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We can't let the former home of one of the great heroes of the American Revolution be demolished. 'One of the great truths of history is that no past event [...]

On November 13, 1942, five Sullivan brothers from Waterloo, Iowa--George, Francis, Joseph, Madison, and Albert--died when the light cruiser USS Juneau was torpedoed and sank off Guadalcanal during World War [...]

Samuel C. O. Holt, the long-time chairman of American Heritage Publishing, passed away on October 11, 2023. He was the first to join me as a director and investor to [...]

Through the years, American Heritage has published many stories of courage on the front lines of war. In this issue, we offer, for the first time, profiles of female journalists [...]

We celebrate one of America's greatest historians with an anthology of his writing. No one ever wrote American history with more easy grace, beauty, and emotional power or greater understanding [...]

A few years ago, we noticed something curious. While every state in the U.S. has a historical society--as do most counties, cities, and towns--there was no national society. So, we [...]

Some of the most important essays on gun rights, gun culture, and the meaning of the Second Amendment have appeared in American Heritage over the last 50 years Over the [...]

This spring, one of the most delightful signs of rebirth after a deadly pandemic and dreary months of winter will be the blossoming of hundreds of cherry trees along the [...]

Earlier this year, we sent our subscribers a list of some of the most recognized history books of 2021 and asked them to choose their favorites. The results of that [...]

David McCullough recalled the moments that got him started 'in the history business.' In 1965, he came across a spectacular photograph of the unveiling of the Statue of Liberty. Showing [...]

Objective: To examine whether nurse practitioner (NP)-assigned patients exhibited differences in utilization, costs, and clinical outcomes compared to medical doctor (MD)-assigned patients. Data Sources: Veterans Affairs (VA) administrative data capturing characteristics, outcomes, and provider assignments of 806 434 VA patients assigned to an MD primary care provider (PCP) who left VA practice between 2010 and 2012. Study Design: We applied a difference-in-difference approach comparing outcomes between patients reassigned to MD and NP PCPs, respectively. We examined measures of outpatient (primary care, specialty care, and mental health) and inpatient (total and ambulatory care sensitive hospitalizations) utilization, costs (outpatient, inpatient and total), and clinical outcomes (control of hemoglobin Ale, LDL, and blood pressure) in the year following reassignment. Principal Findings: Compared to MD-assigned patients, NP-assigned patients were less likely to use primary care and specialty care services and incurred fewer total and ambulatory care sensitive hospitalizations. Differences in costs, clinical outcomes, and receipt of diagnostic tests between groups were not statistically significant. Conclusions: Patients reassigned to NPs experienced similar outcomes and incurred less utilization at comparable cost relative to MD patients. NPs may offer a cost-effective approach to addressing anticipated shortages of primary care physicians. KEYWORDS cost, health workforce, nurse practitioner, primary care, quality of care, utilization, 1 | INTRODUCTION Nurse practitioners (NPs), accounting for about one-fifth of the primary care workforce in the United States (1) serve a significant role in primary care delivery. The Veterans [...]

Editor's Note: The late Sen. Robert Dole and nearly one million other Allied soldiers continued the fight against Nazi Germany in northern Italy after D-Day when the world's attention turned [...]

Perhaps we shouldn't have been surprised in January 2012 when the captain of the Costa Concordia abandoned his ship as it sank in frigid waters off the coast of Italy [...]

Editor's Note: This article, originally published in the Winter 1970 issue, was based on a speech given by Brigadier General Wittbrodt. The occasion was his presentation of the charter to [...]

