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There is a paucity of data guiding treatment duration of oral vancomycin for Clostridiodes difficile infection (CDI) in patients requiring concomitant systemic antibiotics.
Objectives:
To evaluate prescribing practices of vancomycin for CDI in patients that required concurrent systemic antibiotics and to determine whether a prolonged duration of vancomycin (>14 days), compared to a standard duration (10–14 days), decreased CDI recurrence.
Methods:
In this retrospective cohort study, we evaluated adult hospitalized patients with an initial episode of CDI who were treated with vancomycin and who received overlapping systemic antibiotics for >72 hours. Outcomes of interest included CDI recurrence and isolation of vancomycin-resistant Enterococcus (VRE).
Results:
Among the 218 patients included, 36% received a standard duration and 64% received a prolonged duration of treatment for a median of 13 days (11–14) and 20 days (16–26), respectively. Patients who received a prolonged duration had a longer median duration of systemic antibiotic overlap with vancomycin (11 vs 8 days; P < .001) and significantly more carbapenem use and infectious disease consultation. Recurrence at 8 weeks (12% standard duration vs 8% prolonged duration; P = .367), recurrence at 6 months (15% standard duration vs 10% prolonged duration; P = .240), and VRE isolation (3% standard duration vs 9% prolonged duration; P = .083) were not significantly different between groups. Discontinuation of vancomycin prior to completion of antibiotics was an independent predictor of 8-week recurrence on multivariable logistic regression (OR, 4.8; 95% CI, 1.3–18.1).
Conclusions:
Oral vancomycin prescribing relative to the systemic antibiotic end date may affect CDI recurrence to a greater extent than total vancomycin duration alone. Further studies are needed to confirm these findings.
We are grateful to DeFord et al. for the continued attention to our work and the crucial issues of fair representation in democratic electoral systems. Our response (Katz, King, and Rosenblatt Forthcoming) was designed to help readers avoid being misled by mistaken claims in DeFord et al. (Forthcoming-a), and does not address other literature or uses of our prior work. As it happens, none of our corrections were addressed (or contradicted) in the most recent submission (DeFord et al. Forthcoming-b).
Katz, King, and Rosenblatt (2020, American Political Science Review 114, 164–178) introduces a theoretical framework for understanding redistricting and electoral systems, built on basic statistical and social science principles of inference. DeFord et al. (2021, Political Analysis, this issue) instead focuses solely on descriptive measures, which lead to the problems identified in our article. In this article, we illustrate the essential role of these basic principles and then offer statistical, mathematical, and substantive corrections required to apply DeFord et al.’s calculations to social science questions of interest, while also showing how to easily resolve all claimed paradoxes and problems. We are grateful to the authors for their interest in our work and for this opportunity to clarify these principles and our theoretical framework.
What is classical music? This book answers the question in a manner never before attempted, by presenting the history of fifteen parallel traditions, of which Western classical music is just one. Eachmusic is analysed in terms of its modes, scales, and theory; its instruments, forms, and aesthetic goals; its historical development, golden age, and condition today; and the conventions governing its performance. The writers are leading ethnomusicologists, and their approach is based on the belief that music is best understood in the context of the culture which gave rise to it . By including Mande and Uzbek-Tajik music - plus North American jazz - in addition to the better-known styles of the Middle East, the Indian sub-continent, the Far East, and South-East Asia, this book offers challenging new perspectives on the word 'classical'. It shows the extent to which most classical traditions are underpinned by improvisation, and reveals the cognate origins of seemingly unrelated musics; it reflects the multifarious ways in which colonialism, migration, and new technology have affected musical development, and continue to do today. With specialist language kept to a minimum, it's designed to help both students and general readers to appreciate musical traditions which may be unfamiliar to them, and to encounter the reality which lies behind that lazy adjective 'exotic'.
