To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Monitoring antibiotic consumption is a key component to steer antimicrobial stewardship programs, including in nursing homes. We analyzed changes in antibiotic consumption in French nursing homes during 5 years, including the COVID-19 pandemic, to identify potential priorities for improvement.
Design:
A multicenter survey was conducted between 2018 and 2022.
Setting:
The study was conducted across 220 French nursing homes with on-site pharmacies.
Method:
Antibiotic consumption data were collected from pharmacy records and are expressed as defined daily doses per 1,000 resident days. Antibiotic indicators promoted by health authorities were calculated from quantitative data to evaluate the quality of prescribing.
Results:
Antibiotic consumption significantly decreased between 2018 and 2022, particularly during the coronavirus disease 2019 (COVID-19) pandemic, despite a slight increase in 2022. During the study period, the most used antibiotic classes were penicillins (61.9% in 2022) followed by cephalosporins (10.5%), macrolides–lincosamides–streptogramins (7.3%) then fluoroquinolones (7.0%). Amoxicillin–clavulanic acid was the most consumed antibiotic; amoxicillin and ceftriaxone ranked second and third. Azithromycin consumption increased from 2020, as did the indicator regarding broad-spectrum antibiotics.
Conclusions:
The decreasing trend in antibiotic use and control of fluoroquinolone use over the study period suggest compliance with antibiotic use guidelines. However, changes in the use of broad-spectrum antibiotics and the substantial use of amoxicillin-clavulanic acid, although it is rarely a first-line antibiotic, highlight the need for antimicrobial stewardship activities and the usefulness of antibiotic consumption surveillance to identify priorities.
This article examines the constructions of Black “degeneracy” through which white Americans rationalized Jim Crow terror. Ruminations on African Americans’ supposed downward trajectory, I argue, drew relational meaning from a range of colonial discourses. Claims that African Americans were deteriorating outside the bonds of enslavement were articulated within wider transnational imperialist discourses circulating in this period that imagined that the world's savage peoples were destined to recede in the march of civilization. Here, I examine white Americans’ narratives of African American degeneration through two other imagined hemispheric encounters between white civilization and savagery. In the article's first half, I consider images of Haiti employed in cultural and political texts to signify the durability of innate Black savagery and the apocalyptic potential of Black freedom. In the second half, I consider discourses of Black degeneration in freedom alongside the genocidal construction of the “vanishing Indian.” I focus on two memorial projects: the 1931 monument to the Faithful Slave erected in Harpers Ferry and the never-completed National American Indian Memorial, for which ground was broken in 1913 at Fort Wadsworth.
We initiate a systematic study of the perfection of affine group schemes of finite type over fields of positive characteristic. The main result intrinsically characterises and classifies the perfections of reductive groups and obtains a bijection with the set of classifying spaces of compact connected Lie groups topologically localised away from the characteristic. We also study the representations of perfectly reductive groups. We establish a highest weight classification of simple modules, the decomposition into blocks, and relate extension groups to those of the underlying abstract group.
This article develops a blueprint for creating online writing groups (OWGs) to support scholars who are directly and indirectly affected by disaster. Those who are living in regions affected by natural disasters face a severe psychological toll along with physical and logistical challenges. Furthermore, scholars in the diaspora who are watching their colleagues go about daily life while they struggle to meet writing deadlines can also experience detrimental psychological effects, including isolation anxiety. Findings from disaster studies research suggest that communal coping strategies can mitigate the short- and long-term challenges to mental health, including spiraling concerns about productivity that, in turn, inhibit productivity. My research builds on these studies, as well as analyses of virtual platforms used during the COVID-19 pandemic, to identify specific aspects of OWGs that can provide community and structure for scholars in the wake of natural disasters. I draw from my experience of creating and hosting a Zoom writing group for scholars from Turkey and Syria in the aftermath of the February 2023 earthquakes. In addition to participant observation of more than 240 two-hour sessions held over 42 weeks between March and December 2023, I draw from a survey-based assessment and email correspondence with participants to develop a best-practices model that I hope other scholars will replicate.
