Choral blend: sound or sensation? : an interpretative phenomenological analysis of proto-professional singers’ perceptions of ensemble singing

‘Choral blend’ is ill defined in the literature surrounding ensemble singing. The phenomenon is variously described as a noun, the aesthetic product of a choir singing; and as a verb, the technique of singing associated with ensembles. With such wildly varying definitions, the use of this term in rehearsals has become a topic of contention between singing teachers and ensemble directors. This thesis takes a singer-centric approach to investigate the phenomenon of ensemble singing, with a particular focus on ‘choral blend’. Twelve proto-professional training singers with experience of expert ensemble singing were recorded both individually and collectively during a rehearsal led by the researcher. These two auditory perspectives were given as an interview stimulus for participants. Interview data was then analysed using Interpretive Phenomenological Analysis. The use of close microphone techniques in ensemble settings, and their use as auditory interview stimuli, are novel methodological techniques in IPA. Key findings reveal the significance of familiarity in the building up of auditory images, and expectancies as a way to describe the individual modifications needed in an ensemble. These two concepts are drawn together through the Embodied Music Cognition paradigm, and blend as a dynamic and ever-changing concept is advocated. Community of Practice frameworks are proposed as a useful tool for describing the ensemble experience of participants. These communities of practice are created afresh with each group in every session they meet. Some elements of the joint repertoire that spans across experiences are discussed. With these communities of practice being created by singers, the role of the conductor and the agency of choral sound is also interrogated. The sensation of an individual singing well in a choral group is attributed to their being in a flow state. A discussion of how participants achieve flow in peak ensemble experience, and the prerequisites for this state, form a major finding of this thesis. The conflation of blend technique with flow state is interrogated. While individual flow state is equated with blend the verb, the aesthetic object of the choir is equated to blend the noun. This sensation of group flow can lead to an emergent choral instrument being cocreated by singers during performance. This new choral instrument, greater than the sum of the parts of the individual singers goes some way to explaining the physical sensation of being ‘within the choir’. The word blend is used in many different contexts, and participants had an embodied knowledge of that concept. This thesis argues that use of the word blend can be unhelpful in attempting to form a particular aesthetic, and that acknowledging the agency of singers over the creation of the choral sound is more likely to result in a peak ensemble experience for all stakeholders."I would also like to thank the Royal Conservatoire of Scotland for the financial support provided by the studentship process..." -- Acknowledgement

Etablierung eines revers–genetischen Systems für feline Coronaviren

Im Rahmen dieser Arbeit erfolgte die Etablierung eines revers-genetischen Systems für ein Serotyp I felines Coronavirus (FCoV). Dabei wurden folgende Ergebnisse erzielt: 1) Als Grundlage für die Etablierung des Systems wurde die komplette Genomsequenz des FCoV Stammes Black bestimmt und anhand dieser Sequenz der Genomaufbau ermittelt. Es ließ sich der für Coronaviren typische Genomaufbau nachweisen. 2) Die Herstellung eines infektiösen Klons beinhaltete die Integration einer kompletten cDNA Kopie des FCoV Stammes Black in das Vaccinia Virus Genom, welches als Vektor diente. Die coronavirale cDNA wurde in vitro transkribiert und die synthetische RNA in Zellen elektroporiert. Rekombinante FCoV ließen sich nachweisen und somit war die synthetische RNA infektiös, also in der Lage, den coronaviralen Replikationszyklus zu initiieren und zu durchlaufen. Die Analyse der gewonnenen rekombinanten Viren erfolgte nach Infektion feliner Zellkulturen mit verschiedenen Ansätzen. Dabei konnte festgestellt werden, dass die rekombinanten Viren die gleichen Eigenschaften wie der ursprüngliche FCoV Stamm Black besitzen. 3) In nachfolgenden Versuchen erfolgte die Herstellung zweier Reportergenexprimierender FCoV mit dem etablierten revers-genetischen System. Dabei wurden im FCoV Stamm Black Genom die akzessorischen Gene 3abc durch das „green fluorescent protein“ (GFP) oder Renilla Luciferase ersetzt. Die stabile Expression der Reportergene konnte in felinen Zellkulturen nachgewiesen werden. 4) Feline Monozyten, Makrophagen und dendritische Zellen (DCs), die als Zielzellen sowohl von FCoV als auch von anderen Coronaviren gelten, wurden mit Wildtyp und den Reportergen-exprimierenden FCoV in vitro infiziert. Die Infektion von monozytären Zellen konnte ausschließlich mit Hilfe der GFP exprimierenden Mutanten nachgewiesen werden.In this study a reverse genetic system for a serotype I feline coronavirus was established. The following results were obtained: 1) As basis for the establishment of a reverse genetic system the complete genomic sequence of FCoV strain Black was determined. The sequence analysis revealed the typical genome organization for coronavirus. 2) For the generation of an infectious clone the full-length FCoV strain Black cDNA was introduced into vaccinia virus as cloning vector. The FCoV cDNA was used for in vitro transcription and the synthesized RNA electroporated into cells. Recombinant FCoV could be detected which showed that the in vitro transcribed RNA was infectious and could initiate the coronavirus replication cycle. The resulting recombinant virus was analyzed in feline cell culture using different approaches. It could be demonstrated that the properties of the recombinant virus are indistinguishable from those of FCoV wild type virus strain Black. 3) In subsequent experiments based on the newly established reverse genetic system, two reporter gene expressing recombinant FCoV were generated. The accessory genes 3abc were replaced by genes encoding the green fluorescent protein (GFP) and Renilla luciferase. The stable expression of these reporter genes was demonstrated in feline cell culture. 4) Feline monocytes, macrophages and dendritic cells (DCs) which are considered to be important target cells for FCoV and other coronaviruses were infected with the wildtype and the reporter gene expressing FCoV. The infection of the monocytic cells was exclusively shown with the GFP expressing mutant

