US Commission Research Articles

Pickleball-Related Fractures in the United States From 2002 to 2022: An Analysis Using the NEISS Database.

Pickleball is one of the fastest-growing sports in the United States, with more than an 11-fold increase in injuries from 2010 to 2019. To (1) determine the prevalence and demographic variables associated with pickleball-related fractures among patients evaluated at emergency departments in the United States between 2002 and 2022 and (2) identify variables influencing patient disposition status. Descriptive epidemiology study. The US Consumer Product Safety and Commission's publicly available database, the National Electronic Injury Surveillance System (NEISS), was used in this study. Analyses consisted of descriptive statistics for fracture prevalence and demographic variables as well as univariate analysis for disposition status (discharged home vs hospital admission). A total of 397 pickleball-related fractures were recorded between 2002 and 2022, which indicated a 90-fold increase in our study period. Based on weighted national average of NEISS sampling, this equated to approximately 5400 fractures annually. Players who sustained pickleball fractures were primarily aged >60 years (n = 344 [87%]; P < .001) and female (n = 273 [69%]; P < .001). Most fractures involved the upper extremity (n = 262 [66%]; P < .001), with the most common ones involving the radius (n = 79 [30%]), humerus (n = 22 [8%]), and ulna (n = 8 [3%]). Fractures were due most commonly to falls (n = 365 [92%]; P < .001) and occurred in the winter months (n = 142 [36%]; P < .001). There was a significant difference in disposition status, with most patients discharged (n = 320 [81%] vs n = 77 [19%] for hospital admission; P < .001). Univariate analysis revealed that age >60 years, male sex, and fractures to the trunk and lower extremity all led to significantly increased odds of being admitted (odds ratios: 2.27, 2.31, 2.89, and 13.8, respectively). Between 2002 and 2022, there was a 90-fold increase in pickleball-related fractures. Most fractures were of the upper extremity after a fall in women aged >60 years. Despite female fracture predominance, men were 2.3 times more likely to be admitted after sustaining a fracture.

O-RADS US v2022: An Update from the American College of Radiology's Ovarian-Adnexal Reporting and Data System US Committee.

First published in 2019, the Ovarian-Adnexal Reporting and Data System (O-RADS) US provides a standardized lexicon for ovarian and adnexal lesions, enables stratification of these lesions with use of a numeric score based on morphologic features to indicate the risk of malignancy, and offers management guidance. This risk stratification system has subsequently been validated in retrospective studies and has yielded good interreader concordance, even with users of different levels of expertise. As use of the system increased, it was recognized that an update was needed to address certain clinical challenges, clarify recommendations, and incorporate emerging data from validation studies. Additional morphologic features that favor benignity, such as the bilocular feature for cysts without solid components and shadowing for solid lesions with smooth contours, were added to O-RADS US for optimal risk-appropriate scoring. As O-RADS US 4 has been shown to be an appropriate cutoff for malignancy, it is now recommended that lower-risk O-RADS US 3 lesions be followed with US if not excised. For solid lesions and cystic lesions with solid components, further characterization with MRI is now emphasized as a supplemental evaluation method, as MRI may provide higher specificity. This statement summarizes the updates to the governing concepts, lexicon terminology and assessment categories, and management recommendations found in the 2022 version of O-RADS US.

Regulatory Issues when Acquiring US Pump Companies

When a non-US company is buying a US pump company, the proposed acquisition may need to be reviewed by the US Committee on Foreign Investment in the United States (CFIUS). Eric McClafferty and Wyatt Mince walk us through the process.

Tlacoqualli in Monequi "The Center Good"

Tlacoqualli in Monequi "The Center Good"

DETERMINING THE WORLDVIEW ORIENTATIONS OF KAZAKHSTANI USERS IN SOCIAL NETWORKS AND EXPERT OPINIONS THROUGH DISCOURSE ANALYSIS

In the research work, a discourse analysis of the worldview of users of the Kazakhstani segment of social networks and the opinions of experts was carried out in order to determine the processes of religiousization in Kazakhstan and the ideological orientations of the population. The results of a sociological study and the report of the US Commission on International Religious Freedom (USCIRF) were also considered. The author of the article draws his own conclusions by analyzing the content of social networks and online platforms.