Objective. To estimate the effect of Medicare use on the receipt of outpatient services from 2001 through 2015 for a cohort of Veterans Administration (VA) users who became age-eligible for Medicare in 1998-2000.Data Sources/Study Setting. VA administrative data linked with Medicare claims for veterans who participated in the 1999 Large Health Survey of Enrolled Veterans. Study Design. We coded each veteran as VA-reliant or Medicare-reliant based on the number of visits in each system and compared the health and social risk factors between VA-reliant and Medicare-reliant veterans. We used bivariate probit and instrumental variables models to estimate the association between a veteran's reliance on Medicare and the receipt of outpatient procedures in Medicare and the VA. Principal Findings. Veterans who chose to rely on the VA (n = 4,317) had substantially worse social and health risk factors than Medicare-reliant veterans (n = 2,567). Medicare reliance was associated with greater use of outpatient services for 24 of the 28 types of services considered. Instrumental variable estimates found significant effects of Medicare reliance on receipt of advanced imaging and cardiovascular testing. Conclusions. Expanded access to fee-for-service care in the community may be expensive, while the VA will likely continue to care for the most vulnerable veterans.Key Words. Veterans Administration, medicare, ambulatory procedures, community care, Demand for care has overtaken the capacity of the Department of Veterans Affairs (VA) health care system to provide care, resulting in unacceptably long wait times for care at many [...]

Objective. To examine the long-term reliance on outpatient care at the population (i.e., system) level among fee-for-service Medicare-enrolled elderly veterans in the Department of Veterans Affairs (VA) health care system and Medicare from 2003 to 2014.Data Sources/Study Setting. We analyzed a 5 percent random sample, stratified by facility, age, gender, and race, of Medicare-enrolled veterans enrolled in a VA primary care panel using VA administrative data and Medicare claims.Study Design. We performed a repeated cross-sectional analysis over 48 quarters. VA reliance was defined at the system level as the proportion of total visits (VA + Medicare) that occurred in VA. We examined four visit types and seven high-volume medical subspecialties. We applied direct standardization adjusting for age, gender, and race using the 2010 population distribution of Medicare-enrolled veterans. Principal Findings. Over the 12-year period, VA provided the vast majority of mental health care. Conversely, veterans received slightly more than half of their primary care and most of their specialty care, surgical care, and seven high-volume medical subspecialties through Medicare. However, reliance on VA outpatient care steadily increased over time for all categories of care.Conclusions. Despite the controversies about VA access to care, Medicare-enrolled veterans, who have a choice of using VA or Medicare providers, appear to increase their use of VA care prior to the Choice Act.Key Words. VA, Medicare, primary care, The Department of Veterans Affairs (VA) health care system is one of the largest integrated health care systems in the United States having served 8.4 million veteran enrollees in 2016 [...]

September was the cruelest month. The muddy water that filled our offices nearly dealt a fatal blow to American Heritage. As we reported in the last issue, we lost hundreds [...]

The article reports on the destroyer USS The Sullivans on display at the Buffalo Naval Park in New York and two Purple Hearts at the Society of the Cincinnati headquarters in Washington, D.C. in honor of the sacrifice of the Sullivan brothers who all perished in the sinking of the light cruiser USS Juneau during World War II. It looks back at the battles encountered by the USS Juneau warship and informs the naming of the USS The Sullivans as a National Historic Landmark.

Landforms and deposits observed on the Martian surface suggest that Mars’ early climate supported rivers and lakes over a time span of more than a billion years. But, like Earth, which has over the past billion years experienced periods of global glaciations and hyperthermals, the climate history of Early Mars may have been intermittent. Here we synthesize sedimentary and erosional evidence for multiple climate transitions on Early Mars. We suggest that Mars did not undergo a single wet-to-dry transition, but rather experienced seven major climate transitions, with the planet intermittently under climates warm enough to support surface liquid water even after 3.0 billion years ago (Ga). However, there is evidence for long dry spells, with some locations fully dry after 3.6 Ga. We evaluate hypotheses for the cause of the climate transitions, such as volcanic eruptions and changes in mean obliquity. Testing the sequence of events and understanding the underlying drivers of environmental change will require future missions to Mars.

