and gives no hint as to its methodology, its list is emblematic of a newly fluid relation among media, territories, and genres.
Indeed, one popular actor (Omar Chaparro) stars in a high-rated feature film, a reality competition, and children's programming, suggesting a convergence between three genres once held to be distinct. Chaparro's Como caído del cielo (“As If Fallen from Heaven”) came third in the streamer's ranking for features in 2019, even though it was released only on December 24 of that year. El Universal's piece is run under a romantic photo of him and his co-star Ana Claudia Talancón close dancing in what appears to be pretty period costume.
Just one month later academic journal Comunicación y Sociedad also published an article on Netflix's productions in Mexico, this one called “Mexican Melodramas in the Age of Netflix: Algorithms for Cultural Proximity.” While the latter term is taken from Joseph D. Straubhaar, the former refers to Netflix's service model: an algorithm that shapes all aspects of the streamer's production and reception, giving Netflix detailed information about its subscribers and offering them in turn personalized recommendations based on individual interaction with the platform, such as viewing history. In her article, scholar Elia Margarita Cornelio-Marí gives an account of the streamer's “localization for the Mexican market” (5) and the “development of local content” (8). In her survey of the production of series (she does not deal with feature films), she focuses on the platform's apparent lovehate relationship with the classic Mexican genre of melodrama. This, she claims, serves as a method of achieving closeness to Netflix's middle-class spectators, who may feel contemptuous about an overfamiliar mode of television fiction, which requires them to adopt an “ironic” attitude to these new titles (17).
This third chapter shifts the focus from the mainstream to the specialist film that maintains its cultural distinction by strategies of legitimation such as the festival circuit. It begins by building on two pioneering book-length studies of Latin American cinema with implications for the study of the topic.
In first place, and most recently, Tamara Falicov's Latin American Film Industries (2019) situates the institution of the film festival and the genre of “festival films” within the geopolitical dynamics of production and distribution, highlighting the golden triangle between Latin America, Europe, and the US and calling attention to the potential for both neo-colonialism and national agency in such international relations. Crucially, Falicov highlights the role of foreign festivals not only in distribution, where independent producers with small marketing budgets rely on the festival circuit and its “positive word of mouth” (100), but also in the funding of Latin American films. Here festivals have an ambivalent role of “helping and hindering” that she also traces in other areas, such as piracy, new technologies, and television. Implicitly coinciding with Bourdieu's twin logic of the dual and irreconcilable economies of art and money (The Rules of Art), Falicov also sketches how industrial mechanisms intersect unstably with notions of cultural distinction and the construction of the canon.
In second place, Laura Podalsky's influential The Politics of Affect and Emotion in Latin American Cinema (2011), more textbased, focuses in less familiar style on the ways in which emotion structures and dramatizes national and international relations in films exhibited mainly at festivals. Podalsky begins her book by citing a list of awards won by Latin American films in the 2000s (most especially Amores perros in Cannes, 1) and also refers to the role of San Sebastián's Horizontes Latinos strand (where I served as a juror) in promoting the region's cinema (181). More typically, she offers close readings of case studies of films that feature extravagant emotional excess, such as Amores perros once more, whose director, Alejandro González Iñárritu, is closely associated with the history of the Morelia festival. Podalsky's more recent essay, “The Aesthetics of Detachment” (2016), expands her focus, counterintuitively, to films by directors who exhibit a conspicuous lack of affect, such as Mexican festival favorites Fernando Eimbcke and Amat Escalante, of whom more later.
Foreign viewers of Mexican media may still think of Gael García Bernal and Diego Luna as the country's consummate example of bromance. Although they first worked as child stars in television, the celebrated actors came to joint homoerotic fame in Y tu mamá también (Alfonso Cuarón, 2002). As is well known, this crowd- and critic-pleasing feature's notorious last scene showed the couple of best friends, who had spent the course of the film vying for the favors of an older woman, finally making love with each other for just one guilty time. Less known outside Mexico is the pair's soccer comedy, also successful at the local box office, Rudo y cursi (helmed by Alfonso's sibling Carlos Cuarón in 2008), where they played enduringly intimate half-brothers.
Yet, most recently, a new and more youthful male couple has come to fame in Mexico and they are the subject of my fourth chapter, the first on television. The pair has achieved mainstream stardom in two popular genres (telenovela and series) and in two media (free-to-air television and legitimate theater). They have also given rise to a huge social media footprint. And they have done this, surprisingly perhaps, while desublimating Gael and Diego's extended homosocial tease and creating an open and unapologetic queer romance.
Joaquín Bondoni (born 2003) and Emilio Osorio (born 2002) both began, like Gael and Diego before them, as child stars on television. Bondoni starred in the one-off dramas known in Mexico as “unitarios,” where he had already appeared in a muchloved gay role by 2017 at just thirteen years old). Osorio featured in a family-friendly traditional telenovela, Mi corazón es tuyo (“My Heart Is Yours,” Televisa, 2014–15), where he played one of seven children of a wealthy widower cared for by a feisty nanny. The latter show was made by Juan Osorio, Emilio's father, one of Mexican television's most prolific and powerful producers. He is also one of the few content creators who has managed to navigate the choppy media waters of a modern Mexico where familiar fare has fallen out of favor with mass audiences.