Do rights violations deter refugees?

ABSTRACT Do crackdowns by destination countries deter refugees? Much of the existing literature conflates containment measures (forcibly restricting refugees in their home region or country) and deterrence policies (discouraging refugees by making the destination appear less attractive). In addition, empirical studies have focused almost exclusively on Western countries and analyzed the effects of acceptance rates or policy reforms on the number of asylum applications lodged. In contrast, this paper examines whether rights violations deter asylum-seekers and refugees by leveraging a global dataset drawn from reports by the US Committee for Refugees and Immigrants. I find that deportation, detention, and encampment are not associated with decreases in asylum applications or refugee arrivals, and may actually be correlated with increases in them in some cases. While reduced access to the labour market may deter very small numbers of asylum-seekers and refugees, there are other sound reasons for destination countries to eschew restrictive employment policies.

Impacts of reporting lines and joint reviews on internal audit effectiveness

PurposeThis paper aims to examine the extent to which two commonly recommended information sharing and communication interventions, direct reporting lines between the internal audit function (IAF) and the audit committee (AC) and their joint reviews of internal audit standards and procedures, improve the internal audit in the continuous audit control and monitoring efforts.Design/methodology/approachThis study uses data from the Audit Intelligence Suite-Benchmarking (AIS) Report for the years 2007 to 2016 published by the Institute of Internal Auditors. The authors test the research hypotheses using the ordinary least squares regression method.FindingsFunctional reporting lines from the IAF to the AC positively impact the internal audit, but administrative lines have a negative impact. Reviews conducted jointly between the IAF and the AC positively influence the internal audit. The impacts of reporting lines and joint reviews are also associated with accounting complexity within a given industry, organizational control structure, organizational scope and the level of IAF’s responsibilities over internal control environment to comply with Sarbanes–Oxley (SOX) Act of 2002.Research limitations/implicationsBecause the study uses AIS data, operationalization of variables is constrained to items in the given data set. Future studies, including field studies, may identify other variables and measures using diverse data sources. This study expands the knowledge of effective means of information sharing and communication to enhance interactions between the IAF and the AC.Practical implicationsThe results suggest that the use of reporting lines should correspond to accounting complexity, organizational control structure, organizational scope, and reliance on the IAF in handling SOX responsibilities. They also highlight the importance of joint reviews between the IAF and AC in ensuring a high-quality internal audit.Originality/valueThe authors envisioned reporting lines and joint reviews as an excellent tool to balance the relationship between the IAF and the AC for continuous internal auditing beyond generating internal audit reports according to the US Committee of Sponsoring Organizations of the Treadway Commission framework Principle 14.

Dentists as Primary Care Providers: Expert Opinion on Predoctoral Competencies

Dentistry and medicine traditionally practice as separate professions despite sharing goals for optimal patient health. Many US residents experience both poor oral and general health, with difficulty accessing care. More efficient collaboration between these professions could enhance health. The COVID-19 pandemic disclosed further disparities while underscoring concerns that physician supply is inadequate for population needs. Hence, enhancing healthcare provider education to better meet the public's health needs is critical. The proposed titles “Oral Physician” or “Oral Health Primary Care Provider” (OP-PCP) acknowledge dentist's capacity to diagnose and manage diseases of the orofacial complex and provide some basic primary healthcare. The US Surgeon General's National Prevention Council and others recommend such models. Medical and dental education already overlap considerably, thus it is plausible that dental graduates could be trained as OP-PCPs to provide primary healthcare such as basic screening and preventive services within existing dental education standards. In 2018, 23 dental and medical educators participated in an expert-opinion elicitation process to review educational competencies for this model. They demonstrated consensus on educational expansion and agreed that the proposed OP-PCP model could work within existing US Commission on Dental Accreditation (CODA) standards for predoctoral education. However, there were broader opinions on scope of practice details. Existing CODA standards could allow interested dental programs to educate OP-PCPs as a highly-skilled workforce assisting with care of medically-complex patients and to helping to reduce health disparities. Next steps include broader stakeholder discussion of OC-PCP competencies and applied studies including patient outcome assessments.