Huntington’s disease (HD), a genetic neurodegenerative disorder, primarily affects the striatum and cortex with progressive loss of medium-sized spiny neurons (MSNs) and pyramidal neurons, disrupting cortico-striatal circuitry. A promising regenerative therapeutic strategy of transplanting human neural stem cells (hNSCs) is challenged by the need for long-term functional integration. We previously described that, with short-term hNSC transplantation into the striatum of HD R6/2 mice, human cells differentiated into electrophysiologically active immature neurons, improving behavior and biochemical deficits. Here, we show that long-term (8 months) implantation of hNSCs into the striatum of HD zQ175 mice ameliorates behavioral deficits, increases brain-derived neurotrophic factor (BDNF) levels, and reduces mutant huntingtin (mHTT) accumulation. Patch clamp recordings, immunohistochemistry, single-nucleus RNA sequencing (RNA-seq), and electron microscopy demonstrate that hNSCs differentiate into diverse neuronal populations, including MSN- and interneuron-like cells, and form connections. Single-nucleus RNA-seq analysis also shows restoration of several mHTT-mediated transcriptional changes of endogenous striatal HD mouse cells. Remarkably, engrafted cells receive synaptic inputs, innervate host neurons, and improve membrane and synaptic properties. Overall, the findings support hNSC transplantation for further evaluation and clinical development for HD.

What African Americans could not achieve in the courtroom they did in the dance hall, with the invention of a rebellious, and wholly American, new musical artform. On New Year's [...]

To the editors, Among the many nuggets embedded in your feature (February/March 2021) inviting ten historians to offer assessments of the Trump presidency with special attention on the events outside [...]

The answer is complex, confusing, American. One morning last fall, I found myself driving along the Miller's River as it winds through Western Massachusetts. The sun was a pale disc [...]

Jordan's publisher recalls working with the civil rights and corporate leader, who passed away on March 1. Wherever Vernon Jordan happened to be, he was memorable. With extraordinary charisma, he [...]

An exhibit now touring the U.S. highlights the Civil Rights struggles of the 1960s, with a focus on the violence and brutality endured by its participants. On February 1, 1968, [...]

We asked ten historians to give us their assessments of Donald Trump's accomplishments, both good and bad. It is often said that journalism is 'the first rough draft of history,' [...]

Given the widespread ignorance about American history, it is imperative that American Heritage disseminate trusted information about our nation's past to as many people as possible, as we have for [...]

Nineteen members of the National Press Club got together recently to create a Zoom-based radio play version of the classic story 'It's a Wonderful Life.' The program was cosponsored by [...]

Objective. To compare two approaches to measuring racial/ethnic disparities in the use of high-quality hospitals. Data Sources. Simulated data. Study Design. Through simulations, we compared the 'minority-serving' approach of assessing [...]

Facebook and Google have repeatedly blocked American Heritage's 'political' content because they aren't smart enough to tell the difference between Russian trolls and a trusted, award-winning magazine. Americans now average [...]

It's easy to see why curator Adam Erby gets excited entering the Front Parlor at Mount Vernon, which was recently reopened to the public after being closed more than a [...]

Editors Note: We asked Prof. Adam Winkler, a nationally recognized expert on Constitutional law and the history of gun control, to give us his thoughts on how we can steer [...]

Since its founding 70 years ago, American Heritage has stayed out of the fray of partisan politics, focusing instead on a straightforward telling of the American story. But the recurring, [...]

A team from American Heritage helped document some of the most important maps of the Revolution--still stored in the medieval English castle where scenes from Harry Potter were later filmed [...]

Authentic brass 'crickets' issued to American paratroopers on D-Day are now quite rare. A worldwide search recently 'unearthed a lost piece of sound history' D-Day planners gave American paratroopers an [...]

We will never learn from the past if we've forgotten it. Now there's been a dramatic decline in the number of college students studying history. My mother is 101 years [...]

The Seneca Indians called it the Ohi:yo' (pronounced oh-hee-yoh), literally the 'Good River.' When French explorer La Salle first saw the Ohio in 1669, he described it as La Belle [...]

In 1977, American Heritage published an article by Elinor Reichlin, a researcher at Harvard's Peabody Museum, about a startling discovery she had recently made: the oldest photographs of slaves known [...]

While the Civil War raged on battlefields in the East, two armies fought a very different kind of war in the West. The men working for two corporations that were [...]

Editor's Preface The recent furor over the use of blackface by Virginia's governor and attorney general while they were in college reminds us of a sad chapter in our history--the [...]

A third of patients with colorectal cancer who are eligible for surgery in high-income countries have concomitant anaemia associated with adverse outcomes. We aimed to compare the efficacy of preoperative intravenous and oral iron supplementation in patients with colorectal cancer and iron deficiency anaemia.