MICHAEL CHURCH has spent much of his career in newspapers as a literary and arts editor; since 2010 he has been the music and opera critic of The Independent. From 1992 to 2005 he reported on traditional musics all over the world for the BBC World Service; in 2004, Topic Records released a CD of his Kazakh field recordings and, in 2007, two further CDs of his recordings in Georgia and Chechnya.
Contributors: Michael Church, Scott DeVeaux, Ivan Hewett, David W. Hughes, Jonathan Katz, Roderic Knight, Frank Kouwenhoven, Robert Labaree, Scott Marcus, Terry E. Miller, Dwight F.Reynolds, Neil Sorrell, Will Sumits, Richard Widdess, Ameneh Youssefzadeh
We clarify the theoretical foundations of partisan fairness standards for district-based democratic electoral systems, including essential assumptions and definitions not previously recognized, formalized, or in some cases even discussed. We also offer extensive empirical evidence for assumptions with observable implications. We cover partisan symmetry, the most commonly accepted fairness standard, and other perspectives. Throughout, we follow a fundamental principle of statistical inference too often ignored in this literature—defining the quantity of interest separately so its measures can be proven wrong, evaluated, and improved. This enables us to prove which of the many newly proposed fairness measures are statistically appropriate and which are biased, limited, or not measures of the theoretical quantity they seek to estimate at all. Because real-world redistricting and gerrymandering involve complicated politics with numerous participants and conflicting goals, measures biased for partisan fairness sometimes still provide useful descriptions of other aspects of electoral systems.
Local abiotic and biotic conditions can alter the strength of exotic species impacts. To better understand the effects of exotic species on invaded ecosystems and to prioritize management efforts, it is important that exotic species impacts are put in local environmental context. We studied how differences in plant community composition, photosynthetically active radiation (PAR), and available soil N associated with Russian olive presence are conditioned by local environmental variation within a western U.S. riparian ecosystem. In four sites along the South Fork of the Republican River in Colorado, we established 200 pairs of plots (underneath and apart from Russian olive) to measure the effects of invasion across the ecosystem. We used a series of a priori mixed models to identify environmental variables that altered the effects of Russian olive. For all response variables, models that included the interaction of environmental characteristics, such as presence/absence of an existing cottonwood canopy, with the presence/absence of Russian olive canopy were stronger candidate models than those that just included Russian olive canopy presence as a factor. Compared with reference plots outside of Russian olive canopy, plots underneath Russian olive had higher relative exotic cover (exotic/total cover), lower perennial C4 grass cover, and higher perennial forb cover. These effects were reduced, however, in the presence of a cottonwood canopy. As expected, Russian olive was associated with reduced PAR and increased N, but these effects were reduced under cottonwood canopy. Our results demonstrate that local abiotic and biotic environmental factors condition the effects of Russian olive within a heterogeneous riparian ecosystem and suggest that management efforts should be focused in open areas where Russian olive impacts are strongest.
In a previous article we showed that ordinary least squares with panel corrected standard errors is superior to the Parks generalized least squares approach to the estimation of time-series-cross-section models. In this article we compare our proposed method with another leading technique, Kmenta's “cross-sectionally heteroskedastic and timewise autocorrelated” model. This estimator uses generalized least squares to correct for both panel heteroskedasticity and temporally correlated errors. We argue that it is best to model dynamics via a lagged dependent variable rather than via serially correlated errors. The lagged dependent variable approach makes it easier for researchers to examine dynamics and allows for natural generalizations in a manner that the serially correlated errors approach does not. We also show that the generalized least squares correction for panel heteroskedasticity is, in general, no improvement over ordinary least squares and is, in the presence of parameter heterogeneity, inferior to it. In the conclusion we present a unified method for analyzing time-series-cross-section data.