Choice of influenza vaccine in people over 65 years old. Analysis of reports from international vaccination advisory committees

IntroducciónLas recomendaciones anuales sobre el uso de la vacuna frente a la gripe en diferentes países son desarrolladas por grupos de trabajo específicos de gripe dentro de sus Comités Asesores de Inmunización. Los adultos de 65 años o más se incluyen en los grupos para los que se recomienda particularmente la vacunación debido a la morbilidad asociada a este grupo de pacientes. Se dispone de una variedad de vacunas antigripales, algunas de las cuales de inmunidad reforzada, están autorizadas para su uso solo en este grupo de edad específico, donde la respuesta inmune a las vacunas tradicionales puede ser subóptima. Analizamos las principales recomendaciones anuales sobre el uso de la vacuna antigripal emitido por comités de asesoramiento sobre inmunización para población mayor de 65 años.Material y métodosSe han seleccionado las últimas guías de vacunación antigripal (2020-2021) y se han revisado las recomendaciones relativas a mayores de 65 años publicadas por los principales comités asesores de vacunaciónResultadosEl Comité asesor del Reino Unido (JCVI) recomienda el uso de Vacuna antigripal inactivada tetravalente con adyuvante (aQIV) o Vacuna antigripal inactivada tetravalente de dosis alta (QIV-HD). El comité de EEUU (ACIP) no expresa preferencia por ningún tipo de vacuna. El comité australiano (ATAGI) recomienda preferentemente la vacuna frente a la gripe con adyuvante. Lo comités asesores de Canadá y Alemania (NACI, STIKO) y el Centro de Control de Enfermedades Europeo (ECDC) recomienda usar cualquiera de las vacunas contra la gripe apropiadas para la edad disponibles, aunque apuesta por la utilización de vacuna inactivada tetravalente contra la gripe de alta dosis a nivel individual para mayores de 65 años.ConclusiónSe precisan mayores estudios y una mejora en la calidad de los mismos que analicen las distintas vacunas disponibles y la comparabilidad de las mismas, aunque se recomienda, con carácter general, la utilización de vacunas antigri-pales de inmunidad reforzada en población mayor de 65 años.

Standard of care for lipedema in the United States.

BackgroundLipedema is a loose connective tissue disease predominantly in women identified by increased nodular and fibrotic adipose tissue on the buttocks, hips and limbs that develops at times of hormone, weight and shape change including puberty, pregnancy, and menopause. Lipedema tissue may be very painful and can severely impair mobility. Non-lipedema obesity, lymphedema, venous disease, and hypermobile joints are comorbidities. Lipedema tissue is difficult to reduce by diet, exercise, or bariatric surgery.MethodsThis paper is a consensus guideline on lipedema written by a US committee following the Delphi Method. Consensus statements are rated for strength using the GRADE system.ResultsEighty-five consensus statements outline lipedema pathophysiology, and medical, surgical, vascular, and other therapeutic recommendations. Future research topics are suggested.ConclusionThese guidelines improve the understanding of the loose connective tissue disease, lipedema, to advance our understanding towards early diagnosis, treatments, and ultimately a cure for affected individuals.

The relationship between human rights and refugee protection: an empirical analysis

ABSTRACT What is the relationship between a government's respect for the rights of its own citizens and that government's regard for refugee rights? On one hand, we may expect that a country with high human rights standards will also offer a higher quality of asylum. Domestic laws that protect citizens’ rights may be extended to refugees, for example. On the other hand, there are reasons to theorize that a country with high human rights standards may offer a lower quality of asylum. For instance, governments may claim that protecting citizens’ wellbeing necessitates the rejection of refugees. To explore these questions, I analyse a global dataset drawn from reports by the US Committee for Refugees and Immigrants. I find that the relationship between citizens’ rights and refugee rights is modified by economic conditions and the size of the refugee population. Moreover, some domestic rights (like freedom of movement and labor rights) may increase protections for refugees, while others (like rule of law) may decrease them. Refugees have been largely absent from the literature on the politics of human rights. By systematically examining the relationship between human and refugee rights worldwide, this paper fills an important gap in the scholarly and policy literature.