Cuna de lobos (“Cradle of Wolves”) was initially a classic telenovela from 1986 of 170 episodes. It boasts one of the most notorious and enduring female villains of Mexican television, the murderous “black widow” Catalina Creel (played by matronly local veteran María Rubio), who famously wears a sinister eye patch. In response to changes in the ecology and audience of Mexican broadcast television, Cuna de lobos was remade to great critical and popular acclaim by Televisa in 2019 as a “series,” a genre still relatively rare in Mexico. Now it consisted of just twenty-five episodes and starred sensuous Spanish film actress Paz Vega (Illus. 16). The production context for the remake was the still powerful but threatened free-to-air broadcaster's new slate of remade heritage titles, launched under the rubric “Fábrica de sueños, reescribiendo la historia” (“Dream Factory, Rewriting [Hi]Story”), of which Cuna de lobos was the second installment.
The shared premise, which goes unchanged from 1986 to 2019, is that the anti-heroine Catalina kills her wealthy husband in the very first episode, then embarks on a murder spree. She is the mother of one responsible son (Alejandro), who works hard in the family business, and the stepmother of another (José Carlos), an alcoholic gambler who lives abroad (the characters’ names are repeated in both versions). When the patriarch's will is found to stipulate that his estate goes to first of the sons to father a child and thus continue the family dynasty, Catalina encourages her son to impregnate Leonora, a young woman of modest means, in order that she can inherit the family firm.
The first half of this fifth chapter, the second on television, examines the remake's production context, calling attention to the key role played by the experienced executive producer Giselle González, a rare Mexican woman showrunner, comparable in status to Juan Osorio in the previous chapter. The chapter also analyzes the textual differences between the original telenovela and the remade series, especially with regard to the changing characterization of the female protagonist and the emergence of a major new gay male character.
The main focus of this book is popular or mass culture in contemporary Mexico, as expressed in fiction formats from the still distinct but rapidly converging audiovisual art forms of theatrically released cinema, free-to-air television, and streaming platforms. The book also pays attention to the social media footprint of the texts it studies. It thus continues a scholarly tradition of “calls for intermediality” in the Latin American mediascape (Ana López), but now in the new context of the late 2010s.
Mexican Genders, Mexican Genres analyzes both industries and practices, tracking how changes in producers and genres (for example, the relative decline of still hegemonic Televisa and of the heritage telenovela) coincide with changes in gender representations (for example, the relative rise of feminist and queer narratives across different media). These are examples of the new cultural dynamics facilitated by digital technologies, which the series Tamesis Studies in Popular Digital Cultures seeks to explore. In its corpus of primary texts this book also coincides with the popular culture brief of the series, aiming as it does to move beyond the art, auteur, or specialist film that is little seen by Mexicans at home but much studied by Mexicanists abroad.
It is striking that an excellent recent special journal issue entitled “Digital Changes in Latin American Cinemas” (Cerdán and Fernández Labayen), which intends to study both aesthetics and industry (production, distribution, and exhibition), restricts its analysis almost entirely to independent film and is heavily focused on the transnational theme that has long been a central focus for foreign Latin Americanists. Conversely, Niamh Thornton's monograph Tastemakers and Tastemaking: Mexico and Curated Screen Violence, forthcoming at the time of writing, promises to traverse normative boundaries between “high” and “low” media and address at least one telenovela.
This introduction offers a synopsis of Mexican Genders, Mexican Genres, sets out some of my sources for Mexican audiovisual ecology since 2010, and ends with a piece of reportage on media reception on the ground in Mexico City in early 2019. The first section, three chapters of the book proper, deals with cinema.
To examine whether national initiatives have led to improvements in the physical health of people with psychosis. Secondary analysis of a national audit of services for people with psychosis. Proportions of patients in ‘good health’ according to seven measures, and one composite measure derived from national standards, were compared between multiple rounds of data collection.
The proportion of patients in overall ‘good health’ under the care of ‘Early Intervention in Psychosis’ teams increased from 2014–2019, particularly for measures of smoking, alcohol and substance use. There was no overall change in the proportion of patients in overall ‘good health’ under the care of ‘Community Mental Health Teams’ from 2011–2017. However, there were improvements in alcohol use, blood glucose and lipid levels.
There have been modest improvements in the health of people with psychosis over the last nine years. Continuing efforts are required to translate these improvements into reductions in premature mortality.
Disasters have many deleterious effects and are becoming more frequent. From a health-care perspective, disasters may cause periods of stress for hospitals and health-care systems. Telemedicine is a rapidly growing technology that has been used to improve access to health-care during disasters. Telemedicine applied in disasters is referred to as disaster telemedicine. Our objective was to conduct a scoping literature review on current use of disaster telemedicine to develop recommendations addressing the most common barriers to implementation of a telemedicine system for regional disaster health response in the United States. Publications on telemedicine in disasters were collected from online databases. This included both publications in English and those translated into English. Predesigned inclusion/exclusion criteria and a PRISMA flow diagram were applied. The PRISMA flow diagram was used on the basis that it would help streamline the available literature. Literature that met the criteria was scored by 2 reviewers who rated relevance to commonly identified disaster telemedicine implementation barriers, as well as how disaster telemedicine systems were implemented. We also identified other frequently mentioned themes and briefly summarized recommendations for those topics. Literature scoring resulted in the following topics: telemedicine usage (42 publications), system design and operating models (43 publications), as well as difficulties with credentialing (5 publications), licensure (6 publications), liability (4 publications), reimbursement (5 publications), and technology (24 publications). Recommendations from each category were qualitatively summarized.