Presidential Executive Order Research Articles

Injuries from border wall falls after 2018 are more severe: a retrospective cohort study

BackgroundThe U.S.-Mexico “border wall” between El Paso, Texas and Ciudad Juárez, Mexico was raised and extended beginning in 2018 in accordance with Presidential Executive Order 13,767. We hypothesized that these changes resulted in increased incidence and severity of injuries of individuals attempting to cross the border wall in the El Paso region.MethodsA retrospective cohort review was conducted of University Medical Center of El Paso Trauma Registry charts from 2001 to 2022. Year of injury, gender, age, Injury Severity Score, hospital length-of-stay, ICU length-of-stay, ventilator days, and survival were analyzed by Chi-square analysis with Fisher’s exact test for categorical variables and Independent Samples T-test for continuous variables. An independent samples Mann Whitney U Test was used to compare border wall fall injuries before and after 2018.ResultsOf the 842 patients reviewed, 69 patients presented before 2018 and 773 presented from 2018 to 2022. Statistically significant differences were identified in the mean Injury Severity Score which increased from 6.3 (SD ± 3.8) to 8.3 (SD ± 5.5, p < .001) and the mean hospital length-of-stay which increased from 6.7 days (SD ± 5.5) to 9.5 days (SD ± 8.0, p < .005).ConclusionThe incidence, severity, and hospital length-of-stay related to injuries crossing the U.S.-Mexico border have increased with changes in height of the border wall since 2018. Additional resources should be allocated to Emergency Departments and Trauma Centers along the Southwest Border to serve this unique patient population. Additional consideration should be given to the cost of the border wall.

The US Government’s Latest Presidential Executive Order on Artificial Intelligence: Potential Implications in Radiology

The US Government’s Latest Presidential Executive Order on Artificial Intelligence: Potential Implications in Radiology

Inpatient peritoneal dialysis catheters placed across the United States during a 3-year period: Lessons learned from 15,000 patients

BackgroundPeritoneal dialysis is a popular option for patients with end-stage renal disease. A recent presidential executive order has incentivized in-home end-stage renal disease treatments, leading to an increase in peritoneal dialysis use. Guidelines exist for creating and maintaining peritoneal dialysis access without addressing the optimal technique. This study evaluates nationwide peritoneal dialysis catheter placement practices and their long-term outcomes. MethodsRetrospective cohort analysis of Nationwide Readmission Database from 2017 to 2019. Patients with end-stage renal disease undergoing inpatient peritoneal dialysis catheter placement were included. Six-month readmissions, mortality, and peritoneal dialysis catheter-specific outcome measures were assessed among survivors of admission, including catheter leakage, mechanical breakdown, displacement, revision or replacement, removal, exit site infections, intra-abdominal abscess, and sepsis. Binary logistic regression analyses were performed. ResultsIn the study, 14,863 patients with inpatient peritoneal dialysis catheter insertions were identified, of which 7,096 were analyzed (4,150 [59%] laparoscopic, 1,781 [25%] fluoroscopic, 1,165 [16%] open), 847 (12%) had major complications, 931 (13%) were readmitted, and 102 (1.4%) died within 6 months. Univariate analyses demonstrated that laparoscopy had higher mechanical complications, exit-site infections, catheter revision, and removal within 6 months, and fluoroscopy had higher sepsis and mortality. Multivariate analyses showed fluoroscopy was associated with intraabdominal abscess (adjusted odds ratio, 2.36; P = .025), laparoscopy with exit-site infections (adjusted odds ratio, 0.49; P = .005), and open surgery with catheter displacement (adjust odds ratio, 2.95; P = .021). ConclusionThis is the first large-scale study on inpatient peritoneal dialysis catheter placement outcomes in the United States. Fluoroscopic and open surgical placements are routinely performed, but laparoscopy remains the mainstay with fewer exit-site infections. Overall, peritoneal dialysis is a safe option, with 1 in 9 patients having an infectious or mechanical complication within 6 months. Furthermore, large-scale prospective studies are warranted to identify the optimal placement technique.

