Modern US Research Articles

Patients with Sickle Cell Disease in Sicily Have Lower Rates of End Organ Damage, Allo-Immunization and Opioid Prescription Compared to a US Cohort

Background: In developed countries, childhood mortality in sickle cell disease (SCD) is less than 5%, where the SCD morbidity and mortality burden has shifted to adults. As age increases, so do end organ complications like chronic pain. Environmental factors like health economics and genetic factors may influence such outcomes. Recent data from UK, showed higher than expected survival (ASH 2015) in the setting of a national health care system. The Hospital of Gela, Sicily has a well characterized Caucasian SCD population, which also has consistent access to health care via a nationalized system. We hypothesized that traditional disease severity markers including end organ damage, the rate of red blood cell (RBC) alloimmunization and opioid use would be lower in Sicily, compared to a modern US population of African ancestry with inconsistent access to healthcare.Methods: 90 SCD patients in Sicily were followed for over 9 years (2006-2014) to identify clinical complications, alloimmunization rates and survival. Demographics and sickle and alpha globin genotypes were documented. In the US, 632 SCD patients (excluding those with SC) had the same parameters collected as part of the Bethesda Sickle Cell Cohort Study. Laboratory and clinical complications were compared between populations according to phenotype groups (SS/SB0 or SB+ thalassemia). Clinical manifestations included hospitalizations for pain per year, RBC alloimmunization, hydroxyurea prescription rate. Statistical analysis utilized univariate comparisons (t and Chi square tests).Results: In Sicily, 51 patients had SS/SB0 and 28 SB+. All were of self-described Caucasian ancestry. No SC patients were identified in Sicily, therefore all comparisons were limited to SS/SB0 and SB+ thalassemia. Sicilian SS/SB0 patients were older than the US (p<0.0001), had lower AST (p=0.04) and creatinine (p=0.005), and higher HbF (p<0.0001). SB+ patients had similar characteristics (Table 1). Sixteen Sicilian patients (18%) died at a mean age of 53 years (range 31-77). As suggested by these survival data, SCD complications were less frequent for both SS/SB0 and SB+ groups in Sicily compared to the US (Table 2). More Sicilians were prescribed hydroxyurea, especially among those with SB+, although this was not a significant difference. The pain crisis hospitalizations per year was also higher in the US (p=0.008). Consistent with less frequent hospitalizations, only 4 of the Sicilian patients (3 SS/SB0, 1 SB+) were taking long acting opioids, compared to more frequent opioid use in the US. Finally, RBC alloimmunization, another surrogate measure for disease severity, was twice as common in SS/SB0 patients from the US (30%) as in Sicily (14%, p=0.01).Conclusions: These data suggest that end organ complications, like chronic pain and alloimmunization, in self-described Caucasians with uniform access to health care in Sicily, are less common than in a US cohort of adults. These differences could be attributable to access to specialized care, genetic differences in the proportion of African ancestry or environmental factors like more frequent use of preventative therapies like hydroxyurea. RBC alloimmunization in Sicily is significantly lower than reported in the US , but is still higher than observed in thalassemics in Italy. Perhaps this could be explained a matched genetic background between blood donors and recipients in Sicily, as has been suggested as a strategy to reduce RBC alloimmunization in the US. Further studies comparing unique SCD populations from different geographic regions may be helpful to elucidate genetic or environmental risk factors for end organ complications and disease severity. [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Space operations in the modern US military strategy. Analysis of doctrinal documents of the Ministry of defense

Space operations in the modern US military strategy. Analysis of doctrinal documents of the Ministry of defense

Decreasing, not increasing, leaf area will raise crop yields under global atmospheric change.

