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Background: The Clinical & Laboratory Standards Institute (CLSI) recommends use of annual antibiograms to help guide empiric antibiotic therapy. Because CLSI periodically updates minimum inhibitory concentration (MIC) breakpoints, we assessed the impact of these updates on longitudinal trends in antibiotic susceptibility rates for Escherichia coli and Klebsiella pneumoniae at a single academic medical center in Atlanta, GA. Methods: Susceptibilities for cefepime, ceftazidime, and levofloxacin in E. coli and K. pneumoniae were extracted from hospital antibiograms from 1988 to 2022. Starting in 1995, intensive care units (ICUs) and wards had separate annual antibiograms, which we combined using weighted averages to create annual overall hospital antibiograms. After summarizing the frequency of isolates tested and susceptibilities using medians and interquartile ranges (IQR), we conducted an interrupted time series analysis using linear segmented regression models, to evaluate the level changes and trends in susceptibility, before and after CLSI MIC breakpoints were updated for ceftazidime (2010 and 2017), cefepime (2014 and 2017), and levofloxacin (2013). Results: Among 21,214 E. coli, there was a median of 291 [IQR: 104, 555] isolates tested annually. Similarly, among 8,686 K. pneumoniae isolates, the median was 125 per year (IQR: 76, 178). Prior to the MIC breakpoint changes, baseline susceptibility trends of both organisms to all 3 antibiotics significantly declined at a rate between 0.2% to 2.4% per year (Table 1). For cefepime (Figure 1), susceptibility decreased annually during 1988 – 2013 for both E. coli (-0.5%) and K. pneumoniae (-1.2%). There were no significant level changes but there were trend changes after 2018, for E. coli (+2.1%) and K. pneumoniae (– 5.5%). For ceftazidime (Figure 2), significant level changes occurred after 2010 for both organisms (E. coli: -5.7%; K. pneumoniae: -5.2%). For levofloxacin (Figure 3), the breakpoint update in 2013 lead to significant level change in susceptibility (E. coli: +8.4%; K. pneumoniae: +11.4%). Conclusion: Overall, we observed a consistent decrease in antibiotic susceptibility in E. coli and K. pneumoniae over three decades, with immediate increases in the level change of susceptibility when MIC breakpoints were changed, followed by a decreasing trend. These findings highlight the importance of longitudinal surveillance and MIC breakpoint changes to inform antimicrobial stewardship strategies.
This study explores how race impacts the legitimacy of international organizations (IOs). Specifically, we examine whether the representation of Black people in IO leadership positions influences perceptions of IO legitimacy among Black and white individuals. To do so, we fielded seven survey experiments in two racially diverse countries, South Africa and the United States, and three experiments in one predominantly Black country, Kenya. Our experiments were designed to distinguish the effects of an IO leader's race from their region of origin. We find that Black IO leadership enhances perceptions of institutional legitimacy among Black citizens, but does not strongly influence the legitimacy perceptions of their white counterparts. Our findings suggest that improving the representation of historically marginalized racial groups within IOs can enhance their popular legitimacy.
This article is part of the collaborative research project Populist Publics. Housed at Carleton University (www.carleton.ca/populistpublics), it applies a data-driven analysis of online hate networks to trace how false framings of the historical past, what we call historical misinformation, circulates across platforms, shaping the politics of the center alongside the fringes. We cull large datasets from social media platforms and run them through a variety of different programs to help visualize how harmful speech and civilizational rhetoric about race, ethnicity, immigration, multiculturalism, gender equality, and LGBTQ+ rights are circulated by far-right groups across borders, noting specifically when and how they are taken up in the mainstream as legitimate discourse. Our interest is in how the distortion of the historical record is used to build alternative collective memories of the past so as to undermine minority rights and cultures in the present. We began with a basic question: To what extent is this actually new? As much as the atomized publics of our current day create ideal conditions for radical ideas to fester and circulate, it was obvious to us that we needed to look for linkages across time, drawing on interdisciplinary methods from the fields of history, media and communication, and data science to identify the tactics, strategies, and repertoires among such groups and individuals. By analyzing German-Canadian relations in particular, what follows is a first attempt to piece together some of these connections, with a focus on far-right hate groups—homegrown and imported—in the settler colonial project that is today's Canada.
The Myanmar military has dominated that complex country for most of the period since independence in 1948. The fourth coup of 1 February 2021 was the latest by the military to control those aspects of society it deemed essential to its own interests, and its perception of state interests. The military's institutional power was variously maintained by rule by decree, through political parties it founded and controlled, and through constitutional provisions it wrote that could not be amended without its approval. This fourth coup seems a product of personal demands for power between Senior General Min Aung Hlaing and Aung San Suu Kyi, and the especially humiliating defeat of the military-backed party at the hands of the National League for Democracy in the November 2020 elections. The violent and bloody suppression of widespread demonstrations continues, compromise seems unlikely, and the previous diarchic governance will not return.
