Review of George Eliot

Having recalled George Eliot\u27s central position in the pantheon of nineteenth-century thought and belief, Pauline Nestor begins this fine, closely argued book by considering Eliot\u27s relevance today. Was John Bayley, for example, right when he said in his 1999 review of Katherine Hughes\u27s George Eliot: The Last Victorian, \u27George Eliot can reveal much to us today precisely because she and her rnindset and her philosophy of life seem so far off, so irrevocably in a past which has become and will no doubt remain totally a matter of history\u27? No, Nestor says, \u27the landscape of Eliot\u27s fiction is neither so distant, nor so unrecoverable\u27. The importance Eliot placed on sympathy is surely not irrelevant or old-fashioned just because we live in a new millennium. \u27More importantly, Eliot\u27s exploration of ethics in fiction turns not just on the issue of sympathy but, specifically, on the question of difference\u27, and that remains a contemporary concern - witness our own \u27debates on the representation of race and gender, which equally turn on a belief in the consequentiality of the word or image’. There is, then, still much to learn from Eliot\u27s realist fiction, \u27an extended, particularised and dramatic investigation of fundamental ethical problems\u27. The bulk of Nestor\u27s book considers that investigation in Scenes of Clerical Life and the novels. Scenes attempts to force sympathy for ordinary characters but is marked by an uncertain narrative voice - \u27subsequent works manage their didacticism with more grace and flexibility\u27 - and a limited conception of sympathy, or more accurately pity, which, instead of confirming similarities to Eliot\u27s characters, accentuates differences. Adam Bede is structurally and ethically more interesting. Groups of seemingly oppositional characters (Adam and Seth, Adam and Arthur, Dinah and Hetty) are gradually discovered to be more alike than different; consequently, there is a new focus on genuine sympathy and an ethics aimed at preventing, not reacting to, suffering. The Mill on the Floss explores the limits of sympathy. The self-regulation advocated in Adam Bede and imposed on Maggie Tulliver by family, St Ogg\u27s and herself is admired, because ties of family and community have validity; but it is also undesirable, because Maggie\u27s renunciation, in fact, serves as a healthy antidote to the \u27Rhadamanthine\u27 Tom. Her temperament \u27offers the only hope of social and ethical progress\u27. However, in solving Maggie\u27s dilemma, Eliot imposed \u27a form of fantastical euthanasia\u27 on her heroine, thereby faltering in her realism. Silas Mamer examines the \u27ethics of contiguity rather than of genealogy or identity\u27, involving those who can (or fail) to make \u27an extrarational leap\u27, akin to religious faith. Romola may appear to contrast Christianity and paganism, but it \u27actually explores a more fundamental [ethical] divide between a world of partisanship and false simplicities and one of non-partisan openness and diffidence\u27. In contrast, Felix Holt, Eliot\u27s ostensibly political novel, is really \u27a novel about secrets ... less concerned with the machinations of party politics than the working out of a politics of morality \u27, seen in the stories of Felix and Esther, Harold and Mrs. Transome. In Middlemarch, the \u27 ultimate ethical challenge... is to live vigilantly conscious of the fact that the other has [what Eliot\u27s narrator calls] an equivalent centre of self , achieved by, say, Dorothea when she learns to become sympathetically aware of Casaubon\u27s own awareness of his failure

Investigation des cas de dengue dans les départements de l´Atlantique, du Littoral et de l´Ouémé, Bénin, Avril-juillet 2019: Investigation of dengue cases in the Atlantic, Littoral and Ouémé departments, Benin, April-July 2019