Emergence and spread of predominantly community-onset Clostridium difficile PCR ribotype 244 infection in Australia, 2010 to 2012

We describe an Australia-wide Clostridium difficile outbreak in 2011 and 2012 involving the previously uncommon ribotype 244. In Western Australia, 14 of 25 cases were community-associated, 11 were detected in patients younger than 65 years, 14 presented to emergency/outpatient departments, and 14 to non-tertiary/community hospitals. Using whole genome sequencing, we confirm ribotype 244 is from the same C. difficile clade as the epidemic ribotype 027. Like ribotype 027, it produces toxins A, B, and binary toxin, however it is fluoroquinolone-susceptible and thousands of single nucleotide variants distinct from ribotype 027. Fifteen outbreak isolates from across Australia were sequenced. Despite their geographic separation, all were genetically highly related without evidence of geographic clustering, consistent with a point source, for example affecting the national food chain. Comparison with reference laboratory strains revealed the outbreak clone shared a common ancestor with isolates from the United States and United Kingdom (UK). A strain obtained in the UK was phylogenetically related to our outbreak. Follow-up of that case revealed the patient had recently returned from Australia. Our data demonstrate new C. difficile strains are an on-going threat, with potential for rapid spread. Active surveillance is needed to identify and control emerging lineages

Clostridium difficile Infections amongst Patients with Haematological Malignancies: A Data Linkage Study

OBJECTIVES: Identify risk factors for Clostridium difficile infection (CDI) and assess CDI outcomes among Australian patients with a haematological malignancy. METHODS: A retrospective cohort study involving all patients admitted to hospitals in Western Australia with a haematological malignancy from July 2011 to June 2012. Hospital admission data were linked with all hospital investigated CDI case data. Potential risk factors were assessed by logistic regression. The risk of death within 60 and 90 days of CDI was assessed by Cox Proportional Hazards regression. RESULTS: There were 2085 patients of whom 65 had at least one CDI. Twenty percent of CDI cases were either community-acquired, indeterminate source or had only single-day admissions in the 28 days prior to CDI. Using logistic regression, having acute lymphocytic leukaemia, neutropenia and having had bacterial pneumonia or another bacterial infection were associated with CDI. CDI was associated with an increased risk of death within 60 and 90 days post CDI, but only two deaths had CDI recorded as an antecedent factor. Ribotyping information was available for 33 of the 65 CDIs. There were 19 different ribotypes identified. CONCLUSIONS: Neutropenia was strongly associated with CDI. While having CDI is a risk factor for death, in many cases it may not be a direct contributor to death but may reflect patients having higher morbidity. A wide variety of C. difficile ribotypes were found and community-acquired infection may be under-estimated in these patients

Community-acquired pneumonia in the United Kingdom:a call to action

Abstract Pneumococcal disease has a high burden in adults in the United Kingdom (UK); however, the total burden is underestimated, principally because most cases of community-acquired pneumonia (CAP) are non-invasive. Research into pneumonia receives poor funding relative to its disease burden (global mortality, disability-adjusted life years, and years lived with disability), ranking just 20 out of 25 for investment in infectious diseases in the UK. The current accuracy of data for establishing incidence rates is questionable, and it is a reflection of the paucity of research that much of the background information available derives from nearly 30 years ago. Given the relationship between CAP and mortality (pneumonia accounts for 29,000 deaths per annum in the UK, and 5–15% of patients hospitalised with CAP die within 30 days of admission), and the increasing threat of antimicrobial resistance associated with inappropriate antibiotic prescribing, such neglect of a highly prevalent problem is concerning. In this Call to Action, we explore the poorly understood burden of CAP in the UK, discuss the importance of an accurate diagnosis and appropriate treatment, and suggest how national collaboration could improve the management of an often life-threatening, yet potentially preventable disease