Ordinal variables—categorical variables with a defined order to the categories, but without equal spacing between them—are frequently used in social science applications. Although a good deal of research exists on the proper modeling of ordinal response variables, there is not a clear directive as to how to model ordinal treatment variables. The usual approaches found in the literature for using ordinal treatment variables are either to use fully unconstrained, though additive, ordinal group indicators or to use a numeric predictor constrained to be continuous. Generalized additive models are a useful exception to these assumptions. In contrast to the generalized additive modeling approach, we propose the use of a Bayesian shrinkage estimator to model ordinal treatment variables. The estimator we discuss in this paper allows the model to contain both individual group—level indicators and a continuous predictor. In contrast to traditionally used shrinkage models that pull the data toward a common mean, we use a linear model as the basis. Thus, each individual effect can be arbitrary, but the model “shrinks” the estimates toward a linear ordinal framework according to the data. We demonstrate the estimator on two political science examples: the impact of voter identification requirements on turnout and the impact of the frequency of religious service attendance on the liberality of abortion attitudes.
This article considers random coefficient models (RCMs) for time-series—cross-section data. These models allow for unit to unit variation in the model parameters. The heart of the article compares the finite sample properties of the fully pooled estimator, the unit by unit (unpooled) estimator, and the (maximum likelihood) RCM estimator. The maximum likelihood estimator RCM performs well, even where the data were generated so that the RCM would be problematic. In an appendix, we show that the most common feasible generalized least squares estimator of the RCM models is always inferior to the maximum likelihood estimator, and in smaller samples dramatically so.
Katz and King have previously developed a model for predicting or explaining aggregate electoral results in multiparty democracies. Their model is, in principle, analogous to what least-squares regression provides American political researchers in that two-party system. Katz and King applied their model to three-party elections in England and revealed a variety of new features of incumbency advantage and sources of party support. Although the mathematics of their statistical model covers any number of political parties, it is computationally demanding, and hence slow and numerically imprecise, with more than three parties. In this paper we produce an approximate method that works in practice with many parties without making too many theoretical compromises. Our approach is to treat the problem as one of missing data. This allows us to use a modification of the fast EMis algorithm of King, Honaker, Joseph, and Scheve and to provide easy-to-use software, while retaining the attractive features of the Katz and King model, such as the t distribution and explicit models for uncontested seats.
Clad in traditional Hindu dress, a boy removes his shoes, approaches the shrine at the side of the stage and pays homage to a deity sitting garlanded under its canopy. Walking centre stage, making a bow with hands joined in salutation, he then takes his place in a little group seated cross-legged facing the audience, in the front of which are his family and teachers. The other musicians have been tuning their instruments: to his right the percussionist with the double-ended drum laid horizontally before him; to his left a violinist, instrument wedged between chest and foot so as to allow the left hand freedom of movement; behind him a woman gently strumming with one hand the four open strings of the long-necked drone lute. Now the young singer intones the first words of a prayer-song to the elephant-headed Lord Ganesa, the text composed by a sixteenth-century South Indian saint-poet. Against the background drone of upper and lower tonic and perfect fifth, the vocal line of the hymn is inflected and ornamented with little slides and oscillations: an affirmation of religious faith and poetic beauty. People in the audience call out their appreciation during the performance, and with hand-gestures mark the metre of the works the boy sings in his improvisation.
THIS is a South Indian arangētram, or ‘coming to the stage’: a debut performance for family, teachers and friends. The young artist's programme will have been prepared through years of study, and whether staged in India or abroad, this ceremony and its music are strongly redolent of the atmosphere of a Hindu temple. In stark contrast to the Muslim and Central Asian influences pervading Hindustani music, South Indian music's religious underpinning is everywhere apparent. In a famous scriptural passage, an ancient sage asks the God Vishnu how people may best come to know Him, and the God replies: ‘I dwell not in heaven, nor in the hearts of the Yogīs, nor in the sun. Where my devotees are singing, O Nārada, that is where I stand.’
In addition to its primary purpose as an artistic rite of passage for a boy or girl, in expatriate Indian communities the arangetram also makes a statement of cultural identity, and can be supported by musicians and teachers invited from India to take part.