Primary care providers (PCPs), including physicians and advanced practice providers, are the front line of medical care. Patient access must balance PCP availability and patient needs. This work develops a new PCP staffing metric using panel size and full-time equivalent data to determine whether a clinic is adequately staffed and describes variation by clinic rurality. Data were from the Veterans Health Administration, 2017-2021. Results describe the gap staffing metric, provide summary graphics, and compare the gap staffing between rural and urban clinics. This novel gap staffing metric can inform strategic clinic staffing in health care systems.

Substantial variability exists in what pathologists consider as pT4a in colorectal cancer when tumor cells are within 1 mm of the free peritoneal surface. This study aimed to determine if the measured sub-millimeter distance between tumor cells and the free peritoneal surface would offer an objective means of stratifying patients according to the risk of developing peritoneal metastases. Histological slides of patients included in the COLOPEC trial, with resectable primary c/pT4N0-2M0 colon cancer, were centrally reassessed. Specific tumor morphological variables were collected, including distance from tumor to free peritoneal surface, measured in micrometers (µm). The primary outcome, 3-year peritoneal metastasis rate, was compared between four groups of patients stratified for relation of tumor cells to the peritoneum: 1) Full peritoneal penetration with tumor cells on the peritoneal surface, 2) 0–99 µm distance to the peritoneum, 3) 100–999 µm to the peritoneum, and 4) ≥1000 µm to the peritoneum, by using Kaplan-Meier analysis. In total, 189 cases were included in the present analysis. Cases with full peritoneal penetration (n= 89), 0–99 µm distance to the peritoneal surface (n= 34), 100–999 µm distance (n= 33), and ≥1000 µm distance (n= 33), showed significantly different 3-year peritoneal metastases rates of 25% vs 29% vs 6% vs 12%, respectively (Log Rank, p= 0.044). N-category did not influence the risk of peritoneal metastases in patients with a tumor distance beyond 100 µm, while only the N2 category seemed to result in an additive risk in patients with a distance of 0–99 µm. The findings of this study suggest that the measured shortest distance between tumor cells and the free peritoneal surface is useful as an objective means of stratifying patients according to the risk of developing peritoneal metastases. This simple measurement is practical and may help in providing a precise definition of pT4a. Trial registration: NCT02231086 (Clinicaltrials.gov).

In the early 1950s, a young Naval officer and his colleagues struggled to interest the Navy in Arctic operations. Their top secret efforts led to the first submarine trips to [...]

* Special Issue--ZGeorge Washington Prize 2017 A special issue of American Heritage offers excerpts from seven books nominated for the prestigious George Washington Prize. We can feel significant satisfaction in [...]

Banana (Musa acuminatacv. ‘Grand Nain’) is prone to chilling injury (CI) during cold storage, which limits extended storage and shelf life. In this study, we investigated the postharvest application of chitosan (CS) and chitosan nanoparticles (CSNPs) on the CI and quality of unpacked banana fruits during and after cold storage. CSNPs were synthesized using sodium tripolyphosphate (STPP), and analyzed using a Fourier infrared spectrophotometer (FT-IR) and a scanning electron microscope (SEM) to assess the changes in the functional groups and surface morphology. Reacting CS with STPP did not result in changes in the functional groups present but the size and morphology of CS were altered. For the treatments, banana fruits were dip coated in 0.5% (wt/vol) CS and 1.5 g/L CSNPs separately for 2 min in the presence of 1% Tween 80. The fruits were stored at 10 ± 2 °C or the optimal storage temperature of 14 ± 2 °C with relative humidity 85–90% for a 20-day period but subsets were transferred from cold storage on 5-day intervals to a storage rack to ripen at 22 ± 2 °C. The CI index, firmness, hue angle (H°), weight loss, total antioxidant activity (TAA) and total phenolic contents (TPC) were measured at each interval. Untreated fruits were used as a control. Application of CS or CSNPs reduced CI and weight loss but increased firmness, hue angle, TAA and TPC relative to the control samples. These results affirm that CS and CSNP applications maintain banana fruit quality by alleviating CI symptoms throughout cold and ripening temperatures.