Without new innovations, present rates of increase in yields of food crops globally are inadequate to meet the projected rising food demand for 2050 and beyond. A prevailing response of crops to rising [CO 2] is an increase in leaf area. This is especially marked in soybean, the world's fourth largest food crop in terms of seed production, and the most important vegetable protein source. Is this increase in leaf area beneficial, with respect to increasing yield, or is it detrimental? It is shown from theory and experiment using open‐air whole‐season elevation of atmospheric [CO 2] that it is detrimental not only under future conditions of elevated [CO 2] but also under today's [CO 2]. A mechanistic biophysical and biochemical model of canopy carbon exchange and microclimate (MLCan) was parameterized for a modern US Midwest soybean cultivar. Model simulations showed that soybean crops grown under current and elevated (550 [ppm]) [CO 2] overinvest in leaves, and this is predicted to decrease productivity and seed yield 8% and 10%, respectively. This prediction was tested in replicated field trials in which a proportion of emerging leaves was removed prior to expansion, so lowering investment in leaves. The experiment was conducted under open‐air conditions for current and future elevated [CO 2] within the Soybean Free Air Concentration Enrichment facility (SoyFACE) in central Illinois. This treatment resulted in a statistically significant 8% yield increase. This is the first direct proof that a modern crop cultivar produces more leaf than is optimal for yield under today's and future [CO 2] and that reducing leaf area would give higher yields. Breeding or bioengineering for lower leaf area could, therefore, contribute very significantly to meeting future demand for staple food crops given that an 8% yield increase across the USA alone would amount to 6.5 million metric tons annually.

Expanding the Health Care Response to Mass Violence.

For Joseph Ibrahim, MD, the first wake-up call came last year at an Orlando Magic basketball game. The trauma medical director of Orlando Regional Medical Center (ORMC) was sitting in the stands at the Amway Center when he looked around at the crowd of thousands and imagined a mass casualty incident. “Being the only level I [Trauma] Center in this area, we’re responsible for every single person in here,” he recalled thinking to himself. It later struck him that Orlando—with its proximity to Disney World—was a prime target for a mass shooting or bombing. Ibrahim’s fears were realized when the deadliest mass shooting in modern US history unfolded in the early morning hours of June 12 at Orlando’s Pulse nightclub, located 2 blocks from ORMC. But by then, the hospital’s trauma and emergency staff were prepared. Three months before this real-life tragedy, ORMC staged its annual community-wide mass casualty drill. In prior years, the drills have simulated scenarios including a bombing, a rally that became violent, and an airplane crash. This year’s mock disaster—an active shooter incident at a local school with 500 injuries—included all of central Florida’s 15 hospitals, the Federal Bureau of Investigation (FBI), local law enforcement, emergency medical services (EMS), fire personnel, and ORMC’s Air Care Team, which provides transportation and in-flight stabilization for trauma patients. Ibrahim recently pushed to add trauma simulations on a more regular basis, and these smaller drills have been taking place 3 times a month. As 44 injured patients streamed in during 2 waves on the night of the Pulse nightclub shooting, these and other preparations undertaken by the hospital for mass casualties paid off, Ibrahim said: “For the most part, the big needs—anesthesia, operating rooms [and other] space, blood, and people to care for [patients]—were taken care of, and I think it was in large part due to the drills that we had performed.” Jay Kaplan, MD, vice chair of emergency services for Ochsner Health System in New Orleans and president of the American College of Emergency Physicians (ACEP), called the hospital’s response “amazing.” “Within a very short period of time they had 6 trauma surgeons [and] 8 emergency physicians caring for patients,” he said. Surgeons performed 28 operations on Sunday alone. Thirty-five patients survived and, as reported in the media, the 9 patients who did not survive died soon after reaching the hospital, indicating that they had arrived with fatal wounds. Ibrahim said that local EMS reached out to express gratitude for being included in the hospital’s drills. “I’ve had a lot of feedback saying they’re really happy that we did those drills because they knew how to step in and how to best help,” he said. By all accounts, ORMC is an example of how trauma centers and communities should prepare for mass shootings and other intentional mass casualty events. The 2013 Boston Marathon bombing, after which only 3 of 264 patients died, has been cited as another well-coordinated and highly successful response.... Language: en

The Legitimacy of US Administrative Law and the Foundations of English Administrative Law: Setting the Historical Record Straight

The Legitimacy of US Administrative Law and the Foundations of English Administrative Law: Setting the Historical Record Straight

«WHITE GAZE» DENIAL IN THE NORTH AMERICAN INDIGENOUS LITERARY CANON

The article discusses the ethnic differences and their literary depiction in modern US and Canada societies. The paper sets out to explore the First Nations of Canada and Native American literary dimensions through the study of the artistic techniques which demolish and refute the “white gaze” philosophy, widespread in North American societies. Such attitude denies the value of the indigenous people, their history, culture and spirituality in the modern world. Traditional native worldview rests upon the assumptions and life principles very distinct and quite unique from the prevailing Western European thought based upon the patriarchal Christian philosophy, its radical dependency on the masculine supremacy over females and its disdain of indigenous matrilineal lifestyle.