The Inadequacy of the October 2022 New US Presidential Executive Order on Enhancing Safeguards for United States Signals Intelligence Activities

The Inadequacy of the October 2022 New US Presidential Executive Order on Enhancing Safeguards for United States Signals Intelligence Activities

Port of No Return: Enemy Alien Internment in World War II New Orleans by Marilyn Grace Miller

Reviewed by: Port of No Return: Enemy Alien Internment in World War II New Orleans by Marilyn Grace Miller Daniel Hutchinson Port of No Return: Enemy Alien Internment in World War II New Orleans. By Marilyn Grace Miller. (Baton Rouge: Louisiana State University Press, 2021. Pp. xx, 273. $29.95, ISBN 978-0-8071-7527-9.) Decades of activism and historical research have placed Japanese internment as a central element in the narrative of the American home front during World War II. Less attention has been paid to the incarceration of "enemy aliens" of German and Italian descent under the U.S. government's Enemy Alien Control Program (p. 5). Historians such as Max Paul Friedman and Arnold Krammer have written valuable studies examining this internment experience. Marilyn Grace Miller makes a substantial contribution to this scholarship in Port of No Return: Enemy Alien Internment in World War II New Orleans. This engaging account explores the history of Camp Algiers, an internment facility in New Orleans and an important transit point in the international history of wartime detention. Miller argues that "New Orleans represented a 'port of no return,' a brink that, once crossed, could not be traversed in reverse" (p. xii). As in the Japanese American experience, presidential executive orders authorized the extrajudicial detention of potential spies and those affiliated with pro-Nazi and pro-Fascist political organizations. Yet fears of Axis infiltration throughout the Western Hemisphere prompted a wider dragnet of detention. At the request of the U.S. State Department, governments in Latin America executed their own preventive arrests. However, this process was marred by shoddy intelligence, scant evidence, racial prejudice, expropriation of property, and bribery. Jewish refugees fleeing Nazi-occupied Europe were among those detained as potential Axis agents. These refugees were [End Page 801] transported to the United States and interned alongside ardent supporters of National Socialism in a network of detention facilities in Texas, Tennessee, Georgia, Florida, and other states outside the South. Camp Algiers became a place of refuge for some of those Jewish internees. After desperate efforts to communicate their plight, many Jewish internees were transferred to Camp Algiers, which gained a reputation for being friendly to "anti-Nazis" (p. 34). The facility had the capacity to hold up to 250 inmates. Miller skillfully reconstructs the biographies of the camp's internees, utilizing case files held in the National Archives, correspondence with refugee aid agencies, and sources from Europe and Latin America. While the conditions of confinement were generally humane, indefinite (and frequently unjust) detentions left enduring trauma. Suicide and the stress of internment took the lives of some internees. Yet Miller complicates the story of what is sometimes called the "Camp of the Innocents" (p. 34). The U.S. military also detained notorious figures such as exiled Nazi propagandist Kurt Ludecke at Camp Algiers. Miller explores how the shifting rationales of U.S. authorities shaped how they classified the political, religious, and racial identities of internees. Such classifications could change quickly. Ironically, the internment process opened a path for some so-called enemy aliens to claim American citizenship. For others, departure from Camp Algiers represented repatriation and an uncertain future. Port of No Return concludes with an examination of the legacies of wartime detention. While the Japanese internment experience prompted redress and reparation, the first congressional hearings on the Enemy Alien Control Program occurred only in 2009. Yet a full reckoning of this history is overdue. Miller notes that the precedent of internment continues to shape policy and law, particularly for detainees captured during the War on Terror and migrants seeking asylum. "Many aspects of that precedent––indefinite detention without hearings, family separation, the manipulation of detention policy and detainee populations for political purposes and economic gain, repatriation of aliens to hostile environments––are still with us in some form today," Miller notes (p. 207). Camp Algiers itself continued to serve various functions within the federal immigration system until 2018. While the buildings were added to the National Register of Historic Places in 2019, gentrification threatens the site's future. Nonetheless, the installation's past is well chronicled in Port of No Return, a fitting tribute to the struggles of those...