Introduction: Le premier cas de dengue a été diagnostiqué en mai 2019 dans le département de l’Atlantique au Bénin. Entre le 26 avril et le 29 juillet 2019, l’épidémie s’est étendue aux départements du Littoral et de l’Ouémé. Nous avons mené cette investigation pour déterminer l’ampleur de l’épidémie afin de mettre en place des mesures de prévention et de contrôle. Méthodes: Il s’ agissait d’une étude transversale descriptive réalisée du 26 avril au 29 juillet 2019 portant sur les don-nées de surveillance des zones sanitaires ayant notifié les cas de dengue dans les trois (03) départements. Les cas de dengue ont été recensés suivant la définition des cas élaboré. Nous avons examiné les dossiers médicaux des cas, les registres des hôpitaux et les fiches de notification des cas de dengue. Un question-naire a été administré aux malades dans les formations sanitaires ou à domicile. Résultats: Sur 30 cas suspects de dengue notifiés, 08 ont été confirmés. Parmi les 08 cas confirmés deux (02) étaient décédés. L’âge médian des cas était de 26,5 ans, Intervalle inter quartile (IIQ) : 22 ans -32 ans. Les dépar-tements d’Atlantique et du Littoral ont enregistré respectivement 13,3% et 83,3% de cas notifiés. Le délai moyen d’admission des patients à l’hôpital était de 4 jours +/- 3 jours. Tous les cas avaient déclaré qu’ils dormaient sous moustiquaire la nuit mais pas la journée et que leur milieu de vie contient des réceptacles d’eau. Le délai d’admission à l’hôpital du cas index et la confirmation est de 1 jour. Conclusion: Le Bénin a connu sa première épidémie de dengue en 2019. Le renforcement de la surveillance de la den-gue à travers le rapportage hebdomadaire des cas de toutes les formations sanitaires publiques et privées est nécessaire pour le contrôle de la maladie au Benin. Background: The first case of dengue fever was diagnosed in May 2019 in the Atlantic department of Be-nin. From April 26 to July 29, 2019, the epidemic reached the Littoral and Ouémé depart-ments. We conducted this study to determine the scale of the epidemic in order to put in place prevention and control measures. Methods: We conducted a transversal descriptive study by examining the surveillance data in the health districts having notified the cases in the three (03) departments. The cases of dengue were identified according to the definition of the cases developed. We reviewed the Medical case files, hospital registers and dengue case reports. A question-naire was administered to patients in health facilities and at home. Results: Out of 30 suspected cases of dengue fever, 08 were confirmed, of which 02 died. The median age was 26.5 years IIQ22 to 32 years. The departments of Atlantic and Littoral recorded re-spectively 13,3% and 83,3% of confirmed notified. The average time to hospital admission for patients was 4 days (0-10 days). All of the cases reported sleeping under mosquito nets at night but not during the day and that their living environment contains water receptacles. The time to hospital admission for the index case and confirmation was 1 day. Conclusion: Benin experienced its first dengue epidemic in 2019. Strengthening dengue surveillance through weekly case reporting from all public and private health facilities is necessary for disease control in Benin

A formação de engenheiros civis, a estrada de ferro do nordeste e a dupla calçada BTS

This article is the product of a study carried out at the university Santo Tomas in Tunja, regarding the restoration of the Northeast railroad and the training of civil engineers, which is done according to the method of other projects. Work has been done using this method and it has been found that the learning is truly extraordinary. It is observed that the percentage of retention is practically tripled for knowledge, motivation and dedication to creating knowledge. In this project we worked, from the perspective of a teacher, with two students, who devoted important time to the gathering of information, to its processing and analysis and to its verification. There is a clear need to restore the railroad, and in a short time rectify its route and widen the path, given that with studies on mobility, on accident rates, morbidity and mortality in the highway, in constant growth, there are many human, social, environmental, and economic losses being generated. Additionally it is estimated that around the year 2020, the divided highway will be saturated and it will be very expensive to carry out its expansion. The results were obtained based on field work, which was carried out in order to identify the current state of the railroad between Bogotá and Belencito, a stage of information gathering on historical data of vehicle mobility and accident rates registered in recent years, information on environmental pollution related to the emission of polluting agents, a product of fossil fuel use and its negative effects on the environment.Este artículo es producto de una investigación que se llevó a cabo en la Universidad Santo Tomás, seccional Tunja, sobre la propuesta de rehabilitación del ferrocarril del Nordeste y el estudio de la doble calzada BriceñoTunja-Sogamoso (BTS) como estrategia de formación de los ingenieros civiles a partir del método por proyectos. En esta experiencia se observa que prácticamente se triplica el porcentaje de retención, motivación y dedicación a la construcción de los conocimientos. En este proyecto se trabajó con la orientación de un docente y con dos estudiantes, quienes dedicaron un tiempo muy importante a la recolección, el procesamiento, el análisis y la constatación de la información. Se ve la necesidad de rehabilitar el ferrocarril y, en corto tiempo, rectificar su trazado y ampliar la trocha, dado que con los estudios de movilidad, accidentalidad, morbilidad y mortalidad por la carretera, en constante crecimiento, son muchas las pérdidas humanas, sociales, ambientales y económicas que se están generando. Adicionalmente, se estima que hacia el 2020 la doble calzada BTS estará saturada, por lo cual se requiere un costo muy elevado para desarrollar su ampliación. Los resultados se obtuvieron a partir de un trabajo de campo que buscaba identificar el estado actual de la vía férrea entre Bogotá y Belencito, y una etapa de recopilación de información sobre datos históricos de movilidad vehicular y accidentalidad registrados en los últimos años, así como información de contaminación ambiental relacionada con la emisión de agentes contaminantes producto del uso de combustibles fósiles y sus efectos negativos sobre el medioambiente.Este artigo é produto de uma pesquisa realizada na universidade de Santo Tomás, em Tunja, sobre a proposta de reabilitação do caminho de ferro do Nordeste e a formação dos engenheiros civis, que se faz a partir do método por projetos. Tem-se trabalhado com este método e verificou-se que a aprendizagem é realmente extraordinária. Observa-se que, praticamente, foi triplicado o percentual de retenção de conhecimento, de motivação e de dedicação à construção dos conhecimentos. Neste projeto, dois alunos trabalharam sob a orientação de um docente. Estes dedicaram um tempo muito importante para a coleta de informações, processamento e análise e para a contratação da mesma. Vê-se a necessidade de reabilitar a estrada de ferro e, em um curto espaço de tempo retificar o seu traçado e alargar a bitola, dado que, com os estudos de mobilidade, em matéria de sinistralidade, de morbidade e mortalidade na estrada, em constante crescimento, são muitas as perdas humanas, sociais, ambientais e econômicas que podem emergir. Além disso, estima-se que perto do ano 2020, a estrada de duas vias estará saturada e se requer um custo muito elevado para desenvolver a sua ampliação. Os resultados foram obtidos com base em um trabalho de campo, que foi realizado para identificar o estado atual da via férrea entre a cidade de Bogotá e a cidade de Belencito, uma etapa de coleta de informações sobre dados históricos de mobilidade veicular e acidentalidade registradas nos últimos anos; além de informações de poluição ambiental relacionada com a emissão de agentes poluentes, produto do uso de combustíveis fósseis e seus efeitos negativos sobre o meio ambiente

