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The attacks of September 11, 2001, put terrorism at the forefront of the American political landscape. Donald Trump played into these fears of terrorism through his political rhetoric during his presidency, particularly targeting international students as "threats" to the nation. However, we argue that the labeling of international students as security threats was not started after 9/11 nor invented by Trump. Through historical records and accounts across decades of policies related to this issue, we seek to answer two questions: How has the U.S. government monitored visa policies and programs for international students? How have U.S. national policies evolved to view international students as national security threats? We found that mistrust of this population has been embedded throughout U.S. immigration history and that federal tracking policies emerged incrementally from long-held security concerns. The essay closes with a discussion on why the entire population of international students should not be scapegoated due to these fears.

Nonalcoholic fatty liver disease (NAFLD) is a range of pathologies arising from fat accumulation in the liver in the absence of excess alcohol use or other causes of liver disease. Its complications include cirrhosis and liver failure, hepatocellular carcinoma, and eventual death. NAFLD is the most common cause of liver disease globally and is estimated to affect nearly one-third of individuals in the United States. Despite knowledge that the incidence and prevalence of NAFLD are increasing, the pathophysiology of the disease and its progression to cirrhosis remain insufficiently understood. The molecular pathogenesis of NAFLD involves insulin resistance, inflammation, oxidative stress, and endoplasmic reticulum stress. Better insight into these molecular pathways would allow for therapies that target specific stages of NAFLD. Preclinical animal models have aided in defining these mechanisms and have served as platforms for screening and testing of potential therapeutic approaches. In this review, we will discuss the cellular and molecular mechanisms thought to contribute to NAFLD, with a focus on the role of animal models in elucidating these mechanisms and in developing therapies. [ABSTRACT FROM AUTHOR]

Background Female underrepresentation in oncology clinical trials can result in outcome disparities. We evaluated female participant representation in US oncology trials by intervention type, cancer site, and funding. Materials and Methods Data were extracted from the publicly available Aggregate Analysis of ClinicalTrials.gov database. Initially, 270,172 studies were identified. Following the exclusion of trials using Medical Subject Heading terms, manual review, those with incomplete status, non-US location, sex-specific organ cancers, or lacking participant sex data, 1650 trials consisting of 240,776 participants remained. The primary outcome was participation to prevalence ratio (PPR): percent females among trial participants divided by percent females in the disease population per US Surveillance, Epidemiology, and End Results Program data. PPRs of 0.8-1.2 reflect proportional female representation. Results Females represented 46.9% of participants (95% CI, 45.4-48.4); mean PPR for all trials was 0.912. Females were underrepresented in surgical (PPR 0.74) and other invasive (PPR 0.69) oncology trials. Among cancer sites, females were underrepresented in bladder (odds ratio [OR] 0.48, 95% CI 0.26-0.91, P =.02), head/neck (OR 0.44, 95% CI 0.29-0.68, P <.01), stomach (OR 0.40, 95% CI 0.23-0.70, P <.01), and esophageal (OR 0.40 95% CI 0.22-0.74, P <.01) trials. Hematologic (OR 1.78, 95% CI 1.09-1.82, P <.01) and pancreatic (OR 2.18, 95% CI 1.46-3.26, P <.01) trials had higher odds of proportional female representation. Industry-funded trials had greater odds of proportional female representation (OR 1.41, 95% CI 1.09-1.82, P =.01) than US government and academic-funded trials. Conclusions Stakeholders should look to hematologic, pancreatic, and industry-funded cancer trials as exemplars of female participant representation and consider female representation when interpreting trial results. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorders (AUD) are prevalent and often go untreated. Patients are commonly screened for AUD in primary care, but existing treatment programs are failing to meet demand. Digital therapeutics include novel mobile app-based treatment approaches which may be cost-effective treatment options to help fill treatment gaps. The goal of this study was to identify implementation needs and workflow design considerations for integrating digital therapeutics for AUD into primary care. Methods: We conducted qualitative interviews with clinicians, care delivery leaders, and implementation staff (n = 16) in an integrated healthcare delivery system in the United States. All participants had experience implementing digital therapeutics for depression or substance use disorders in primary care. Interviews were designed to gain insights into adaptations needed to optimize existing clinical processes, workflows, and implementation strategies for use with alcohol-focused digital therapeutics. Interviews were recorded and transcribed and then analyzed using a rapid analysis process and affinity diagramming. Results: Qualitative themes were well represented across health system staff roles. Participants were enthusiastic about digital therapeutics for AUD, anticipated high patient demand for such a resource, and made suggestions for successful implementation. Key insights regarding the implementation of digital therapeutics for AUD and unhealthy alcohol use from our data include: (1) implementation strategy selection must be driven by digital therapeutic design and target population characteristics, (2) implementation strategies should seek to minimize burden on clinicians given the large numbers of patients with AUD who are likely to be interested in and eligible for digital therapeutics, and (3) digital therapeutics should be offered alongside many other treatment options to accommodate individual patients' AUD severity and treatment goals. Participants also expressed confidence that previous implementation strategies used with other digital therapeutics such as clinician training, electronic health record supports, health coaching, and practice facilitation would be effective for the implementation of digital therapeutics for AUD. Conclusions: The implementation of digital therapeutics for AUD would benefit from careful consideration of the target population. Optimal integration requires tailoring workflows to meet anticipated patient volume and designing workflow and implementation strategies to meet the unique needs of patients with varying AUD severity. Contributions to the literature: Provides insights regarding the best ways to implement app-based treatments for alcohol use disorder (AUD) in primary care. Represents the perspectives of a variety of stakeholders including care delivery leaders, clinicians, and implementation staff. Identifies the following recommendations to improve the implementation of digital therapeutics for AUD: (1) plan for high patient volume, (2) support teams during implementation, and (3) account for individual patient needs. [ABSTRACT FROM AUTHOR]