Amerika Birleşik Devletleri’nin Uluslararası Din Özgürlüğü Raporları: Türkiye Örneği

Son yıllarda din özgürlüğünü teşvik etme çabası uluslararası ilişkilerde artarak devam eden bir ivme kazanmıştır. Amerika Birleşik Devletleri din özgürlüğüne ‘ilk hak’ olarak inanan bazı vatandaşları ile uluslararası din özgürlüğünün en ateşli savunucularından olmuştur. Bu makale ABD Uluslararası Din Özgürlüğü Ofisi ve ABD Uluslararası Din Özgürlüğü Komisyonu’nun Türkiye raporlarını incelemektedir. Makale ilk olarak Ofis ve Komisyonun kurulmasına sebep olan 1998 Uluslararası Din Özgürlüğü Yasası’nın nasıl vücut bulduğunu ve neler içerdiğini anlatmaktadır. Makale ardından Türkiye raporlarını analiz eder ve raporların din özgürlüğü ihlalleri ile ideal din-devlet ilişkileri üzerinde cereyan eden siyasi tartışmaları birbirinden ayrı kategoriler olarak görmediğini iler sürer. Benzer bir şekilde, raporlar dini azınlıkların yaşadığı münferit hadiselerle sistematik hak ihlallerini aynı kategoride değerlendirir. Raporlardaki bu birbirine karışmış yaklaşım Amerikan sekülerizm ve din özgürlüğü paradigmasının bir yansıması olduğu izlenimi vermektedir. Ayrıca raporlar ‘toplumsal tavırlar’ ve ‘toplumsal zulümler’ bölümlerinde Türkiye toplumunu dini aidiyet çizgileri ile bölmekte ve dini özgürlük hakkını bir bütün olan insan haklarından ayırmaktadır.

Border Land, Border Water: A History of Construction on the US-Mexico Divide

Border Land, Border Water: A History of Construction on the US-Mexico Divide

Do Rights Violations Deter Refugees?

Do crackdowns by destination countries deter refugees? Much of the existing literature conflates containment measures (forcibly restricting refugees in their home region or country) and deterrence policies (discouraging refugees by making the destination appear less attractive). In addition, empirical studies have focused almost exclusively on Western countries and analyzed the effects of acceptance rates or policy reforms on the number of asylum applications lodged. In contrast, this paper examines whether rights violations deter asylees and refugees by leveraging a global dataset drawn from reports by the US Committee for Refugees and Immigrants. I find that deportation, detention, and encampment do not decrease asylum applications or refugee arrivals, and may actually raise them in some cases. While reduced access to the labor market may deter very small numbers of asylees and refugees, there are other sound reasons for destination countries to eschew restrictive employment policies.

Editor's comments

This issue of the URSI Radio Science Bulletin contains papers by six of the 20 Young Scientist Awardees from the Commission B triennial Electromagnetic Theory Symposium, held May 27–31, 2019, in San Diego, California, USA. The guest Editors for this special section are Kazuya Kobayashi, the Chair of URSI Commission B, and Sembiam Rengarajan, Chair of the EMTS 2019 Local Organizing Committee and Chair of the US Committee for URSI. Their efforts are greatly appreciated.

A robot took my job! How STEM education might prepare students for a rapidly changing world

[Excerpt] While automation has been with us since the Industrial Revolution, recent developments in computing processing power, global connectivity, robotics and artificial intelligence (AI) have the potential to reshape our future labour markets. Analysis of the Australian job market found that 44% of current Australian jobs are at high risk of being affected by automation over the next 20 years (PWC, 2015). However, in the same way we can have full employment but no longer need chimney sweeps or town criers, some jobs as we currently know them, are highly likely to be displaced (WEF, 2018). Fortunately, history has demonstrated that new jobs will emerge. For example, 18% of the workforce today is employed in an occupation that essentially did not exist in 1980 (Lin, 2011). This presents a huge challenge for educators when preparing our students for their future. As the former US Secretary of Education, Richard Riley, famously said, "… none of the top ten jobs that will exist in [the future] exist today and that these jobs will employ technology that hasn’t yet been invented to solve problems we haven’t yet imagined" (US Committee on Small Business, 2004, p. 184). This paper considers the threat automation poses to the future workplace and then explores how the knowledge, skills and capabilities developed in the Science, Technology, Engineering and Mathematics (STEM) subjects should ensure that our students are well-prepared for the upcoming challenges of a rapidly changing world.