Myanmar's political and economic future is endangered and suppression will only result in future outbreaks of political frustration.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and
• The Myanmar military has dominated that complex country for most of the period since independence in 1948. The fourth coup of 1 February 2021 was the latest by the military to control those aspects of society it deemed essential to its own interests, and its perception of state interests.
• The military's institutional power was variously maintained by rule by decree, through political parties it founded and controlled, and through constitutional provisions it wrote that could not be amended without its approval.
• This fourth coup seems a product of personal demands for power between Senior General Min Aung Hlaing and Aung San Suu Kyi, and the especially humiliating defeat of the military-backed party at the hands of the National League for Democracy in the November 2020 elections.
• The violent and bloody suppression of widespread demonstrations continues, compromise seems unlikely, and the previous diarchic governance will not return.
• Myanmar's political and economic future is endangered and suppression will only result in future outbreaks of political frustration.
Burma was “quite unlike any land you know about,” so Kipling wrote. He thought it unique even if appended to India as a province. But he could not have predicted the future singular role of the military in that country, for the Tatmadaw has been, and remains, the longest-ruling military elite in modern Asia, and perhaps in the contemporary world. For over half a century it commanded power, ran the state, and has been pivotal since independence in 1948. Its dominance lay not only in its complete control over the powers of state coercion, but also in its early prestige and heritage, and, later, its vice-like grip on all important elements of the society.
Its militarized Burman leadership was the only Asian group that fought early against the Allies for independence early in World War II, despite very limited military training those participating received from their Japanese allies and before the Burmese (mostly Burmans) turned against the Axis in March 1945. Unusual in Asia, the military formedpolitical parties; this became a pattern. Its leader, Aung San, orchestrated a conference at Panglong in 1947 that brought some minorities into what became the Union of Burma. He negotiated independence from Great Britain in 1948, and his assassination just before its fruition gave an almost mystic reverence to him, his family, and those military personnel associated with him. The Tatmadaw saved the state from multiple communist and ethnic rebellions in the 1950s, tried (unsuccessfully) to counter fleeing Nationalist Chinese anti-communist remnants that occupied some of Burma's northern reaches, and later, on multiple occasions, prevented actual and perceived threats of secession and what it continuously referred to as internal “chaos”. In 1958, it unfortunately acquired both false confidence in its capacity to govern and to manage an economy as well as in the widespread, inevitable corruption of its civilian elite.
This leadership was early viewed, and viewed themselves, as patriots and defenders of the state, and the Tatmadaw was a most desirable career, the officer class graduating from the Defence Services Academy at Maymyo with University of Rangoon degrees, although they were too junior to become leaders of the 1962 coup.
Reward Deficiency Syndrome (RDS) is an umbrella term for all drug and nondrug addictive behaviors, due to a dopamine deficiency, “hypodopaminergia.” There is an opioid-overdose epidemic in the USA, which may result in or worsen RDS. A paradigm shift is needed to combat a system that is not working. This shift involves the recognition of dopamine homeostasis as the ultimate treatment of RDS via precision, genetically guided KB220 variants, called Precision Behavioral Management (PBM). Recognition of RDS as an endophenotype and an umbrella term in the future DSM 6, following the Research Domain Criteria (RDoC), would assist in shifting this paradigm.
There is a paucity of long-term prospective disaster studies of the psychological sequelae among survivors.
Methods
At 1½ and 25 years after the Spitak earthquake, 142 early adolescents from two cities were assessed: Gumri (moderate–severe exposure) and Spitak (very severe exposure). The Gumri group included treated and not-treated subjects, while the Spitak group included not-treated subjects. Instruments included: DSM-III-R PTSD-Reaction Index (PTSD-RI); DSM-5 PTSD-Checklist (PCL); Depression Self-Rating Scale (DSRS); and Center for Epidemiological Studies-Depression Scale (CES-D).
Results
(1) Between 1½ and 25 years, PTSD rates and mean scores decreased significantly in the three groups (over 50%). However, at 25 years 9.1–22.4% met DSM-5 PTSD criteria. (2) At 1½ years, the Spitak group had higher PTSD-RI (p < 0.001) and DSRS scores (p < 0.001) compared to the Gumri-not-treated group. At 25 years, the Spitak group that had experienced fewer post-earthquake adversities (p < 0.03), had a greater decrease in PTSD-RI scores (p < 0.02), and lower CES-D scores (p < 0.01). (3) Before treatment, PTSD-RI and DSRS scores did not differ between the Gumri-treated and not-treated groups. At 25-years, the Gumri-treated group showed a greater decrease in PTSD-RI scores (p < 0.03), and lower mean PTSD-RI (p < 0.02), PCL (p < 0.02), and CES-D (p < 0.01) scores. (4) Predictors of PTSD symptom severity at 25-years included: home destruction, treatment, social support, post-earthquake adversities, and chronic medical illnesses.