After a long decline, the Labor Force Participation Rate (LFPR) of older men in the United States leveled off in the 1980s, and began to increase in the late 1990s. We examine how changes in Social Security rules affected these trends. We attribute only a small portion of the decline from the 1960s-80s to the increasing generosity of Social Security over this period. Increases in the Full Retirement Age and the Delayed Retirement Credit explain one quarter to one half of the recent increase in the LFPR. Increasing educational attainment and increasing LFPR of married women also contributed to the recent rise. (Contains 10 figures, 6 tables, and 36 footnotes.)

Field performance of herbaceous annual plants is largely determined by plant architecture and flowering performance. A Petunia axillaris × P. exserta F7 recombinant inbred line population was grown in four field environments across the United States, and phenotyped for seven plant habit and flowering-related traits: plant height (Height), maximum (MaxWid) and minimum (MinWid) plant width, vigor, compactness (Comp), flowering canopy coverage (Flow) and flower color retention (ColorRet). Robust QTL (rQTL; QTL detected in two or more environments) were identified for all traits except minimum canopy width and were distributed across five of the seven Petunia chromosomes. The largest effect rQTL explained up to 23.8, 19.7, 16.7, 16, 25.7, and 36.9% of the observed phenotypic variation for Flow, Vigor, Comp, ColorRet, Height and MaxWid, respectively. rQTL for Flow, Comp, Height, and MaxWid colocalized on Chr 2, indicating this region could be particularly useful for mining candidate genes underlying important field performance traits in petunia. [ABSTRACT FROM AUTHOR]

