Reading Musicals : Andrea Most\u27s Making Americans: Jews And The Broadway Musical

Andrea Most\u27s Making Americans:Jews and the Broadway Musical studies eight musicals (Thejazz Singer, Whoopee, Girl Crazy, Babes in Arms, Oklahoma!, Annie Get Your Gun, South Pacific, and The King and I) in an effort to explore how first- and second-generation American Jewish writers, composers, and performers used the theater to fashion their own identities as Americans. Most offers imaginative and often insightful sociological readings of musical librettos, lyrics, even stage directions, but virtually ignores music. That music can sometimes elucidate or contradict an exclusively social or literary reading may be seen, for example, in Emile de Becque\u27s immobility at the end of Some Enchanted Evening. In other cases, when the social assimilation of Jewish characters is revealed to be a musical one as well, music can support Most\u27s argument. The problem exemplified by writings such as Most\u27s-the distortions and misreadings that may result from a social history that does not engage music-may be seen in the broader context of Broadway and opera scholarship. Lessons to be learned from studying the musical Show Boat and the works of Sondheim point to the need for scholars and critics to consider how the music in musicals might convey social meanings, intellectual content, and dramatic ideas beyond words, stories, and stage directions

Review of: Charles Ives: The Ideas Behind The Music by J. Peter Burkholder

This article is a review of the book Charles Ives: The Ideas Behind The Music by J. Peter Burkholder

Review of: Analyzing Schubert by Suzannah Clark, Vanishing Sensibilities: Schubert, Beethoven, Schumann by Kristina Muxfeldt, and Schubert’s Fingerprints: Studies in the Instrumental Works by Susan Wollenberg

The article reviews several books including Analyzing Schubert, by Suzannah Clark, Vanishing Sensibilities: Schubert, Beethoven, Schumann, by Kristina Muxfeldt and Schubert\u27s Fingerprints: Studies in the Instrumental Works, by Susan Wollenberg

Mogelijke toekomsten van stadsprojecten en fysiek-ruimtelijke ontwikkelingen. Exploratieve scenario’s voor de Gentse Oostkant in 2035-2050.

In dit onderzoek, kaderend binnen de onderzoeksactiviteiten van het Steunpunt Bestuurlijke Organisatie Vlaanderen (SBOV), was het de bedoeling passende antwoorden te formuleren op vragen die zich richten op langere termijnen. Daarvoor maakten we gebruik van de techniek van ‘exploratieve scenario’s’, ook wel ‘foresights’ genoemd. Dergelijke scenario’s brengen in kaart wat mogelijk kan gebeuren op langere termijn, niet wat zal of hoort te gebeuren. De focus lag op een essentieel thema voor onze Vlaamse steden: hun fysiek-ruimtelijke ontwikkeling binnen en buiten de administratieve grenzen. In het onderzoek ontwikkelden we dus exploratieve scenario’s met betrekking tot stadsprojecten en fysiek-ruimtelijke ontwikkelingen in en rond Vlaamse steden in 2035. De centrale onderzoeksvragen hierbij waren: Wat zijn de bepalende of drijvende factoren die dergelijke ontwikkelingen mogelijks bepalen? Welke van deze ‘kritische’ factoren worden door de verschillende sleutelfiguren als onzeker ingeschat? En welke vorm en inhoud krijgen exploratieve scenario’s als men met deze kritische onzekerheden aan de slag gaat? In een voorbereidende generieke fase werden de drijvende factoren voor de fysiek-ruimtelijke ontwikkelingen in Vlaanderen in kaart gebracht. Dit werd gedaan aan de hand van literatuur- en documentanalyse en expertinterviews. In de tweede fase werkten we samen met 10 à 15 scenariobouwers specifieke toekomstscenario’s uit voor de fysiek-ruimtelijke ontwikkeling van een gebiedsuitsnede aan de oostkant van Gent, gaande van Gent-centrum over Gentbrugge en Melle tot Wetteren. De Gentse scenariobouwers, namelijk academici, actoren uit de privésector (vooral architecten), ambtenaren en politici werkzaam in deze Gentse regio, leverden over een periode van een 6-tal maanden en doorheen 4 workshops 8 scenario’s af met als tijdshorizon 2035 à 2050. Deze verschillende scenario’s schat men allen als even waarschijnlijk in. De 8 scenario’s zijn gebaseerd op twee assenstelsels met telkens verschillende kritische onzekerheden. Voor het eerste assenstelsel werden de assen ‘sociaal-economische status’ (opleiding, werk, inkomen en huisvesting zijn relatief laag/slecht/zwak vs. hoog/goed/sterk) en ‘stedelijke mentaliteit wonen’ (positieve vs. negatieve houding tegenover stad en stedelijke woontypologieën, dichtheden, dynamiek,…) geselecteerd. Het tweede assenstelsel bestond uit een horizontale as rond ‘dualisering’ (lage vs. hoge sociaal-economische ongelijkheid) en een verticale as rond de evolutie van het aandeel ‘collectieve vormen van mobiliteit’ (dit aandeel is hoog vs. laag). De scenariobouwers kozen om bij het uitschrijven van de scenario’s vooral met sterke ‘storylines’ te werken en geen prikkelende titel of een schetsmatige visualisering aan elk scenario te koppelen. Op die manier hoopten men de complexiteit en samenhang per scenario’s te bewaren. Hoewel een gebrek aan duidelijk eigenaarschap deze toekomstverkenning een (te) verblijvend karakter gaf, evalueerden de meeste scenariobouwers deze scenario-oefening als positief. Meer nog dan het ‘relatieve’ eindproduct werd het belang van het proces beklemtoond. Bedoeling van dergelijke toekomstverkenningen is immers niet alleen ‘a technique for raising decision makers’ awareness of several plausible futures’ (Chermack et al. 2003), het zet de betrokken actoren ook aan tot het hippe ‘out of the box’-denken, het durven omgaan met onzekerheden en complexiteit, het verruimen van gangbare (beleids)kaders, het samen en ontkokerd verkennen van alternatieve lange termijnontwikkelingen en ook wel het koppelen van een korte termijnaanpak aan lange termijndoelen