Reconsidering the Resources Needed for Multiple Casualty Events: Lessons Learned From the Crash of Asiana Airlines Flight 214.

To date, a substantial portion of multiple casualty incident literature has focused exclusively on prehospital and emergency department resources needed for optimal disaster response. Thus, inpatient resources required to care for individuals injured in multiple casualty events are not well described. To highlight the resources beyond initial emergency department triage needed for multiple casualty events, using one of the largest commercial aviation disasters in modern US history as a case study. Prospective case series of injured individuals treated at an urban level I trauma center following the crash of Asiana Airlines flight 214 on July 6, 2013. This analysis was conducted between June 1, 2014, and December 1, 2015. Commercial jetliner crash. Medical records, imaging data, nursing overtime, blood bank records, and trauma registry data were analyzed. Disaster logs, patient injuries, and blood product data were prospectively collected during the incident. Among 307 people aboard the flight, 192 were injured; 63 of the injured patients were initially evaluated at San Francisco General Hospital and Trauma Center (the highest number at any of the receiving medical facilities; age range, 4-74 years [23 were aged <17 years and 3 were aged >60 years]; median injury severity score of 19 admitted patients, 9 [range, 9-45]), including the highest number of critically injured patients (10 of 12). Despite the high impact of the crash, only 3 persons (<1%) died, including 1 in-hospital death. Among the 63 patients, 32 (50.8%) underwent a computed tomographic imaging study, with imaging of the abdomen and pelvis being the most common. Sixteen of the 32 patients undergoing computed tomography (50.0%) had a positive finding on at least 1 scan. Nineteen patients had major injuries and required admission, with 5 taken directly from the emergency department to the operating room. The most frequent injury was spinal fracture (13 patients). In the first 48 hours, 15 operations were performed and 117 total units of blood products were transfused. A total of 370 nursing overtime hours were required to treat the injured patients on the day of the event. Proper disaster preparedness requires attention to hospital-level needs beyond initial emergency department triage. The Asiana Airlines flight 214 crash highlights the need to plan for high use of advanced imaging, blood products, operating room availability, nursing resources, and management of inpatient hospital beds.

Body and Nation: The Global Realm of U.S. Body Politics in the Twentieth Century, edited by Emily S. Rosenberg and Shanon Fitzpatrick

Body and Nation: The Global Realm of U.S. Body Politics in the Twentieth Century, edited by Emily S. Rosenberg and Shanon Fitzpatrick. Durham, Duke University Press, 2014. viii, 331 pp. $94.95 US (cloth), $26.95 US (paper). The essays collected in Body and Nation approach twentieth-century depictions of bodies within the United States through a transnational lens. The relationship of the human body to the body politic has emerged in recent decades as a prominent node of historical and interdisciplinary analyses of national identity, and this volume provides a necessary but often-overlooked global context for US discourses of the body. Exploring the ways in which US body politics have been translated and refracted through political, military, and media engagements abroad, as well as the ways in which US national identity has been defined over and against the bodies of alien others, the essays illustrate the transnational vectors along which twentieth-century representations of bodies have moved. Along with an introduction and epilogue by the editors, Body and Nation contains twelve essays, ten of which have not been previously published. The essays are arranged simply in chronological order, although they focus broadly on three themes articulated in the introduction: the challenges of defining a national body in an age of imperialism and global migration; the relationship of the body to discourses of national security; and the depiction of the modern, national body in transnational mass media. Most if not all of the essays take up more than one of these themes. For example, the first essay in the collection, Paul A. Kramer's study of US military and domestic understandings of prostitution during the Philippine-American War, addresses the perceived dangers that the prostitute body presented to the US empire, to American military forces, and to the domestic nation and its citizens. The presence of regulated prostitution in the US-occupied Philippines only came to the attention of the American public through the efforts of journalists in the anti-colonialist, social purity, and suffragist presses, who saw in the practice a risk of miscegenation and immigration that would pollute the US population, disease that would weaken the US military, and sexual license that would soil US morality, among other concerns. Kramer's essay deftly establishes the myriad ways in which discourses of disease penetrating the body are intermingled with those of foreign customs and institutions invading the nation and empire, a focus thoughtfully mirrored in the final essay of the collection, Kristina Shull's history of the Mariel Boatlift from Cuba to Key West in 1980, following which fears regarding security, disease, and sexual deviance helped to give rise to the modern US immigration detention system. …