South American camelids (SACs) have become increasingly popular as livestock and companion animals in the Midwestern United States. With increased ownership, postmortem evaluations and samples available for diagnostic assessment are being submitted more frequently to veterinary diagnostic laboratories. We searched archived pathology records at the Wisconsin Veterinary Diagnostic Laboratory (WVDL) between 2009–2019 for SAC cases. Postmortem records from 166 alpacas and 27 llamas were included, with an average of 1.42 diagnoses per animal. The overall average diagnostic rate was 79.8%. Abortion and neonatal cases (fetus to 1-wk-old) had the lowest diagnostic rate (33.3%) and was the only group with a diagnostic rate statistically significantly lower than the average. The most common diagnoses were gastrointestinal parasitism and suboptimal nutritional status or inanition; 78% of cases diagnosed with suboptimal nutritional status were also parasitized. The gastrointestinal parasites identified most frequently were Eimeria sp. and strongyles, especially Nematodirus sp. Our findings may aid allocation of diagnostic resources to better serve regional SAC populations and provide a framework for practitioners who send samples to laboratories for analysis. Submission of whole bodies, euthanized animals, fresh tissue, and inclusion of placental tissues in abortion cases are recommended for optimal diagnostic outcome. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies illustrate significant increases in pelvic fracture incidence; however, there is a paucity of information on the incidence of osteoporotic pelvic ring injuries based on large-scale examinations of geographically and ethnically diverse populations. This study addresses the epidemiology of osteoporotic pubic ramus fractures in the United States and details differences in incidence rates with respect to age, gender, and race. Materials and Methods: National Electronic Injury Surveillance System (NEISS) data between 2002 and 2019 was gathered for individuals aged 60 and above presenting to U.S. emergency departments with ramus fractures. Incidence rates for ramus injuries were calculated using adjusted U.S. Census Bureau estimates of population. Fracture incidences were calculated for age, gender, and race strata. Results: The overall incidence rate of pubic ramus fractures in the United States between 2002 and 2019 was 13.47 per 1,000,000 people 60 years and older (95% confidence limit: 9.92-17.01). The incidence of pubic ramus fractures for females in the US was 21.71 (16.08-27.34). Rates of ramus fracture increased overall (P <.001) and for both genders between the ages of 60 and 100, though the rate increase was significantly greater in females than in males (P <.001). In terms of race, incidence was highest Asian females and lowest in Native American and Pacific Islander men. Discussion/Conclusion: : As the first national study addressing the epidemiology of ramus injuries in the United States, this work reveals these injuries comprise a significant fracture risk in the elderly. In addition, it highlights gender and ethnic strata that are more susceptible to these injuries. [ABSTRACT FROM AUTHOR]

Racial discrepancies among patients in the United States undergoing orthopedic trauma surgery have not been investigated. Issues relating to socioeconomic status and access to care have played a role in the health outcomes of racial groups. In orthopedic surgery, recent joint arthroplasty literature has shown significant racial differences in the use of elective joint arthroplasty. Furthermore, studies also suggest increased rates of early complication in racial minority groups. In general, little information exists on the postoperative outcomes of racial minority groups in orthopedic surgery. We retrospectively queried the National Surgical Quality Improvement Program database to identify patients undergoing orthopedic trauma surgery between 2008 and 2016. Patients of all ages who underwent orthopedic trauma surgery were identified using Current Procedural Terminology codes. Patients classified as either Black or White were included in the study. Demographic data, comorbidities, and basic surgical data were compared between the groups. Adverse outcomes in the initial 30 days postoperative were also examined. Higher frequencies of deep wound infection (0.5% vs 0.3%, P=.002) were noted among Black patients, with decreased mortality (0.3% vs 0.6%, P=.004) and postoperative transfusion (2.7% vs 3.8%, P<.001) rates, compared with White patients. Clear differences exist in the demographic, surgical, and outcome data between Black and White patients undergoing orthopedic trauma surgery. More epidemiological studies are required to further investigate racial differences in orthopedic trauma surgery. [Orthopedics. 2022;45(2):71-76.]. [ABSTRACT FROM AUTHOR]

Dog importation data from 2018–2020 were evaluated to ascertain whether the dog importation patterns in the United States changed during the COVID-19 pandemic, specifically with regard to denial of entry. Dog denial of entry reports from January 1, 2018, to December 31, 2020, stored within the Centers for Disease Control and Prevention (CDC) Quarantine Activity Reporting System (QARS), were reviewed. Basic descriptive statistics were used to analyze the data. Reason for denial, country of origin, and month of importation were all examined to determine which countries of origin resulted in the largest number of denials, and whether there was a seasonal change in importations during the COVID-19 pandemic (2020), compared to previous years (2018 and 2019). During 2020, CDC denied entry to 458 dogs. This represents a 52% increase in dogs denied entry compared to the averages in 2018 and 2019. Dogs were primarily denied entry for falsified rabies vaccination certificates (56%). Three countries exported 74% of all dogs denied entry into the United States, suggesting that targeted interventions may be needed for certain countries. Increased attempts to import inadequately vaccinated dogs from countries with canine rabies in 2020 may have been due to the increased demand for domestic pets during the COVID-19 pandemic. Educational messaging should highlight the risk of rabies and the importance of making informed pet purchases from foreign entities to protect pet owners, their families, and the public. [ABSTRACT FROM AUTHOR]