Vertical convection is the fluid motion that is induced by the heating and cooling of two opposed vertical boundaries of a rectangular cavity (see e.g. Wang et al., J. Fluid Mech., vol. 917, 2021, A6). We consider the linear stability of the steady two-dimensional flow reached at Rayleigh numbers of O($10^8$). As a function of the Prandtl number, $Pr$, and the height-to-width aspect ratio of the domain, $A$, the base flow of each case is computed numerically and linear simulations are used to obtain the properties of the leading linear instability mode. Flow regimes depend on the presence of a circulation in the entire cavity, detachment of the thermal layer from the boundary or the corner regions and on the oscillation frequency relative to the natural frequency of oscillation in the stably temperature-stratified interior, allowing for the presence of internal waves or not. Accordingly, the regime is called slow or fast, respectively. Either the global circulation or internal waves in the interior may couple the top and bottom buoyancy currents, while their absence implies asymmetry in their perturbation amplitude. Six flow regimes are found in the range of $0.1 \leq Pr \leq 4$ and $0.5 \leq A \leq 2$. For $Pr \lessapprox 0.4$ and $A>1$, the base flow is driven by a large circulation in the entire cavity. For $Pr \gtrapprox 0.7$, the thermal boundary layers are thin and the instability is driven by the motion along the wall and the detached boundary layer. A transition between these regimes is marked by a dramatic change in oscillation frequency at $Pr = 0.55 \pm 0.15$ and $A <2$.
This paper proposes a novel view in the the philosophy of race & causation literature known as “causal agnosticism” about race. Causal agnosticism about race implies that it is reasonable to refrain from making judgments about whether race is a cause. The paper’s thesis asserts that certain conditions must be met to infer that something is a cause, according to the fundamental assumptions of causal inference. However, in the case of race, these conditions are often violated. By advocating for causal agnosticism, the paper suggests a more modest approach to understanding the role of race in causal relationships.
Burials of eminent Quanzhen masters, particularly in the form of extravagant assembly-funerals, served as the initial step in the development of a Quanzhen-style ancestor worship. This ancestor worship functioned as the bedrock of a thriving Quanzhen lineage-building movement in thirteenth-century north China. Quanzhen Daoists attributed great significance to the physical remains of a lineage's founding master and commonly conducted multiple burials of the master. Each instance of reburial presented an opportunity for specific lineage members to assert their lineage identity, as well as ownership over the founding master's spiritual and material legacy. Lineage members commonly materialized their ancestor worship through a series of memorial objects established within a hosting monastery, including tombs, statues, portraits, memorial shrines, and commemorative steles. These lineage-building efforts strengthened dynamic networks of people, monasteries, and material culture, shaping regional interactions and transformations in north China under Mongol rule.
Rotational effects are commonly neglected when considering the dynamics of freely rising or settling isotropic particles. Here, we demonstrate that particle rotations play an important role for rising as well as for settling cylinders in situations when mass eccentricity, and thereby a new pendulum time scale, is introduced to the system. We employ two-dimensional simulations to study the motion of a single cylinder in a quiescent unbounded incompressible Newtonian fluid. This allows us to vary the Galileo number, density ratio, relative moment of inertia (MOI) and centre-of-mass (COM) offset systematically and beyond what is feasible experimentally. For certain buoyant density ratios, the particle dynamics exhibits a resonance mode, during which the coupling via the Magnus lift force causes a positive feedback between translational and rotational motions. This mode results in vastly different trajectories with significantly larger rotational and translational amplitudes and an increase of the drag coefficient easily exceeding a factor two. We propose a simple model that captures how the occurrence of the COM offset induced resonance regime varies, depending on the other input parameters, specifically the density ratio, the Galileo number and the relative MOI. Remarkably, depending on the input parameters, resonance can be observed for COM offsets as small as a few per cent of the particle diameter, showing that the particle dynamics can be highly sensitive to this parameter.
Tang expansion in the early seventh century brought about a series of changes to the eastern Tianshan region, including the incorporation of the region into the imperial postal relay and defence system. Important structures, including cities for the soldiers and other immigrants from Tang territory, along with fortresses and relay posts, were established along the major routes in the region, especially on the northern slopes of the Tianshan range. However, the era after the decline of the Tang is not as well known, due to a lack of contemporary sources. This article, based on a comprehensive analysis of documentary and unearthed materials, discusses a previously unacknowledged process of urbanisation in the region during the Uighur era. Uighur immigrants, originally nomads on the Mongolian steppe, occupied not only the cities, but also the garrisons and other infrastructure established by the Tang. As a result, urban settlements were established at sites that had previously served military purposes. Clusters of new cities emerged in the region, especially on the northern slopes of the Tianshan, which had long been part of the nomadic cultural zone. The sedentary and mercantile culture of the Uighurs played an important role in this process, serving as an impetus for economic prosperity along the eastern section of the Silk Road between the Tang and Mongol–Yuan eras.