Impact of Hemodialysis Catheter Dysfunction on Dialysis and Other Medical Services: An Observational Cohort Study

Practice guidelines define hemodialysis catheter dysfunction as blood flow rate (BFR) <300 mL/min. We conducted a study using data from DaVita and the United States Renal Data System to evaluate the impact of catheter dysfunction on dialysis and other medical services. Patients were included if they had ≥8 consecutive weeks of catheter dialysis between 8/2004 and 12/2006. Actual BFR <300 mL/min despite planned BFR ≥300 mL/min was used to define catheter dysfunction during each dialysis session. Among 9,707 patients, the average age was 62,53% were female, and 40% were black. The median duration of catheter dialysis was 190 days, and the cohort accounted for 1,075,701 catheter dialysis sessions. There were 70,361 sessions with catheter dysfunction, and 6,33 1 (65.2%) patients had at least one session with catheter dysfunction. In multivariate repeated measures analysis, catheter dysfunction was associated with increased odds of missing a dialysis session due to access problems (Odds ratio [OR] 2.50; P < 0.001), having an access-related procedure (OR 2.10; P < 0.001), and being hospitalized (OR 1.10; P = 0.001). Catheter dysfunction defined according to NKF vascular access guidelines results in disruptions of dialysis treatment and increased use of other medical services

Bardoxolone Methyl Improves Kidney Function in Patients with Chronic Kidney Disease Stage 4 and Type 2 Diabetes:Post-Hoc Analyses from Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes Study

Background: Increases in measured inulin clearance, measured creatinine clearance, and estimated glomerular filtration rate (eGFR) have been observed with bardoxolone methyl in 7 studies enrolling approximately 2,600 patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). The largest of these studies was Bardoxolone Methyl Evaluation in Patients with Chronic Kidney Disease and Type 2 Diabetes (BEACON), a multinational, randomized, double-blind, placebo-controlled phase 3 trial which enrolled patients with T2D and CKD stage 4. The BEACON trial was terminated after preliminary analyses showed that patients randomized to bardoxolone methyl experienced significantly higher rates of heart failure events. We performed post-hoc analyses to characterize changes in kidney func-tion induced by bardoxolone methyl. Methods: Patients in -BEACON (n = 2,185) were randomized 1: 1 to receive oncedaily bardoxolone methyl (20 mg) or placebo. We compared the effects of bardoxolone methyl and placebo on a post-hoc composite renal endpoint consisting of = 30% decline from baseline in eGFR, eGFR <15 mL/min/1.73 m2, and end-stage renal disease (ESRD) events (provision of dialysis or kidney transplantation). Results: Consistent with prior studies, patients randomized to bardoxolone methyl experienced mean increases in eGFR that were sustained through study week 48. Moreover, increases in eGFR from baseline were sustained 4 weeks after cessation of treatment. Patients randomized to bardoxolone methyl were significantly less likely to experience the composite renal endpoint (hazards ratio 0.48 [95% CI 0.36-0.64]; p <0.0001). Conclusions: Bardoxolone methyl preserves kidney function and may delay the onset of ESRD in patients with T2D and stage 4 CKD. (C) 2018 The Author(s) Published by S. Karger AG, Base

Effect of Etelcalcetide vs Cinacalcet on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism A Randomized Clinical Trial