Substantial, involved, and expensive efforts to promote the dissemination of scientific knowledge and career interest in Science, Technology, Engineering, and Mathematics (STEM) are enthusiastically supported by many scientific, federal, and local organizations. The articulated underlying goals for these efforts include an enhanced public understanding of science and science-related policy, an increased diversity in STEM careers, and an increase in the future STEM workforce. This effort is primarily driven by an underperformance of the United States that includes poor test performance and limited number of students pursuing STEM degrees. Despite this investment, attitudes toward STEM have not notably changed. The goal of this project was to determine students' attitudes toward STEM in response to a previously established scientific outreach event. This event was used to address three common goals in STEM outreach: STEM literacy, diversity and inclusion, and career preparedness. We found there was a notable difference in the attitudes toward scientific activities and interest in pursuing a "Science Career" after participation in this event. Strikingly, interest in hypothesis development, the keystone of all STEM disciplines, was the least liked of all the activities offered during the event. Our data suggest that events designed to enhance interest in pursuing a STEM career may benefit from different elements compared with events designed to increase understanding of STEM literacy concepts, such as hypothesis development. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has had a significant impact on the economy, health care, and society as a whole. To prevent the spread of infection, local governments across the United States issued mandatory lockdowns and stay-at-home orders. In the surgical world, elective cases ceased to help "flatten the curve" and prevent the infection from spreading to hospital staff and patients. We explored the effect of the cancellation of these procedures on trainee operative experience at our high-volume, multihospital neurosurgical practice. Methods: Our department cancelled all elective cases starting March 16, 2020, and resumed elective surgical and endovascular procedures on May 11, 2020. We retrospectively reviewed case volumes for 54 days prelockdown and 54 days postlockdown to evaluate the extent of the decrease in surgical volume at our institution. Procedure data were collected and then divided into cranial, spine, functional, peripheral nerve, pediatrics, and endovascular categories. Results: Mean total cases per day in the prelockdown group were 12.26 ± 7.7, whereas in the postlockdown group, this dropped to 7.78 ± 5.5 (P = 0.01). In the spine category, mean cases per day in the prelockdown group were 3.13 ± 2.63; in the postlockdown group, this dropped to 0.96 ± 1.36 (P < 0.001). In the functional category, mean cases per day in the prelockdown group were 1.31 ± 1.51, whereas in the postlockdown group, this dropped to 0.11 ± 0.42 (P < 0.001). For cranial (P = 0.245), peripheral nerve (P = 0.16), pediatrics (P = 0.34), and endovascular (P = 0.48) cases, the volumes dropped but were not statistically significant decreases. Conclusion: The impact of this outbreak on operative training does appear to be significant based solely on statistics. Although the drop in case volumes during this time can be accounted for by the pandemic, it is important to understand that this is a multifactorial effect. Further studies are needed for these results to be generalizable and to fully understand the effect this pandemic has had on trainee operative experience. [ABSTRACT FROM AUTHOR]

Aquatic plants (macrophytes) are important components of freshwater ecosystems and serve numerous functions, both physical and biological, that help to structure aquatic communities. However, invasive macrophytes may negatively alter ecosystem properties. Non-native invasive species have been identified as a major cause of biodiversity loss and the increasing prevalence of invasive species has prompted studies to help understand their impacts and to conserve biodiversity. Studying mechanisms of invasion also gives ecological insight into how communities are structured and assembled. This study examined a set of potential factors influencing invasion including biotic resistance, exposure, and water depth using mixed-effects models on macrophyte survey data collected from twenty-nine lakes across the United States. The results of this study indicated that biotic resistance measured from native species richness, exposure due to fetch, and water depth interact, often in non-linear ways to influence probability of invasive species occurrence at a given location; however, models explained a relatively low percentage of variation in probabilities. It is likely that strong predictive principles governing macrophyte invasions do not exist, at least among comparisons across a range of ecosystem types and environmental conditions. However, ecologists should continue to search for general patterns within definable ecosystem units to increase understanding about factors contributing to invasibility. [ABSTRACT FROM AUTHOR]