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

La didáctica y la necesidad de rectificar, ampliar y rehabilitar el ferrocarril del Nordeste

The paper shows the results of a research about the rehabilitation, expansion and correction of the Northeast Railroad, which covers the route from Belencito, in Nobsa Boyaca, to Bogota. With several visits the state of the railway was observed. Data was collected about the index of accidents, morbidity, and mortality. Further information was obtained about the average daily traffic variation in different points along the route. The first results are presented about the evaluation of these variables and their changes. En este artículo se presentan los principales resultados de una investigación que se está concluyendo sobre la rehabilitación, ampliación y rectificación del Ferrocarril del Nordeste, que cubre la ruta de Belencito, en Nobsa (Boyacá), hasta la ciudad de Bogotá. Para ello, se hicieron las visitas indispensables que permitieran observar el actual estado de la vía férrea; además, se documentó en varias formas este ferrocaril, se adelantó la recolección de los datos sobre accidentalidad, morbilidad y mortalidad, y se obtuvo la información sobre la variación del tráfico promedio diario en diferentes puntos de la ruta de los automotores. En este texto se muestran los primeros resultados que se tienen de este diagnóstico, donde se analizan los cambios presentados en estas variables.

CuInGaS2 photocathodes treated with SbX3 (X = Cl, I): the effect of the halide on solar water splitting performance

The realization of photoelectrochemical tandem cells for efficient solar-to-hydrogen energy conversion is currently impeded by the lack of inexpensive, stable, and efficient photocathodes. The family of sulfide chalcopyrites (CuInxGa1-xS2) has recently demonstrated a remarkable stability and performance even when prepared by solution-based routes that potentially lower the cost of fabrication. However, the photovoltage delivered by the photocathodes is still well-below the attainable values, a classical limitation linked to a large density of surface states in these materials. In the present work, we show that the identity of halide present during the growth of the solution-processed CuIn0.3Ga0.7S2 (CIGS) thin-films governs the overall performance by directing the crystal growth and the passivation of surface states. Replacing chlorine by iodine leads to CIGS photocathodes that deliver photocurrents of 5 mA cm(-2) (at 0 V versus RHE) and a turn-on voltage of 0.5 V versus RHE without charge extracting overlayer nor any sign of deterioration during stability test

Hippocampal atrophy and cognitive function in transient ischemic attack and minor stroke patients over three years

Introduction: Transient ischemic attack (TIA) and minor ischemic stroke (IS) is associated with a increased risk of late life dementia. In this study we aim to study the extent to which the rates of hippocampal atrophy in TIA/IS differ from healthy controls, and how they are correlated to neuropsychological measurements. Methods: TIA or minor stroke patients were tested with a neuropsychological battery including tests of executive function, and verbal and non-verbal memory at three time points out to 3 years. Annualized rates of hippocampal atrophy in TIA/IS patients were compared to controls. A linear-mixed regression model was used to assess the difference in rates of hippocampal atrophy after adjusting for time and demographic characteristics. Results: TIA/IS patients demonstrated a higher hippocampal atrophy rate than healthy controls over a 3-year interval: the annual percentage change of the left hippocampal volume was 2.5% (78 mm3 per year (SD 60)) for TIA/IS patients compared to 0.9% (29 mm3 per year (SD 32)) for controls (p < 0.01); and the annual percentage change of the right hippocampal volume was 2.5% (80 mm3 per year (SD 46)) for TIA/IS patients compared to 0.5% (17 mm3 per year (SD 33)) for controls (P < 0.01). Patients with higher annual hippocampal atrophy were more likely to report higher TMT B times, but lower ROC total score, lower California Verbal Learning Test-II total recall, and lower ROC Figure recall scores longitudinally. Conclusion: TIA/IS patients experience a higher rate of hippocampal atrophy independent of TIA/IS recurrence that are associated with changes in episodic memory and executive function over 3 years