Klotho in Kidney Transplantation: A New and Important Target?

Klotho in Kidney Transplantation: A New and Important Target?

Modeling protected species distributions and habitats to inform siting and management of pioneering ocean industries: A case study for Gulf of Mexico aquaculture.

Marine Spatial Planning (MSP) provides a process that uses spatial data and models to evaluate environmental, social, economic, cultural, and management trade-offs when siting (i.e., strategically locating) ocean industries. Aquaculture is the fastest-growing food sector in the world. The United States (U.S.) has substantial opportunity for offshore aquaculture development given the size of its exclusive economic zone, habitat diversity, and variety of candidate species for cultivation. However, promising aquaculture areas overlap many protected species habitats. Aquaculture siting surveys, construction, operations, and decommissioning can alter protected species habitat and behavior. Additionally, aquaculture-associated vessel activity, underwater noise, and physical interactions between protected species and farms can increase the risk of injury and mortality. In 2020, the U.S. Gulf of Mexico was identified as one of the first regions to be evaluated for offshore aquaculture opportunities as directed by a Presidential Executive Order. We developed a transparent and repeatable method to identify aquaculture opportunity areas (AOAs) with the least conflict with protected species. First, we developed a generalized scoring approach for protected species that captures their vulnerability to adverse effects from anthropogenic activities using conservation status and demographic information. Next, we applied this approach to data layers for eight species listed under the Endangered Species Act, including five species of sea turtles, Rice’s whale, smalltooth sawfish, and giant manta ray. Next, we evaluated four methods for mathematically combining scores (i.e., Arithmetic mean, Geometric mean, Product, Lowest Scoring layer) to generate a combined protected species data layer. The Product approach provided the most logical ordering of, and the greatest contrast in, site suitability scores. Finally, we integrated the combined protected species data layer into a multi-criteria decision-making modeling framework for MSP. This process identified AOAs with reduced potential for protected species conflict. These modeling methods are transferable to other regions, to other sensitive or protected species, and for spatial planning for other ocean-uses.

Mature and old-growth forests contribute to large-scale conservation targets in the conterminous United States

Mature and old-growth forests (MOG) of the conterminous United States collectively support exceptional levels of biodiversity but have declined substantially from logging and development. National-scale proposals to protect 30 and 50% of all lands and waters are useful in assessing MOG conservation targets given the precarious status of these forests. We present the first coast to coast spatially explicit MOG assessment based on three structural development measures—canopy height, canopy cover, and above-ground living biomass to assess relative maturity. MOG were displayed by major forest types (n = 22), landownerships (federal, state, private, and tribal), and Gap Analysis Project (GAP) management status overlaid on the NatureServe’s Red-listed Ecosystems and species, above-ground living biomass, and drinking water source areas. MOG total ∼67.2 M ha (35.9%) of all forest structural classes and were scattered across 8 regions with most in western regions. All federal lands combined represented the greatest (35%) concentrations of MOG, ∼92% of which is on national forest lands with ∼9% on Bureau of Land Management (BLM) and ∼3% on national park lands (totals do not sum to 100% due to minor mapping errors in the datasets). MOG on national forest lands supported the highest concentration of conservation values. However, national forests and BLM lands did not meet lower bound (30%) targets with only ∼24% of MOG in GAP1,2 (5.9 M ha) protection status. The vast majority (76%, 20.8 M ha) of MOG on federal lands that store 10.64 Gt CO2 (e) are vulnerable to logging (GAP3). If federal MOG are logged over a decade, and half their carbon stock emitted, there would be an estimated 0.5 ppm increase in atmospheric CO2 by 2030, which is equivalent to ∼9% of United States total annual emissions. We recommend upper bound (100%) protection of federal MOG, including elevating the conservation status of Inventoried Roadless Areas. This would avoid substantial CO2 emissions while allowing ongoing carbon sequestration to act as natural climate solutions to aid compliance with the Paris Climate Agreement and presidential executive orders on MOG and 30% of all lands and waters in protection by 2030. On non-federal lands, which have fewer MOG, regulatory improvements and conservation incentives are needed.