Over half of global rivers and streams lack perennial flow, and understanding the distribution and drivers of their flow regimes is critical for understanding their hydrologic, biogeochemical, and ecological functions. We analyzed nonperennial flow regimes using 540 U.S. Geological Survey watersheds across the contiguous United States from 1979 to 2018. Multivariate analyses revealed regional differences in no‐flow fraction, date of first no flow, and duration of the dry‐down period, with further divergence between natural and human‐altered watersheds. Aridity was a primary driver of no‐flow metrics at the continental scale, while unique combinations of climatic, physiographic and anthropogenic drivers emerged at regional scales. Dry‐down duration showed stronger associations with nonclimate drivers compared to no‐flow fraction and timing. Although the sparse distribution of nonperennial gages limits our understanding of such streams, the watersheds examined here suggest the important role of aridity and land cover change in modulating future stream drying. Plain Language Summary: A majority of global streams are nonperennial, flowing only part of the year, and are critical for sustaining flow downstream, providing habitat for many organisms, and regulating chemical and biological processes. Using long‐term U.S. Geological Survey measurements for 540 watersheds across the contiguous United States, we mapped patterns and examined the causes of no‐flow fraction, the fraction of each climate year with no flow, no‐flow timing, the date of the climate year on which the first recorded no flow takes place, and length of the dry‐down period, the average number of days from a local peak in daily flow to the first occurrence of no flow. We found differences in patterns of no‐flow characteristics between regions, with higher no‐flow fraction, earlier timing, and shorter dry‐down duration in the western United States. No‐flow fractions were greater and less variable in natural watersheds, while no‐flow timing was earlier and dry‐down duration was shorter in human‐modified watersheds. Aridity had the greatest effect on intermittence across the United States, but unique combinations of climate, biophysical, and human impacts were important in different regions. The number of gages measuring streamflow in nonperennial streams is small compared to perennial streams, and increased monitoring is needed to better understand drying behavior. Key Points: Three metrics reveal regional and human‐driven patterns of nonperennial flow: no‐flow fraction, day of first no flow, and dry‐down durationStreams with human modifications generally dry more quickly than unmodified streams, especially in California and the Southern Great PlainsClimate strongly influences no‐flow fraction and timing, but physiographic variables are more important for the duration of dry down [ABSTRACT FROM AUTHOR]

Background The economic burden of cancer in the United States is substantial, and better understanding it is essential in informing health care policy and innovation. Leptomeningeal carcinomatosis (LC) represents a late complication of primary cancer spreading to the leptomeninges. Methods The IBM MarketScan Research databases were queried for adults diagnosed with LC from 2001 to 2015, secondary to 4 primary cancers (breast, lung, gastrointestinal, and melanoma). Health care resource utilization (HCRU) and treatment utilization were quantified at baseline (1-year pre-LC diagnosis) and 30, 90, and 365 days post-LC diagnosis. Results We identified 4961 cases of LC (46.3% breast cancer, 34.8% lung cancer, 13.5% gastrointestinal cancer, and 5.4% melanoma). The median age was 57.0 years, with 69.7% female and 31.1% residing in the South. Insurance status included commercial (71.1%), Medicare (19.8%), and Medicaid (9.1%). Median follow-up was 66.0 days (25th percentile: 24.0, 75th percentile: 186.0) and total cumulative costs were highest for the gastrointestinal subgroup ($167 768) and lowest for the lung cancer subgroup ($145 244). There was considerable variation in the 89.6% of patients who used adjunctive treatments at 1 year, including chemotherapy (64.3%), radiotherapy (57.6%), therapeutic lumbar puncture (31.5%), and Ommaya reservoir (14.5%). The main cost drivers at 1 year were chemotherapy ($62 026), radiation therapy ($37 076), and specialty drugs ($29 330). The prevalence of neurologic impairments was 46.9%, including radiculopathy (15.0%), paresthesia (12.3%), seizure episode/convulsive disorder not otherwise specified (11.0%), and ataxia (8.0%). Conclusions LC is a devastating condition with an overall poor prognosis. We present the largest study of LC in this real-world study, including current treatments, with an emphasis on HCRU. There is considerable variation in the treatment of LC and significant health care costs. [ABSTRACT FROM AUTHOR]