Afghan Frontier: Understanding Tobacco Practices among Migrant Population in India

Background:According to the World Refugee Survey by US Committee for Refugees and Immigrants, migrants from Afghanistan constitute the 4th largest group of migrants to India. No previous study has been conducted to assess the tobacco consumption status and pattern among this marginalised migrant population. Aim:To get an insight of the tobacco usage pattern, accessibility and attitude towards tobacco cessation among the migrant population from Afghanistan. Methodology:A cross-sectional study was conducted among a convenience sample of Afghan tobacco users residing in Delhi, India in the month of June 2017. A close-ended self-administered validated questionnaire in Persian language was distributed at local cafés and restaurants. Statistical analysis:Data was entered in MS Excel Spreadsheet and descriptive statistics using SPSS version 21 were carried out. Results:A total of 127 male Afghan tobacco users with mean age of 33.49± 11.97 years completed the questionnaire. Better work opportunities were the most common reason for migration. Most of them (69%) smoked tobacco and 15.5% used only Naswar. Half (52%) of the respondents continue to use tobacco products manufactured in Afghanistan with 62% procuring the product through social means (friends/family). On assessing barriers to tobacco use, majority (85%) found higher cost of tobacco products to be a deterrent while19% agreed lack of availability to be a barrier. 50% felt that law enforcement and tobacco use regulation in India curbed their tobacco use. Tobacco usage was a stress buster for 64% of the respondents. Although 72% were interested in quitting tobacco, 58% feared losing friends if they quit. Strikingly, 93% were unaware about the availability of cessation services. Conclusion:Even as Afghans migrate from their homeland, they carry their cultural and social practices with them, including tobacco products, patterns and practices.

In vitro activity of plazomicin compared to other clinically relevant aminoglycosides in carbapenem-resistant Enterobacteriaceae

We evaluated the in vitro activity of plazomicin against other aminoglycosides in 122 clinical carbapenem-resistant Enterobacteriaceae isolates using several clinical susceptibility breakpoints. Plazomicin had excellent in vitro activity with 98% overall susceptibility. Amikacin was the next most active with 86% overall susceptibility. This dropped to 55% when switching from Clinical Laboratory and Standards Institute to US Committee on Antimicrobial Susceptibility Testing breakpoints.

COVID-19: Review of Epidemiology and Potential Treatments Against 2019 Novel Coronavirus

An epidemic of extreme respiratory deterrence, pneumonia and shortness of breath, the SARS-CoV-2 viral infection began in Wuhan, Hubei Province, China in December 2019, and rapidly spread across China and beyond, with human to human transmission. On February 12, 2020, World Health Organization officially named the new coronavirus disease as coronavirus disease 19 (COVID-19). Most COVID-19 patients were diagnosed with pneumonia and many were treated using Chinese medicines and other secondary therapies. As of April 22, 2020, the total figure of infected patients has crossed 2.6 million people worldwide with over 180,000 deaths and 700,000 patients that have recovered. Preliminary reports suggest that certain drugs, such as chloroquine and antiviral nucleotide analogues such as remdesivir, which inhibit viral replication, can target the new coronavirus, although their usefulness in the clinic is still under debate. An expert US committee developed the US NIH guidelines for COVID-19 treatment, which was just released and will be regularly updated. This manuscript reviews the epidemiology, etiology, mortality, COVID-19 clinical symptoms, and potential therapeutic drugs, while highlighting the seriousness and damage-induced by SARS-CoV-2.

International Clinical Research and Justice in the Belmont Report.

The Belmont Report was written by a US Commission charged by the US Congress to advise on research supported by the US government. Its focus was understandably domestic. In the 40 years since its publication, clinical research has become increasingly international. Many clinical trials have sites in multiple countries, and many of the host countries are relatively impoverished. Such research raises some distinctive ethical issues. This paper outlines some of the key ethical challenges that have been raised by clinical research conducted in low- and middle-income countries (LMICs) and sponsored by high-income country (HIC) institutions. It then considers whether the Belmont Report has the resources to address these problems and argues that it does not. The article closes by noting some parallels between this international research and domestic US research, which suggest that the US might benefit from the discussions abroad.