Importance Secondary hyperparathyroidism contributes to extraskeletal calcification and is associated with all-cause and cardiovascular mortality. Control is suboptimal in the majority of patients receiving hemodialysis. An intravenously (IV) administered calcimimetic could improve adherence and reduce adverse gastrointestinal effects. Objective To evaluate the relative efficacy and safety of the IV calcimimetic etelcalcetide and the oral calcimimetic cinacalcet. Design, Setting, and Participants A randomized, double-blind, double-dummy active clinical trial was conducted comparing IV etelcalcetide vs oral placebo and oral cinacalcet vs IV placebo in 683 patients receiving hemodialysis with serum parathyroid hormone (PTH) concentrations higher than 500 pg/mL on active therapy at 164 sites in the United States, Canada, Europe, Russia, and New Zealand. Patients were enrolled from August 2013 to May 2014, with end of follow-up in January 2015. Interventions Etelcalcetide intravenously and oral placebo (n = 340) or oral cinacalcet and IV placebo (n = 343) for 26 weeks. The IV study drug was administered 3 times weekly with hemodialysis; the oral study drug was administered daily. Main Outcomes and Measures The primary efficacy end point was noninferiority of etelcalcetide at achieving more than a 30% reduction from baseline in mean predialysis PTH concentrations during weeks 20-27 (noninferiority margin, 12.0%). Secondary end points included superiority in achieving biochemical end points (>50% and >30% reduction in PTH) and self-reported nausea or vomiting. Results The mean (SD) age of the trial participants was 54.7 (14.1) years and 56.2% were men. Etelcalcetide was noninferior to cinacalcet on the primary end point. The estimated difference in proportions of patients achieving reduction in PTH concentrations of more than 30% between the 198 of 343 patients (57.7%) randomized to receive cinacalcet and the 232 of 340 patients (68.2%) randomized to receive etelcalcetide was −10.5% (95% CI, −17.5% to −3.5%, P for noninferiority, <.001; P for superiority, .004). One hundred seventy-eight patients (52.4%) randomized to etelcalcetide achieved more than 50% reduction in PTH concentrations compared with 138 patients (40.2%) randomized to cinacalcet (P = .001; difference in proportions, 12.2%; 95% CI, 4.7% to 19.5%). The most common adverse effect was decreased blood calcium (68.9% vs 59.8%). Conclusions and Relevance Among patients receiving hemodialysis with moderate to severe secondary hyperparathyroidism, the use of etelcalcetide was not inferior to cinacalcet in reducing serum PTH concentrations over 26 weeks; it also met superiority criteria. Further studies are needed to assess clinical outcomes as well as longer-term efficacy and safety

Effect of Etelcalcetide vs Placebo on Serum Parathyroid Hormone in Patients Receiving Hemodialysis With Secondary Hyperparathyroidism

Importance Secondary hyperparathyroidism contributes to extraskeletal complications in chronic kidney disease. Objective To evaluate the effect of the intravenous calcimimetic etelcalcetide on serum parathyroid hormone (PTH) concentrations in patients receiving hemodialysis. Design, Setting, and Participants Two parallel, phase 3, randomized, placebo-controlled treatment trials were conducted in 1023 patients receiving hemodialysis with moderate to severe secondary hyperparathyroidism. Trial A was conducted in 508 patients at 111 sites in the United States, Canada, Europe, Israel, Russia, and Australia from March 12, 2013, to June 12, 2014; trial B was conducted in 515 patients at 97 sites in the same countries from March 12, 2013, to May 12, 2014. Interventions Intravenous administration of etelcalcetide (n = 503) or placebo (n = 513) after each hemodialysis session for 26 weeks. Main Outcomes and Measures The primary efficacy end point was the proportion of patients achieving greater than 30% reduction from baseline in mean PTH during weeks 20-27. A secondary efficacy end point was the proportion of patients achieving mean PTH of 300 pg/mL or lower. Results The mean age of the 1023 patients was 58.2 (SD, 14.4) years and 60.4% were men. Mean PTH concentrations at baseline and during weeks 20-27 were 849 and 384 pg/mL vs 820 and 897 pg/mL in the etelcalcetide and placebo groups, respectively, in trial A; corresponding values were 845 and 363 pg/mL vs 852 and 960 pg/mL in trial B. Patients randomized to etelcalcetide were significantly more likely to achieve the primary efficacy end point: in trial A, 188 of 254 (74.0%) vs 21 of 254 (8.3%; P < .001), for a difference in proportions of 65.7% (95% CI, 59.4%-72.1%) and in trial B, 192 of 255 (75.3%) vs 25 of 260 (9.6%; P < .001), for a difference in proportions of 65.7% (95% CI, 59.3%-72.1%). Patients randomized to etelcalcetide were significantly more likely to achieve a PTH level of 300 pg/mL or lower: in trial A, 126 of 254 (49.6%) vs 13 of 254 (5.1%; P < .001), for a difference in proportions of 44.5% (95% CI, 37.8%-51.2%) and in trial B, 136 of 255 (53.3%) vs 12 of 260 (4.6%; P < .001), for a difference in proportions of 48.7% (95% CI, 42.1%-55.4%). In trials A and B, respectively, patients receiving etelcalcetide had more muscle spasms (12.0% and 11.1% vs 7.1% and 6.2% with placebo), nausea (12.4% and 9.1% vs 5.1% and 7.3%), and vomiting (10.4% and 7.5% vs 7.1% and 3.1%). Conclusions and Relevance Among patients receiving hemodialysis with moderate to severe secondary hyperparathyroidism, use of etelcalcetide compared with placebo resulted in greater reduction in serum PTH over 26 weeks. Further studies are needed to assess clinical outcomes as well as longer-term efficacy and safety