Деструктивность в политическом дискурсе

Destructiveness is among the fundamental discourse categories that play a significant role in the organization of communicative interaction and define the pragmatics of discourse; its study helps to understand some mechanisms and principles of communication, identify strategies and tactics used by a destructive communicative personality. The relevance of this study is determined by the increasing aggressiveness in various types of discourse, and, accordingly, by the need to extend the knowledge of destructive behavior of a communicative personality. The study is based on the theory of discourse-analysis and theory of destructiveness (Z. Harris, T. van Dijk, A. Buss, E. Fromm, D. Ponton, K. Hacker, R. Wodak. N. Arutyunova, V. Karasik, M. Makarov, E. Sheigal et al). Developing the theory of destructiveness and relying on Erich Fromm’s research (1973), we specify the concept of “destructiveness” in relation to the political discourse and compare it with the related concept of aggressiveness. The paper analyses the category of destructiveness in modern US political discourse, using excerpts from the speeches of the candidates for presidency of 2016. Particular attention is paid to the dominant destructive intention - to harm the reputation of the opponent and reduce his political chances, as well as to the functions of verbal aggression: on the one hand - to discredit the opponent, bring accusations, on the other hand - to poison the audience mind against him/her and arouse the feeling of danger posed by a political opponent. The analysis of verbal and nonverbal means of destructiveness in the US political discourse is carried out. The article concludes that abusive remarks of politicians do not result from spontaneous emotional outburst, but from an elaborated destructive strategy where the agonistic nature of political discourse stipulates the use of instrumental aggression (Buss, 1971) for the sake of the conquest of power, lowering the opponent’s status, deteriorating his/her public image.

The historic development of modern US advertising regulation

Purpose – The purpose of this article is to examine the US history of advertising regulation, both formal and informal and public and private – particularly focused on advertising that is likely to mislead consumers about attributes, characteristics or performance of advertised products. Design/methodology/approach – This research examines both primary sources such as legal challenges and contemporary writings as well as secondary sources. Findings – Although early court decisions were reluctant to find advertising to be dishonest, the Post Office was the first government agency to challenge blatantly false advertisements through criminal prosecution. At the end of the 1800s, the nascent advertising industry developed an interest in regulating truthfulness to enhance advertising credibility. It proposed a model state criminal code and advertising clubs, followed by local Better Business Bureaus, began to informally resolve advertising dispute. In 1914, the Federal Trade Commission (FTC) was established with authority to prevent unfair methods of competition which it used to challenge advertising that was likely to injure competitors. This authority was later expanded to cover advertising that was likely to mislead consumers regardless of competitive injury. The FTC experimented with trade association advertising provisions and expanding its concepts and tools overtime until a period of retrenchment in the 1980s that set the foundations of modern advertising regulation. Originality/value – This is the first treatment of advertising regulatory history that simultaneously covers and compares various sources of advertising regulation to develop a comprehensive exposition of advertising regulation history.

CONTRASTING U.S., CHINESE AND RUSSIAN PERCEPTIONS OF SOVEREIGNTY

Abstract: According to realist approach, three most modern influential states Russia, China and US strive to gain maximum freedom in the international arena while retaining independence in domestic policies. The author suggests that a different constructivist approach should be used. Paying attention to the peculiarities of norms and acknowledging the influence of domestic policy on the norms, this approach allows to explain the differences in understanding sovereignty in different states. The political elites of Russia and China tend to consider that the strong central power secures the Westphalian sovereignty, while the historic experience of the US formed the ideal of decentralized power. Aiming at population protection, democracy promotion, terrorist persecution and maintaining US hegemony, American liberal internationalists and neocons are in general eager to step away from the traditional understanding of sovereignty. Russia and China consider sovereignty from the absolutist standpoint, though they have made a number of concessions to the changing norms of territorial integrity and humanitarian intervention. The article proves that the Russian, American and Chinese understanding of sovereignty (both domestic sovereignty and interdependence sovereignty in S.Krasner’s terms) is changing with the emergence of common interests and the necessity to counteract new global threats.