Conclusion
Post-disaster PTSD and depressive symptoms can persist for decades. Trauma-focused treatment, alleviation of post-disaster adversities, improving the social ecology, and monitoring for chronic medical illnesses are essential components of recovery programs.
Khovanov–Lauda–Rouquier (KLR) algebras of finite Lie type come with families of standard modules, which under the Khovanov–Lauda–Rouquier categorification correspond to PBW bases of the positive part of the corresponding quantized enveloping algebra. We show that there are no non-zero homomorphisms between distinct standard modules and that all non-zero endomorphisms of a standard module are injective. We present applications to the extensions between standard modules and modular representation theory of KLR algebras.
The Republic of Korea's global expansion has been mirrored by its interest and presence in Southeast Asia. From trade, investment, aid, tourism, to the cultural "Korean wave", its various roles have blossomed and its influence has grown. The ASEAN region has not only affected Korean foreign policy, but also many aspects of Korean life, from the migration of Southeast Asian industrial workers to marriages and the curricula of academic institutions. This volume explores various aspects of these new relationships and their importance to all concerned parties. It brings together a group of specialists who have documented the growing interlocking roles between Korea and ASEAN and its constituent states in detail. These developments have profound implications for relations in the East and Southeast Asian regions, and for the world as a whole.
Conventional wisdom holds that autocracies are more likely than democracies to adopt interventionist and protectionist economic policies, including fixed and undervalued exchange rates. This article suggests that this view is only partially correct: nondemocracies are a heterogeneous grouping, and only some types of authoritarian regimes adopt different foreign economic policies from those of their democratic counterparts. Using the example of exchange rate policy, the authors show that foreign economic policy varies across monarchic, military, and civilian dictatorships. More specifically, they hypothesize that monarchies and military regimes are more likely than democracies and civilian dictatorships to maintain fixed exchange rate regimes because the former regimes have smaller “selectorates” than the latter. The authors also expect that monarchies and civilian dictatorships maintain more undervalued exchange rates than democracies and military regimes because the former regimes provide their leaders with greater tenure security than the latter regimes. These hypotheses are evaluated using a time-series–cross-sectional data set of a large sample of developing countries from 1973 to 2006. The statistical results accord with these predictions. These findings indicate that the ways in which democracies engage with the global economy may be less unique than many believe.
Recent actions in Congress that threaten political science funding by the National Science Foundation (NSF) have caught the attention of political scientists, but this was not the first attack and not likely to be the last. Less than one year ago, the Harper government ended the Understanding Canada program, an important source of funding for academics in the United States and abroad. This article stresses the value of the program and the importance of this funding steam by demonstrating what the grants have done both more generally as well as for the authors individually. In addition, by looking at the political process that led to the end of the Understanding Canada program and the similarities in the attacks on NSF political science funding, this article identifies potential reasons why these funds were and are at risk. We conclude by arguing that normative action in support of political science is a necessity for all political scientists.
Abstract. Why did most central banks continue to purchase dollar reserves during the 2000s even though they suffered mounting financial losses as a result of this policy? This paper argues that domestic political considerations determine whether policy makers accumulate or dump the reserve currency. We hypothesize that central bank independence decreases support for the dollar because independent central banks reduce the political clout of exporters and increase the salience of financial performance. This argument is tested using data on countries' holdings of US Treasury securities between 2000 and 2008. The statistical results indicate that countries with independent central banks were more likely to sell and less likely to purchase US treasuries. Our findings suggest that a complete understanding of the international dollar standard requires greater attention to domestic politics and how political institutions influence the balance of power between competing interest groups.
Résumé. Pourquoi est-ce que la plupart des banques centrales ont continué à acheter des réserves de dollars au cours des années 2000, même quand ils souffraient des pertes financières en raison de cette politique? Cet article soutient que des considérations de politiques nationale déterminent si les responsables des politiques décident d'accumuler ou de vider leurs monnaie de réserve. Nous émettons l'hypothèse que l'indépendance de la banque centrale décourage le soutien pour le dollar, car les banques centrales indépendantes réduise la puissance politique des exportateurs et augmente l'importance de la performance financière. Cet argument est testé en utilisant des données sur la quantité de titres du Trésor américain possédée par pays entre 2000 et 2008. Les résultats statistiques démontrent que les pays avec des banques centrales indépendantes étaient plus susceptibles de vendre et moins susceptibles d'acheter des obligations du Trésor américain. Nos résultats suggèrent qu'une compréhension complète de l'étalon dollar international exige une plus grande attention à la politique nationale, et comment les institutions politiques influencent l'équilibre du pouvoir entre les groupes d'intérêts concurrents.