Drawing on data generated from a two-year ethnographic observation with a group of multiethnic Black women, this investigation delves into the ways they employ discursive and linguistic strategies, namely solidarity through difference and distinction, solidarity through denaturalizing difference, and solidarity through shared struggles and learning in deictically anchored interactions. The study presents a moment-by-moment analysis of culturally and socially situated conversations. These conversations allow us to see how the social actors enact different stance-taking and scaling practices to construct meanings about race that intersect with gender/transnational identities. Discursive practices show that when we closely attend to race, transnationalism, and gender, specifically considering the particularity of Black womanhood, new and more complex ways of understanding transnational identity formation emerge. Participants’ constructions indicate that women co-construct a unique brand of Black feminist solidarity that is not based on similarity but meaningfully created through differentiation and distinction. (Black immigrant women, solidarity, stance-taking, scaling and deixis difference, African diaspora, intersectionality)*
The Lower Ordovician (Floian) Al Rose Formation from the Inyo Mountains, California, is a deeper-water, graptolitic equivalent of the well-known and richly fossiliferous successions described from Utah and Nevada. It is considered to have been originally marginal to the Laurentian paleocontinent. It has yielded a low-diversity trilobite fauna that differs strikingly from contemporary faunas to the east in its abundance of raphiophorid, nileid, olenid, and agnostoid trilobites, resembling that of the Nileid Biofacies known from scattered locations marginal to Laurentia. Two new trilobite species are described: Globampyx sexsegmentatus (Raphiophoridae) and Protopresbynileus divergens (Nileidae). Carolinites genacinaca Ross, 1951 is a link with the Great Basin. Other trilobites include the olenid Cloacaspis cf. C. ceryx anataphra Fortey, 1974, metagnostid Geragnostus cf. G. (Novoagnostus) longicollis Raymond, 1925, and pliomerid Hintzeia sp.
We reviewed outcomes in all 36 consecutive children <5 kg supported with the Berlin Heart pulsatile ventricular assist device at the University of Florida, comparing those with acquired heart disease (n = 8) to those with congenital heart disease (CHD) (n = 28).
Methods:
The primary outcome was mortality. The Kaplan-Meier method and log-rank tests were used to assess group differences in long-term survival after ventricular assist device insertion. T-tests using estimated survival proportions were used to compare groups at specific time points.
Results:
Of 82 patients supported with the Berlin Heart at our institution, 49 (49/82 = 59.76%) weighed <10 kg and 36 (36/82 = 43.90%) weighed <5 kg. Of 36 patients <5 kg, 26 (26/36 = 72.22%) were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 36 patients <5 kg was [days]: median = 109, range = 4–305.) Eight out of 36 patients <5 kg had acquired heart disease, and all eight [8/8 = 100%] were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 8 patients <5 kg with acquired heart disease was [days]: median = 50, range = 9–130.) Twenty-eight of 36 patients <5 kg had congenital heart disease. Eighteen of these 28 [64.3%] were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 28 patients <5 kg with congenital heart disease was [days]: median = 136, range = 4–305.) For all 36 patients who weighed <5 kg: 1-year survival estimate after ventricular assist device insertion = 62.7% (95% confidence interval = 48.5–81.2%) and 5-year survival estimate after ventricular assist device insertion = 58.5% (95% confidence interval = 43.8–78.3%). One-year survival after ventricular assist device insertion = 87.5% (95% confidence interval = 67.3–99.9%) in acquired heart disease and 55.6% (95% confidence interval = 39.5–78.2%) in CHD, P = 0.036. Five-year survival after ventricular assist device insertion = 87.5% (95% confidence interval = 67.3–99.9%) in acquired heart disease and 48.6% (95% confidence interval = 31.6–74.8%) in CHD, P = 0.014.
Conclusion:
Pulsatile ventricular assist device facilitates bridge to transplantation in neonates and infants weighing <5 kg; however, survival after ventricular assist device insertion in these small patients is less in those with CHD in comparison to those with acquired heart disease.
