On Being “Anti-Sublimed”: Early Tales of Fear and Glory at Niagara Falls

This essay reads accounts of travel to Niagara from the 1790s-1840s through thelens of the sublime and the picturesque. Beginning with masculine adventurers whohave special claims to the Burkean sublime, and moving onto later male and femaletravellers who master their feelings of weakness and irrationality through a moreKantian-based approach to reasoning, the essay ultimately isolates the criticalstage in sublime logic when incomprehension diverts to meaning and presents thisbreaking through as a discursive strategy the author calls "the anti-sublime."Dans cet essai, l’auteure examine des récits de voyages à Niagara desannées 1790 aux années 1840 sous l’angle du sublime et du pittoresque. Ellecommence par évoquer les aventuriers de sexe masculin se réclamant du sublimeburkien, pour s’intéresser ensuite aux voyageurs, hommes et femmes, quimaîtrisent leurs sentiments de faiblesse et d’irrationalité en adoptant unedémarche argumentative plus kantienne. Pour finir, elle isole l’étapecruciale de la logique du sublime, où l’on chemine du non-sens vers le sens,cette percée se présentant sous forme de stratégie discursive qu’elle nomme« l’anti-sublime »

A Retrospective Futurity: Daniel MacIvor's Marion Bridge

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Prophylaxis of postoperative endophthalmitis following cataract surgery: Results of the ESCRS multicenter study and identification of risk factors

Purpose: To identify risk factors and describe the effects of antibiotic prophylaxis on the incidence of postoperative endophthalmitis after cataract surgery based on analysis of the findings of the European Society of Cataract & Refractive Surgeons (ESCRS) multicenter study. Setting: Twenty-four ophthalmology units in Austria, Belgium, Germany, Italy, Poland, Portugal, Spain, Turkey, and the United Kingdom. Methods: A prospective randomized partially masked multicenter cataract surgery study recruited 16 603 patients. The study was based on a 2 × 2 factorial design, with intracameral cefuroxime and topical perioperative levofloxacin factors resulting in 4 treatment groups. The comparison of case and non-case data was performed using multivariable logistic regression analyses. Odds ratios (ORs) associated with treatment effects and other risk factors were estimated. Results: Twenty-nine patients presented with endophthalmitis, of whom 20 were classified as having proven infective endophthalmitis. The absence of an intracameral cefuroxime prophylactic regimen at 1 mg in 0.1 mL normal saline was associated with a 4.92-fold increase (95% confidence interval [CI], 1.87-12.9) in the risk for total postoperative endophthalmitis. In addition, the use of clear corneal incisions (CCIs) compared to scleral tunnels was associated with a 5.88-fold increase (95% CI, 1.34-25.9) in risk and the use of silicone intraocular lens (IOL) optic material compared to acrylic with a 3.13-fold increase (95% CI, 1.47-6.67). The presence of surgical complications increased the risk for total endophthalmitis 4.95-fold (95% CI, 1.68-14.6), and more experienced surgeons were more likely to be associated with endophthalmitis cases. When considering only proven infective endophthalmitis cases, the absence of cefuroxime and the use of silicone IOL optic material were significantly associated with an increased risk, and there was evidence that men were more predisposed to infection (OR, 2.70; 95% CI, 1.07-6.8). Conclusions: Use of intracameral cefuroxime at the end of surgery reduced the occurrence of postoperative endophthalmitis. Additional risk factors associated with endophthalmitis after cataract surgery included CCIs and the use of silicone IOLs. © 2007 ASCRS and ESCRS