Khatt Islāmi: Sacred Scripts from Islamic Africa

Khatt Islāmi: Sacred Scripts from Islamic Africa

Analysis of a national response to a White House directive for ending veteran suicide.

Analyze responses to a national request for information (RFI) to uncover gaps in policy, practice, and understanding of veteran suicide to inform federal research strategy. An RFI with 21 open-ended questions generated from Presidential Executive Order #1386, administered nationally from July 3 to August 5, 2019. Semi-structured, open-ended responses analyzed using a collaborative qualitative and text-mining data process. We aligned traditional qualitative methods with natural language processing (NLP) text-mining techniques to analyze 9040 open-ended question responses from 722 respondents to provide results within 3 months. Narrative inquiry and the medical explanatory model guided the data extraction and analytic process. Five major themes were identified: risk factors, risk assessment, prevention and intervention, barriers to care, and data/research. Individuals and organizations mentioned different concepts within the same themes. In responses about risk factors, individuals frequently mentioned generic terms like "illness" while organizations mentioned specific terms like "traumatic brain injury." Organizations and individuals described unique barriers to care and emphasized ways to integrate data and research to improve points of care. Organizations often identified lack of funding as barriers while individuals often identified key moments for prevention such as military transitions and ensuring care providers have military cultural understanding. This study provides an example of a rapid, adaptive analysis of a large body of qualitative, public response data about veteran suicide to support a federal strategy for an important public health topic. Combining qualitative and text-mining methods allowed a representation of voices and perspectives including the lived experiences of individuals who described stories of military transition, treatments that worked or did not, and the perspective of organizations treating veterans for suicide. The results supported the development of a national strategy to reduce suicide risks for veterans as well as civilians.

Implementation of National and Federal Projects for the Development of Russian Science: Statistical Analysis

The article presents the results of the author's study of the content of Russian science development programs and their implementation, which was carried out based on official statistics. The author emphasizes that the creation of the National Project «Science and Univer- sities» has become a logical development and an update of two national projects – «Science» and «Education» – that conformed with the objectives of the Presidential Executive Order on Russia’s national development goals through 2030. The paper describes the information and statistical support for the development and assessment of the implementation of state pro- grams for the development of Russian science. The author considers the lists of target indicators of the National Project «Science and Universities» and its four federal projects «Research Leadership», «Infrastructure», «Personnel», «Integration» generated and approved by the directives and orders of the Minobrnauki of Russia (Ministry of Education and Science of Russia) and Rosstat (Federal State Statistics Service). Considerable attention is given to the international comparative analysis of the most significant indicators reflecting the status of science in the country, including the amount of investment in science, the assessment of the scale of state support for scientific activities in different countries, which is necessary for transferring the Russian economy to an innovative path of development. In this regard, the necessity of expanding and improving statistical observation is substantiated by conducting a range of additional thematic questionnaires and surveys of scientific and educational organizations engaged in research and development.

What does critical race theory have to do with academic medicine?