Molecular, microbiological and clinical characterization of Clostridium difficile isolates from tertiary care hospitals in Colombia

In Colombia, the epidemiology and circulating genotypes of Clostridium difficile have not yet been described. Therefore, we molecularly characterized clinical isolates of C.difficile from patients with suspicion of C.difficile infection (CDI) in three tertiary care hospitals. C.difficile was isolated from stool samples by culture, the presence of A/B toxins were detected by enzyme immunoassay, cytotoxicity was tested by cell culture and the antimicrobial susceptibility determined. After DNA extraction, tcdA, tcdB and binary toxin (CDTa/CDTb) genes were detected by PCR, and PCR-ribotyping performed. From a total of 913 stool samples collected during 2013–2014, 775 were included in the study. The frequency of A/B toxins-positive samples was 9.7% (75/775). A total of 143 isolates of C.difficile were recovered from culture, 110 (76.9%) produced cytotoxic effect in cell culture, 100 (69.9%) were tcdA+/tcdB+, 11 (7.7%) tcdA-/tcdB+, 32 (22.4%) tcdA-/tcdB- and 25 (17.5%) CDTa+/CDTb+. From 37 ribotypes identified, ribotypes 591 (20%), 106 (9%) and 002 (7.9%) were the most prevalent; only one isolate corresponded to ribotype 027, four to ribotype 078 and four were new ribotypes (794,795, 804,805). All isolates were susceptible to vancomycin and metronidazole, while 85% and 7.7% were resistant to clindamycin and moxifloxacin, respectively. By multivariate analysis, significant risk factors associated to CDI were, staying in orthopedic service, exposure to third-generation cephalosporins and staying in an ICU before CDI symptoms; moreover, steroids showed to be a protector factor. These results revealed new C. difficile ribotypes and a high diversity profile circulating in Colombia different from those reported in America and European countries

Ridinilazole: A novel therapy for Clostridium difficile infection

Clostridium difficile infection (CDI) is the leading cause of infectious healthcare-associated diarrhoea. Recurrent CDI increases disease morbidity and mortality, posing a high burden to patients and a growing economic burden to the healthcare system. Thus, there exists a significant unmet and increasing medical need for new therapies for CDI. This review aims to provide a concise summary of CDI in general and a specific update on ridinilazole (formerly SMT19969), a novel antibacterial currently under development for the treatment of CDI. Owing to its highly targeted spectrum of activity and ability to spare the normal gut microbiota, ridinilazole provides significant advantages over metronidazole and vancomycin, the mainstay antibiotics for CDI. Ridinilazole is bactericidal against . C. difficile and exhibits a prolonged post-antibiotic effect. Furthermore, treatment with ridinilazole results in decreased toxin production. A phase 1 trial demonstrated that oral ridinilazole is well tolerated and specifically targets clostridia whilst sparing other faecal bacteria. Phase 2 and 3 trials will hopefully further our understanding of the clinical utility of ridinilazole for the treatment of CDI

Novel therapies and preventative strategies for primary and recurrent Clostridium difficile infections

Clostridium difficile is the leading infectious cause of antibiotic‐associated diarrhea and colitis. C. difficile infection (CDI) places a heavy burden on the healthcare system, with nearly half a million infections yearly and an approximate 20% recurrence risk after successful initial therapy. The high incidence has driven new research on improved prevention such as the emerging use of probiotics, intestinal microbiome manipulation during antibiotic therapies, vaccinations, and newer antibiotics that reduce the disruption of the intestinal microbiome. While the treatment of acute C. difficile is effective in most patients, it can be further optimized by adjuvant therapies that improve the initial treatment success and decrease the risk of subsequent recurrence. Finally, the high risk of recurrence has led to multiple emerging therapies that target toxin activity, recovery of the intestinal microbial community, and elimination of latent C. difficile in the intestine. In summary, CDIs illustrate the complex interaction among host physiology, microbial community, and pathogen that requires specific therapies to address each of the factors leading to primary infection and recurrence.Clostridium difficile is the leading infectious cause of antibiotic‐associated diarrhea and colitis. This has driven new research on improving the prevention, primary treatment, and reduction of recurrence of C. difficile infection. This review summarizes current therapy recommendations for C. difficile infection, indicates areas for improvement, and describes the new emerging drugs and treatments that we hope will address these areas.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147228/1/nyas13958.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147228/2/nyas13958_am.pd