Health outcomes of statin users compared to non-users with Clostridium difficile infection

Background: Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea, and the primary cause of healthcare-associated infections in the United States. Statins have beneficial effects independent of their lipid-lowering effects; these pleiotropic effects may include anti-inflammatory and immunomodulatory activity. The potential role for statins in CDI is unique in that both the cholesterol-lowering and pleiotropic effects of statins could lead to improvements in clinical response for patients with CDI. Rationale: Limited data currently exist in the literature on the outcomes of statin users who develop CDI compared with non-users. The primary objective of this study was to compare CDI health outcomes in statin users and non-users in a national cohort of patients from a single-payer health system. Methods: This was a longitudinal, retrospective cohort study of all adult CDI patients receiving care from the Veterans Health Administration. Patients were divided into two groups based on statin exposure prior to and during the first CDI encounter. For the primary analysis, we created a propensity score-matched cohort to account for variables associated with indications for statin use. Once the matched cohort was derived, additional variables known to impact CDI outcomes were entered into a multivariable logistic regression model in order to determine the risk of individual CDI outcomes. Results: CDI outcomes were evaluated for statin users and non-users before and after propensity score-matching. In the unmatched cohort, statin use was significantly associated with reduced risk of 30-day mortality (aOR 0.60, 95% CI 0.36-1.00, p=0.0478). In the matched cohort, statin use remained significantly associated with a reduced risk of 30-day mortality (aOR 0.45, 95% CI 0.23-0.88, p=0.0198). No significant trends were found for inpatient mortality, 60-day recurrence, and severe or complicated CDI. Conclusion: This is the largest study comparing CDI health outcomes among statin users and non-users. Statin users were found to have significantly reduced 30-day mortality in both an unmatched and matched patient cohort compared to non-users. While these data support previous findings reported in the literature, no change in routine care of CDI patients can be recommended at this time.Pharmaceutical Science

High-level rent-seeking and corruption in African regimes : theory and cases

One explanation for Africa's failure to develop is the weakness of its public institutions. The authors consider one aspect of that weakness: rent-seeking and corruption at the top of government. Under the conditions of their model, and autocrat who seeks to maximize personal financial return favors an inefficiently large public sector and distorts other public sector priorities more than does an autocrat who seeks to maximize national income. However, if civil servants and public officials are also venal, the ruler will not favor so large a government. To show how African regimes operate, the authors present four cases illustrating issues raised by their theoretical model. Among their observations about the relationship between the motivations of top officials and policies to control corruption and other types of rent-seeking are these: A kleptocrat whose decision variable is the level of government intervention in the economy will select an excessive level of interventions, in which national income is less than optimal. Like all monopolies, the kleptocrat seeks productive efficiency except where inefficiency creates extra rents. Facing a kleptocrat, citizens prefer a smaller than optimal-sized government but get one that is too big. A kleptocrat may need to permit lower-level officials to share in corrupt gains thus introducing additional costs. He or she will then favor a smaller government than if subordinates could be perfectly controlled. Dropping the assumption of a single dimension of government intervention, the kleptocrat will favor a different mixture of tax, spending, and regulatory programs than will a benevolent autocrat. Dropping the assumption that rulers are writing on a clean slate, decisions to privatize or nationalize firms can differ across autocratic regimes. In particular, although kleptocrats will often be reluctant to privatize, they may in some cases support privatization that a benevolent ruler would oppose. Investment in countries with kleptocratic rules may have an overly short-run orientation. When rent-seeking at top levels is pervasive, both natural resources and foreign aid under state control may hamper, not encourage, growth.Decentralization,Economic Theory&Research,Environmental Economics&Policies,Payment Systems&Infrastructure,Labor Policies,Economic Theory&Research,National Governance,Environmental Economics&Policies,Governance Indicators,Health Economics&Finance

Catholicism and anti-Catholicism in Arlington’s world : polemic, persuasion and the conversion of Anne Hyde, Duchess of York

Conversions to Catholicism at the later Stuart court are usually associated with political crises and panic over popery. While the experience of the most famous convert, James duke of York, the future James II, fits this model, that of his first wife Anne Hyde challenges it. Anne’s quiet conversion shortly before she died resembles Arlington’s own change of religion revealed when he called for a Catholic priest just before his death. Setting Anne’s turn to Catholicism in the context of recent work on conversion, this chapter explores both her change of faith and reactions to it. It interrogates Anne’s ‘conversion narrative’ to explore its textual history and how typical it was of converts, especially elite converts, to Catholicism. It then considers reactions to these events, particularly those of Anne’s father, the exiled Edward Hyde, earl of Clarendon, and of Anne’s former spiritual adviser George Morley, bishop of Winchester, to show how responses were shaped by questions of status, gender and family relationships, as well as by a sensitivity to the political damage caused by rumours of popery – rumours which in the 1650s had been associated with both the exiled royal family and Arlington himself. Since Clarendon’s response was expressed in a number of different works, ranging from meditative commentary on the Psalms to essays, and from correspondence to his daughter to polemical attacks on Catholic theologians, comparisons will be made between the various ways in which opposition to Catholicism was expressed in different settings. That Anne’s conversion took place in 1670, when Arlington’s power was reaching its height, and that a renewed argument about it broke out in the early to mid-1680s, just before Arlington’s death, is intriguing. Both offer suggestive examples of politically successful conversions to Catholicism, despite the anti-popish fervour that pervaded Arlington’s world.Postprin