Critical Race Theory (CRT) has recently become a target of national attention due to recent Presidential Executive Orders and state and local governmental bodies banning its use in public school settings. However, such attention has only led to critical race theory being misconstrued by the media and misunderstood by the common lay person. Critical Race Theory is a specific pedagogical and theoretical approach to understand how racialized historical contexts influence contemporary society. Clarifying and positioning CRT in a manner within which to understand health inequities experienced by racialized groups in the United States is paramount for the field of academic medicine and medical practice. A critical examination of the historical and contemporary issues of race and racism in America provides the necessary context within which to understand the long-standing and persistent existence of health disparities experienced among racial/ethnic populations in the United States. Ignoring historical and contemporary political and social influences of race and racism on health will only hinder the country's ability to narrow expanding gaps in racial/ethnic health disparities. Academic medicine has a professional and ethical responsibility to educate its trainees and health professionals on the history of medicine – including its ugly side – and to critically examine how historical and contemporary political and social factors have created racial/ethnic health disparities. Until such reckoning occurs the field of medicine's ability to achieve health equity for all will continue to be futile.

Media Attention and Strategic Timing in Politics: Evidence from U.S. Presidential Executive Orders

AbstractDo politicians tend to adopt unpopular policies when the media and the public are distracted by other events? We examine this question by analyzing the timing of executive orders signed by U.S. presidents over the past four decades. We find robust evidence that executive orders are more likely to be signed on the eve of days when the news is dominated by other important stories that can crowd out coverage of executive orders. This relationship only holds in periods of divided government when unilateral presidential actions are more likely to be criticized by Congress. The effect is driven by executive orders that are more likely to make the news and to attract negative publicity, particularly those on topics on which president and Congress disagree. Finally, the timing of executive orders appears to be related to predictable news but not unpredictable ones, which suggests it results from a deliberate and forward‐looking PR strategy.

Automotive Ground Vehicles' Resilience to HEMP Attack: An Emergency Management Mitigation Plan

United States exposure to attack from a nuclear weapon of mass destruction (WMD) optimized to generate a high‐altitude electromagnetic pulse (HEMP) is a concern in national security forums. Such an attack could lead to widespread damage to the electrical components of many critical infrastructures. The purpose of this study was to develop a framework to better understand the hazard risks from a HEMP attack on non‐military (non‐MIL), “electronics‐heavy” automotive ground vehicles that could inform an effective emergency management response and recovery plan. A hybrid emergency management and engineering hazards risk analysis utilizing a Failure Modes and Effects Analysis (FMEA) format helped visualize the critical vehicle electronics subsystems and components, and their respective potential failure modes. A design of experiments test plan was developed to quantify the risks, and to develop a pathway to validate cost‐effective mitigation countermeasures based on present‐day best practices for HEMP hardening. The proposed emergency management plan emphasized strategic implementation of HEMP mitigation countermeasures to support continuity in emergency services and delivery of community lifelines to the public. The results of this study will serve as a foundation for future HEMP projects with automotive ground vehicles that will support the FEMA National Preparedness Goal, Presidential Executive Order 13865, and the recent FY2020 National Defense Authorization Act (NDAA) legislation. The methodologies can also apply to other critical infrastructure segments.

Meditations from a Black Woman Chair: Social Justice Values and a New Normal in Academic Administration

Meditations from a Black Woman Chair: Social Justice Values and a New Normal in Academic Administration

Perinatal Counseling at the Margin of Gestational Viability: Where We’ve Been, Where We’re Going, and How to Navigate a Path Forward

Perinatal Counseling at the Margin of Gestational Viability: Where We’ve Been, Where We’re Going, and How to Navigate a Path Forward

Proclamations and Paraphernalia: #Bellwether, Editor’s Notes, and the Art of Remixing the Political Document