CONTRASTING U.S., CHINESE AND RUSSIAN PERCEPTIONS OF SOVEREIGNTY

Abstract: According to realist approach, three most modern influential states Russia, China and US strive to gain maximum freedom in the international arena while retaining independence in domestic policies. The author suggests that a different constructivist approach should be used. Paying attention to the peculiarities of norms and acknowledging the influence of domestic policy on the norms, this approach allows to explain the differences in understanding sovereignty in different states. The political elites of Russia and China tend to consider that the strong central power secures the Westphalian sovereignty, while the historic experience of the US formed the ideal of decentralized power. Aiming at population protection, democracy promotion, terrorist persecution and maintaining US hegemony, American liberal internationalists and neocons are in general eager to step away from the traditional understanding of sovereignty. Russia and China consider sovereignty from the absolutist standpoint, though they have made a number of concessions to the changing norms of territorial integrity and humanitarian intervention. The article proves that the Russian, American and Chinese understanding of sovereignty (both domestic sovereignty and interdependence sovereignty in S.Krasner’s terms) is changing with the emergence of common interests and the necessity to counteract new global threats.

The Radical Formalism of Suzan-Lori Parks and Sarah Kane

When Suzan-Lori Parks's play Venus, about the displays of Saartjie Baartman in early nineteenth-century Europe, opened in 1996, the outrage it provoked by suggesting that its central, black character may have been complicit in her plight raised yet again one of the most inspiring and frustrating questions in modern US theatre history: how to stage the racial Other. Even the most sympathetic responses to the play revealed the difficulty of assuming a critical stance toward the racially marked body (especially the black female body) that is affectively fixed as a symbol of martyrdom and victimization. In fact, Shannon Jackson has proposed that the racially marked body's resistance to being reduced to a critical sign, free from affect, may be definitive of race as a social phenomenon. As US theatre history demonstrates, onstage this resistance is highly productive of controversy, much of which has focused on the question of which representational contracts may most accurately convey the experiences of racially marked people. In this sense, art critic Abiola Sinclair's reading of Parks's experimental aesthetic as a traitorous concession to a white theatrical tradition was unexceptional; it was a reminder of the historical efforts of African American artists to create distinctly black art.

The Politics of Obstruction: Republican Holds in the U.S. Senate

A defining feature of the modern US Senate is obstruction. Almost all pieces of legislation considered in the Senate are affected either directly or indirectly by obstruction. Obstruction takes many forms in the modern Senate, but one of the most prevalent, yet least studied, is the hold. Using a newly created dataset on Republican Senate holds, we cast light on this important practice. Our results suggest that a variety of factors including timing, party status, and a senator's voting record are related to both the prevalence of holds and the success of legislation subject to holds in the Senate.

Large-scale tactical urbanism: the Denver bike share system

How did one of the most historically automobile-dependent US cities end up with the first large-scale modern US bike-sharing system? The story reveals that it is less about transportation demand planning and engineering and more about the principles of what has been termed tactical urbanism. The tactical urbanism movement revolves around the idea that temporary interventions can help one understand what interventions might work in a particular context and lay the foundation for more permanent ones. That the first large-scale bike-sharing system in the US began as such an intervention is quite remarkable and illustrative of the potential of this strategy to build public aspiration and political will via temporary, short-term empirical success. Beginning with preparations for the 2008 Democratic National Convention (DNC) in Denver, Colorado, this paper details what went into creating the temporary Freewheel!n bike-share system and how that was able to be leveraged into a permanent bike-sharing system, Denver B-Cycle, two years later. Consistent with the characteristics of tactical urbanism, the partnerships formed with the temporary DNC implementation served as a catalyst. The paper then identifies lessons that other cities can learn and apply in similar large-scale tactical urbanism interventions.

