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Clinical trials for assessing the effects of infection prevention and control (IPC) interventions are expensive and have shown mixed results. Mathematical models can be relatively inexpensive tools for evaluating the potential of interventions. However, capturing nuances between institutions and in patient populations have adversely affected the power of computational models of nosocomial transmission.
Methods:
In this study, we present an agent-based model of ICUs in a tertiary care hospital, which directly uses data from the electronic medical records (EMR) to simulate pathogen transmission between patients, HCWs, and the environment. We demonstrate the application of our model to estimate the effects of IPC interventions at the local hospital level. Furthermore, we identify the most important sources of uncertainty, suggesting areas for prioritization in data collection.
Results:
Our model suggests that the stochasticity in ICU infections was mainly due to the uncertainties in admission prevalence, hand hygiene compliance/efficacy, and environmental disinfection efficacy. Analysis of interventions found that improving mean HCW compliance to hand hygiene protocols to 95% from 70%, mean terminal room disinfection efficacy to 95% from 50%, and reducing post-handwashing residual contamination down to 1% from 50%, could reduce infections by an average of 36%, 31%, and 26%, respectively.
Conclusions:
In-silico models of transmission coupled to EMR data can improve the assessment of IPC interventions. However, reducing the uncertainty of the estimated effectiveness requires collecting data on unknown or lesser known epidemiological and operational parameters of transmission, particularly admission prevalence, hand hygiene compliance/efficacy, and environmental disinfection efficacy.
Chapter 7 investigates the nationalizations of property adopted by the communist regime during the crucial (formative) six years of its power (1945–1950) and their role in shaping the lives of Jewish individuals and communities, especially in relation to their emigration from Romania. It shows that many Jews feared and opposed the communist measures of nationalizing private and communal property and that many of them were victimized through these dispossession policies in a higher proportion than the majority gentile population.
Displacement owing to climate change is quickly outpacing conflict, political oppression, and other sociopolitical forces from which people flee the states in which they habitually reside. However, at present, most ongoing state-based programs to admit displaced persons explicitly address themselves to people displaced by conflict and human rights abuses. One notable exception is Temporary Protected Status (TPS) in the US. Nationals of countries experiencing “natural disasters” can be designated for TPS while in the US. Recipients often renew these twelve- to eighteen-month visas for many years, meanwhile putting down roots in the US and forming mixed status families. Such relief is episodic, insofar as it treats natural disasters as discrete and unpredictable events, and discretionary, insofar as it depends on the judgment of the United States Attorney General. This chapter raises questions about whether such an approach is a good model for future programs that will be needed to support people seeking refuge from uninhabitable or inhospitable environments.
After the putsch that toppled the Antonescu regime in August 1944, Romania changed sides: It abandoned the Axis and joined the Allies. Even though the new transitional governments proceeded to build a democratic society, formally abolished the Romanianization legislation, and adopted the main restitution laws rather quickly (by the summer of 1945), restitution did not proceed smoothly in practice. A fair, rapid, complete, and permanent restitution of real estate, businesses and other rights did not take place. Restituting Romanianized Jewish property and repairing Holocaust injustices in the aftermath of the Antonescu regime proved to be a complicated process involving Jewish leaders and ordinary survivors, Jewish domestic and international organizations, individual gentile profiteers, Romania’s transitional governments, and political and social groups.
The added mass force resulting from the acceleration of a body in a fluid is of fundamental and practical interest in dispersed multiphase flows. Euler–Lagrange (EL) and Euler–Euler (EE) simulations require closure terms for the added mass force in order to accurately couple the conserved variables between phases. Presently, a more thorough understanding of the added mass force in a multi-particle system is developed based on potential flow resulting in a resistance matrix formulation analogous to Stokesian dynamics. This formulation is then used to generate a dataset of added mass resistance matrices for large systems of randomly generated particles. This methodology is used to create a volume fraction corrected binary model for predicting the added mass force in large systems as well as generate statistics of the added mass force in such systems. This work provides clarification to the theory of the added mass force for particle clouds, and modelling options that may be implemented in existing EL and EE codes.