The festival is cock-a-doodle-now

By designing and building a nine-foot rooster puppet I am utilizing my foundation in: pattern making, sculpting, mold making, fabric paint and dye, puppet building, garment construction and project planning. I will use the skills I have obtained in my master’s program while pushing them to new levels. I chose to challenge myself with a materials budget of only seven hundred dollars when a project of this scale could easily cost fifteen hundred to five thousand. This budget limitation forced me to utilize products and resources already available in our fabric and craft supplies and very carefully plan out where my money would be best served. I feel the task of learning how to build big on a small budget while maintaining quality best emulates a professional theatre setting. My second objective was to learn how to build on a large scale while staying under fifty pounds. It was important to me that this puppet stay light enough to be sustained for a minimum of thirty minutes by a variety of body types. My third objective was to make the puppet to be easily disassembled and transported in my Honda Fit. This project was accepted into the Cohen New Works Festival and concluded with nine live performances of Randy the Rooster and his Farmer Friend improvising with the public. This project will demonstrate not only a technical proficiency but the ability to convey personality and story with a large-scale puppet.Theatre and Danc

Deformation of the Douglas till, northwestern Wisconsin

The bed-deformation model asserts that a glacier can move by pervasively shearing its bed to strains sufficiently large to account for most glacier motion (\u3e100). Although commonly invoked, this hypothesis has never been unequivocally tested using the geologic record. In this study, laboratory fabric-strain calibrations are used to evaluate strain magnitude and shear direction in the Douglas till of northwestern Wisconsin and to thereby test elements of the bed-deformation hypothesis. The Douglas till is a clay-rich basal till deposited by a late-Wisconsinan advance of the Superior lobe of the Laurentide ice sheet. This till contains unusual pebble fabrics that lie transverse (NW-SE) to the regional ice-flow direction (NE-SW), as indicated by flutes.;Anisotropy of magnetic susceptibility (AMS) was measured along eight vertical profiles through the Douglas till at 0.2 m intervals, and AMS fabrics were computed from principal directions of magnetic susceptibility. Sand-particle fabrics and microshear orientations were also measured in one of these profiles. AMS data were interpreted using results of ring-shear experiments, which demonstrated that strong, flow-parallel fabrics (steady-state S1 eigenvalue of 0.83) develop in the Douglas till at a shear strain of ∼20.;AMS fabrics are generally strong (63% of S1 ≥ 0.83), indicating that most of the till has been sheared to a strain ≥ ∼20. Sand-particle and AMS fabrics were similarly oriented, and microshears indicate fabric development was subglacial, rather than in shearing basal ice. Major variations in fabric orientation and strength occur laterally over distances of a few meters and with depth over decimeters, indicating that the till deformed heterogeneously, probably during progressive accretion of till to the bed by lodgement. Strong fabrics transverse to the regional glacier-flow direction are interpreted to reflect shear divergence or convergence in a heterogeneously deforming bed, resulting in local flow directions commonly perpendicular the regional one. These measurements indicate that deep, unidirectional, simple shear of the bed, as is usually assumed in models, was unlikely

A godly law? Bulstrode Whitelocke, puritanism, and the common law in seventeenth-century England

Debates surrounding both the church and the law played an important role in the conflicts that marked seventeenth-century England. Calls for reform of the law in the Civil Wars and Interregnum complicated the apparent relationship between puritanism and the common law, as the first fragmented and the second came under attack in the 1640s and 1650s. This article first analyses the common lawyer Bulstrode Whitelocke's historical and constitutional writings that defended the common law against demands for its reform and argued that its legitimacy derived from its origins in, and resemblances to, the law of Moses. Refraining from the radical application of this model employed by some contemporaries, Whitelocke instead turned to British history to make his case. This article then examines Whitelocke's views of the relationship between common law and ecclesiastical jurisdiction in his own day, showing how, both as a lawyer and as a puritan, he navigated laws demanding religious conformity. Whitelocke's career therefore demonstrates how lawyers could negotiate the fraught relationship between the church and the law in the aftermath of the reconfigurations provoked by the Civil Wars and Restoration.Postprin

Predictive AI for the S&P 500 Index

Artificial intelligence has powerful applications in virtually every field, and the financial world is no exception. Utilizing various elements of artificial intelligence, this research aims to predict the future value of the S&P 500 index using numerous models, and in doing so, identify relevant features. More specifically, models that include combinations of historical data, public sentiment, and technical indicators were employed to predict the stock price one day and three days forward. To account for public opinion, the sentiment of tweets and news headlines from the beginning of 2015 through the end of 2019 was calculated using FinBERT, a pre-trained version of BERT retrieved from the HuggingFace Model Hub and designed specifically for financial-related text. For each textual input, FinBERT provides three outputs: the probability that the text is positive, negative or neutral. These probability values were applied to approximate the number of positive, negative, and neutral tweets and news headlines each day. The following features were used in complex LSTM models: open, close, low and high prices; volume; the number of positive, negative, and neutral tweets and news headlines; relative strength index; and earnings per share. The highest performing predictive model for one day forward and three days forward utilized historical data, tweet sentiment, and the relative strength index. Coupled with other tools wielded by investors, this model can help anticipate market movements and inform decisions