In the summer of 2019, two of us began our term as co-editors of Politics & Gender. We were excited to manage the top journal in the study of women, gender, and politics; help to shape our field; and advance outstanding scholarship. Before our first year ended, the global COVID-19 pandemic disrupted normal routines for many professions, including within the academy. Access to offices, professional networks, and fieldwork was halted or severely limited. Both new and experienced teachers quickly transitioned to online teaching. Scholars became ill or cared for sick family members. Faculty with preschool or school-aged children spent many hours on childcare and homeschooling, leaving them with less time for research and writing. Not all impacts were necessarily negative: those without caretaking responsibilities enjoyed more flexibility and often had more time for research and writing as in-person events were canceled and lengthy commutes disappeared.
The majority of protests in support of racial justice are peaceful. However, since the racial reckoning of 2020, there has been debate about when and how exposure to violent or disruptive protest activities can shift public opinion towards a social movement. Using the Black Lives Matter Movement as a lens, we design a survey experiment to test the causal effects of different protest tactics on support for protesters and the movement itself among Black and white Americans. We include a control condition with no protest and manipulate the level of disruption in each treatment condition, ranging from a simple march in response to the police killing of an unarmed Black man to a protest in which participants set fire to an empty police headquarters. We use OLS regressions to estimate average treatment effects. Overall, we find that both Blacks and whites react negatively to more disruptive protests but whites tend to react more negatively than Blacks. Conversely, we also find that whites overall report more confidence in the ability of Black Lives Matter to facilitate racial equality after exposure to a protest, even when that protest employs disruptive tactics. We also test for the moderating effects of racial identity and racial resentment. We conclude by discussing the implications of our findings for the broader literature on social movements and public opinion.
Predicting coastal change depends upon our knowledge of postglacial relative sea-level variability, partly controlled by glacio-isostatic responses to ice-sheet melting. Here, we reconstruct the postglacial relative sea-level changes along the Caribbean and Pacific coasts of northwestern South America by numerically solving the sea-level equation with two scenarios of mantle viscosity: global standard average and high viscosity. Our results with the standard model (applicable to the Pacific coast) agree with earlier studies by indicating a mid-Northgrippian high stand of ~2 m. The high-viscosity simulation (relevant to the Caribbean coast) shows that the transition from far- to intermediate-field influence of the Laurentide Ice Sheet occurs between Manzanillo del Mar and the Gulf of Morrosquillo. South of this location, the Colombian Caribbean coast has exhibited a still stand with a nearly constant Holocene relative sea level. By analyzing our simulations considering sea-level indicators, we argue that tectonics is more prominent than previously assumed, especially along the Caribbean coast. This influence prevents a simplified view of regional relative sea-level changes on the northwestern South American coast.
Elevated plasma concentrations of several one-carbon metabolites are associated with increased CVD risk. Both diet-induced regulation and dietary content of one-carbon metabolites can influence circulating concentrations of these markers. We cross-sectionally analysed 1928 patients with suspected stable angina pectoris (geometric mean age 61), representing elevated CVD risk, to assess associations between dietary macronutrient composition (FFQ) and plasma one-carbon metabolites and related B-vitamin status markers (GC–MS/MS, LC–MS/MS or microbiological assay). Diet-metabolite associations were modelled on the continuous scale, adjusted for age, sex, BMI, smoking, alcohol and total energy intake. Average (geometric mean (95 % prediction interval)) intake was forty-nine (38, 63) energy percent (E%) from carbohydrate, thirty-one (22, 45) E% from fat and seventeen (12, 22) E% from protein. The strongest associations were seen for higher protein intake, i.e. with higher plasma pyridoxal 5’-phosphate (PLP) (% change (95 % CI) 3·1 (2·1, 4·1)), cobalamin (2·9 (2·1, 3·7)), riboflavin (2·4 (1·1, 3·7)) and folate (2·1 (1·2, 3·1)) and lower total homocysteine (tHcy) (–1·4 (–1·9, −0·9)) and methylmalonic acid (MMA) (–1·4 (–2·0, −0·8)). Substitution analyses replacing MUFA or PUFA with SFA demonstrated higher plasma concentrations of riboflavin (5·0 (0·9, 9·3) and 3·3 (1·1, 5·6)), tHcy (2·3 (0·7, 3·8) and 1·3 (0·5, 2·2)) and MMA (2·0 (0·2, 3·9) and 1·7 (0·7, 2·7)) and lower PLP (–2·5 (–5·3, 0·3) and −2·7 (–4·2, −1·2)). In conclusion, a higher protein intake and replacing saturated with MUFA and PUFA were associated with a more favourable metabolic phenotype regarding metabolites associated with CVD risk.