One of the most famous catchphrases to describe the First World War was H.G. Well's ‘war to end all wars’. Once an idealistic slogan, it is now mainly used sardonically as a tragic depiction of what felt at the time to be the longest and bloodiest war of the age. But Wells described what in 1914 seemed a plausible outcome of the war: this was expected to be the last great conflict between nations before an international order was finally established. This view was later shared by another well-known liberal internationalist, Alfred Zimmern, who advocated for a treaty that made war a crime in any circumstance and a covenant to substitute the old order of ‘power-politics’ with ‘responsibility-polities’. As one of the chief interpreters of the League of Nations (LON), Zimmern remains a symbol of the contradictions of the institution in its quest to establish a ‘new order’ through the rule of law. However, this new order was not destined to last, as the League's life was short, eventful and ultimately tragic.
This essay situates Mary Astell’s understanding of women’s moral freedom in the context of her under-studied vocabulary of “Epicurism.” It foregrounds Astell’s engagement with two contemporaneous accounts of the will, both of which can be broadly characterized as hedonistic. On the first, developed by John Norris (1688, 1693), God ensures conformity between his will and the human will by endowing agents with a love of pleasure that moves them in his direction. On the second, delineated by John Locke (1690), human wills are motivated by a morally neutral desire for pleasure, which acquires moral significance only when agents exercise their power of freedom or bring their reason to evaluate the goods that give them pleasure. In her writings of the 1690s, Astell develops a feminist ethics that is far closer to Locke’s than has been recognized. Like Locke, and unlike Norris, she suggests that agents are themselves responsible for aligning their wills with God’s, and they must do so by cultivating reason and a taste for virtuous pleasures. In a distinctively feminist move, she maps how patriarchal society corrupts women’s wills by directing their desires to sense-based goods only, preventing them from achieving the happiness due to them as rational beings. While Astell is routinely characterized as a rationalist philosopher, she is a rationalist who, like Locke, is highly aware of the limits of reason, and deeply interested in the potential of agents to transform their likes and dislikes so that they find pleasure in the exercise of virtue.
This article is part of Religious Studies’ new initiative to publish a series of interviews with distinguished philosophers of religion. Each interview explores the personal and academic background of the interviewee and discusses their core philosophical views. The aim is to inspire students and scholars and to provide an overview of some of the most important works developed by contemporary philosophers of religion. In this interview, Tyler Dalton McNabb interviews Keith Ward, covering such topics as his upbringing, his first years of teaching, his view on natural theology, and his view on special revelation in the world religions.
For over 400 years, Sassanid Persia was the greatest state in Asia. To the east, the Kushan Empire was already in decline. The only strong opponent of Iran was the Roman Empire in the west. Military competition for influence in northern Mesopotamia, Armenia and the Caucasus region dominated Iranian–Roman relations, orienting the strategic activities of the early Sassanids to the western fringes of the empire. The breakthrough came in the mid-fourth century, with the emergence of the Kidara Huns in the east. Iran faced a ‘strategic dilemma’: it was crucial to avoid wars on multiple fronts. The Hephthalites or White Huns, became the most important enemy of the Sassanians until the end of the following century; the adoption of such a strategic paradigm enforced the maintenance of peace with the Roman Empire in the west. However, the Sassanian ruler, having secured the eastern territories, was able to move against Iran’s age-old enemy, Rome, this way beginning a period of wars in the west that, with few interruptions, lasted almost until the collapse of the Persian state. Defending such an enormous area was a challenge, as was preventing it from centrifugal tendencies, typical for multi-ethnic states. Despite these factors, the Iranian state managed to assure the territorial integrity of its core areas for four centuries. The tool to achieve this was the army – mobile, efficient, disciplined and motivated.
In this paper, we study the ranges of the Schwartz space $\mathcal {S}$ and its dual $\mathcal {S}'$ (space of tempered distributions) under the Bargmann transform. The characterization of these two ranges leads to interesting reproducing kernel Hilbert spaces whose reproducing kernels can be expressed, respectively, in terms of the Touchard polynomials and the hypergeometric functions. We investigate the main properties of some associated operators and introduce two generalized Bargmann transforms in this framework. This can be considered as a continuation of an interesting research path that Neretin started earlier in his book on Gaussian integral operators.