The History of US: From Bats and Boats to the Bedside and Beyond: RSNA Centennial Article.

The article traces the emergence of modern US from knowledge accumulated gradually over 2 centuries from scientific observation, including experiments with flying bats, underwater church bells, iceberg detection devices, and imaging systems that required the patient to be submerged in a tank of water.

Tourniquet use at the Boston Marathon bombing: Lost in translation.

The Boston Marathon bombing was the first major, modern US terrorist event with multiple, severe lower extremity injuries. First responders, including trained professionals and civilian bystanders, rushed to aid the injured. The purpose of this review was to determine how severely bleeding extremity injuries were treated in the prehospital setting in the aftermath of the Boston Marathon bombing. A database was created and populated by all the Boston Level I trauma centers following the Boston Marathon bombing. Data regarding specific injuries, extremities affected, demographics, prehospital interventions (including tourniquet types), and outcomes were extracted. Of 243 injured, 152 patients presented to the emergency department within 24 hours. Of these 152 patients, there were 66 (63.6% female) experiencing at least one extremity injury, with age ranging from younger than 15 years to 71 years, and with a median Injury Severity Score (ISS) of 10 (range, 1-38). Of the 66 injured patients, 4 had upper limbs affected, 56 had injuries on the lower limbs only, and 6 had combined upper and lower limbs affected. The extremity Abbreviated Injury Scale (AIS) scores had a median of 3 (range, 1-4). There were 17 lower extremity traumatic amputations in 15 patients. In addition, there were 10 patients with 12 lower extremities experiencing major vascular injuries. Of 66 injured patients, 29 patients had recognized extremity exsanguination at the scene. In total, 27 tourniquets were applied: 16 of 17 traumatic amputations, 5 of 12 lower extremities with major vascular injuries, and 6 additional limbs with major soft tissue injury. All tourniquets were improvised, and no commercial, purpose-designed tourniquets were identified. Among all 243 patients, mortality was 0%. After the Boston Marathon bombings, extremity exsanguination at the point of injury was either left untreated or treated with an improvised tourniquet in the prehospital environment. An effective, prehospital extremity hemorrhage control posture should be translated to all civilian first responders in the United States and should mirror the military's posture toward extremity bleeding control. The prehospital response to extremity exsanguination after the Boston Marathon bombing demonstrates that our current practice is an approach, lost in translation, from the battlefield to the homeland. Epidemiologic study, level V.

A modern critical accountant in the French Revolution: Pierre B. Boucher of Bordeaux

This article was written in 1989, the bicentenary of the first French Revolution of 1789. At that time it was published in French in the Revue Francaise de Comptabilite (French Journal of Accounting), review of French public accountants (Degos, 1989). Citing an author and facts about an important period for France, for the USA and for the relations between France and the USA, the editorial board of IJCA saw fit it is reissued. In the following decades historical research undertaken then allowed a better understanding of ancient and modern European accounting and US accounting, and a better understanding of how, across the Atlantic Ocean, accountants of the two banks had concerns close to each other. And French sailors, fishing cod or whale near the American continent, helping and supporting the Americans in their desire for freedom and independence, maybe already understood many essentials things, both physical and philosophical.

Who Receives Unemployment Insurance?

This paper uses Unemployment Insurance (UI) administrative data combined with Current Population Survey data in 2003 to examine socioeconomic patterns in UI receipt for new job losers. We find that key socioeconomic groups – women, nonwhites, youth, and workers with no high school diploma – were much less likely than average to start collecting UI benefits once they lost their jobs. These differences are partly attributable to differences in part-time employment and unionization; workers in groups with low part-time employment and high unionization rates had higher than average UI receipt rates. We also find that certain groups of job losers – women, youth, workers with no college education, and blue collar workers – collected much lower benefits once they entered the program. These differences are mainly attributed to variation in benefit entitlements and other factors. Our findings enhance our understanding of the effectiveness of the UI program to serve the diverse population of new job losers in the modern US economy.

Tuberculosis cases in a modern US fertility center: a retrospective review

Tuberculosis cases in a modern US fertility center: a retrospective review