In 2016 I created an installation entitled #Bellwether, which was a visual exploration of social media content surrounding the 2016 United States presidential primaries, focused specifically on voters in Ohio. Over the course of a year, I collected more than 14 million public Twitter posts that referenced the candidates by name, and repurposed the design of their campaign merchandise to reflect voter sentiment, replacing the curated messaging that they were pushing into the political sphere. After the election, I collected public data from Trump’s administration—including tweets from the @realDonaldTrump account, executive orders and memoranda and transcripts of interviews and news conferences—and edited the text of the US Constitution from his perspective, using the data to justify changes I made to the original text. I presented the final work in the form of a Presidential Executive Order, mirroring everything from typography to paper choices to the leather holders in which Executive Orders are publicly presented after signing. This creative study explores the lessons learned from these two projects; specifically, I examine the appropriation of political design and its signifiers. I argue that by manipulating and subverting this visual language, the work attempts to counter monolithic narratives perpetuated by dominant political systems, while illuminating the effects of media, technology and the Internet on our perceptions of the government and those who serve in it. By employing alternate historical narratives, the speculative nature of these works also offers a way of imagining a more nuanced approach to current political analysis and meaning-making.

Institutional Roles and Goals for Retrospective Regulatory Analysis

AbstractDespite repeated calls for retrospective regulatory review by every President since the 1970s, progress on implementing such reviews has been slow. We argue that part of the explanation for the slow progress to date stems from misalignment between the goals of regulatory review and the institutional framework used for the review. We define three distinct goals of regulatory review – the rule relevance goal, the rule improvement goal, and the regulatory learning goal. We then examine the text of the Presidential Executive Orders and major Congressional legislation addressing retrospective review, and document which goals were targeted and which institutions were used to conduct the reviews. We find that the U.S. federal government has almost always sought review of one rule at a time, conducted by the agency that issued or promulgated the rule and that these reviews tend to focus on rule relevance and costs. This institutional framework for retrospective review – one rule, assessed by the promulgating agency, focused on relevance and cost – is only well-suited to a narrow interpretation of the rule improvement goal. We then review alternative institutional structures that could better meet the rule improvement goal and the broader regulatory learning goal across multiple rules and agencies, and we offer recommendations for developing new guidance and institutions to promote multiagency regulatory learning.

Revolução nas políticas públicas: a institucionalização das mudanças na economia, de 1930 a 1945

Resumo O artigo analisa os legados da Revolução de 1930 por um novo ângulo: o das políticas públicas. Para tanto, estabelece um recorte sobre as políticas econômicas lançadas desde 1930, evidenciando o fio de Ariadne dessas transformações. A metodologia combina, de forma inédita, história serial e análise com foco em políticas públicas, tendo como fonte básica os decretos presidenciais, buscando impressões digitais do presidente nessas mudanças. Conclui-se que mudanças mais significativas só ganharam impulso na virada para os anos 1940, a ponto não só de reorientar a política econômica, mas de se criar uma nova economia política.

Control System Cyber Security

Cyber security for Information Technology (IT)/Operational Technology (OT) is about the protection of Internet protocol (IP) networks from cyber attacks. Control system cyber security is about protecting physical processes from unintentional incidents and malicious attacks. Technologically, control system cyber security is different than IT cyber security because of the control system devices and their low‐level communication protocols. Yet IT and OT cyber security policy has been developed by the network security organization with minimal participation from the engineering organizations that “own” the hardware and control systems.Control system cyber security is real—there have been more than 1,250 actual incidents identified to date.1 But there currently is widespread lack of appropriate control system cyber forensics and cyber security training. With the availability of IT cyber security hardware, testing, and training, IT systems continue to be compromised, and control system cyber security is arguably 5‐10 years behind IT.In addition to the need to upgrade control system cyber security at the levels of individual organizations and critical infrastructures, this is a matter of national security import. It was widely reported that a large Chinese‐built electric transformer may have contained hardware backdoors, allowing access to transformer equipment control parameters. (Wall Street Journal, 2020). Attack vectors in the control system area resulted in Presidential Executive Order (EO) 13920 in May 2020.2Consequently, this paper advocates a paradigm shift to work around the current lack of a robust capability to secure control system networks. In order to address the limitations in securing control legacy and “next generation” control systems and networks, new approaches for improving control system cyber security and the ability to widely deploy them are needed.