The article describes the legal defects inherent in the U.S. Department of Defense's (DoD) law enforcement DNA indexing program. Topics covered include the U.S. government's weak constitutional interest in taking DNA samples from service members, a brief history of DNA profiling and the DNA Identification Act of 1994. It also discusses the factors that set the DoD's program apart from its constitutionally approved civilian forebear.

Background: Sleep and mood are critical factors that contribute to health and wellness and are of particular interest to collegiate athletes who are juggling high physical, academic, and social demands. The aim of this study was to examine how psychological measures, player status, and sex-related factors were associated with perceived sleep quality.Hypothesis: Higher levels of global sleep dysfunction will be related to poor mood and increased anxiety, and there will be differences in sleep dysfunction in male compared with female athletes as well as regarding playing status.Study Design: Prospective cohort study.Level Of Evidence: Level 4.Methods: During the 2016 through 2018 National Collegiate Athletic Association (NCAA) seasons, the Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States, and Sports Anxiety Scale-2 questionnaires were administered to 230 soccer athletes at 6 separate time points throughout each season.Results: PSQI results yielded scores ≥5 in 54% of observations. Increased sleep dysfunction was significantly related to decreased vigor and increased tension, depression, anger, fatigue, somatic anxiety, worry, and concentration disruption, although effect sizes (ES) were trivial (ES, -0.03 to 0.15). The odds ratio (OR) of reporting global sleep dysfunction increased by 8%, 9%, and 25% for every 1-unit increase in tension (OR, 1.08; 95% CI, 1.02-1.16; P = 0.015), fatigue (OR, 1.09; 95% CI, 1.03-1.16; P = 0.002), and concentration disruption (OR, 1.25; 95% CI, 1.09-1.45; P = 0.002), respectively. The odds of reporting global sleep dysfunction were 55% lower for males than females (OR, 0.45; 95% CI, 0.25-0.79; P = 0.006).Conclusion: Global sleep dysfunction was prevalent in NCAA soccer players and was related to negative mental health outcomes. Female participants experienced increased odds of reporting global sleep dysfunction.Clinical Relevance: Regular monitoring allows for a greater understanding of the interrelatedness between sleep and mental health in athletes. [ABSTRACT FROM AUTHOR]

Several US states have expanded Medicaid under the Patient Protection and Affordable Care Act (ACA), extending Medicaid coverage to millions of previously uninsured low-income individuals[2] including those with non-dialysis-dependent kidney disease.[3] The goal of this study was to determine whether Medicaid expansion was associated with changes in Medicaid coverage for pre-emptive living-donor KT (LDKT) and deceased-donor KT (DDKT) in the US. After Medicaid expansion, Medicaid-covered pre-emptive KT recipients from expansion states were more likely to be minorities and to be employed than those from non-expansion states (Table 1). To account for different calendar dates of Medicaid expansion, results are presented as the number of quarters before and after a standardized Medicaid expansion date, where the date of Medicaid expansion is set to equal zero. [Extracted from the article]

The challenges of the 21st century, post-industrial society are increasingly complex. They will not be solved by the actions of individual, "heroic" leaders; instead, they require the participation of diverse stakeholders in order to make progress. Through a discussion of the evolution of leadership theory, we demonstrate that theories emerging from a post-industrial paradigm highlight the collective dimensions of leadership in contrast to the leader-centric theories of the Industrial Era. We draw from this literature to problematize the leader-centric nature of community leadership programs in the United States by specifically examining their sponsorship, content, and structure. Finally, we offer a vision for how to re-imagine community leadership programs so that they are more responsive to the complexity of the 21st century by drawing upon collective leadership and postmodern curriculum theory. [ABSTRACT FROM AUTHOR]

Introduction: Each year, rabies causes approximately 59,000 deaths worldwide, including approximately two deaths in the United States. Before 1960, dogs were a common reservoir of rabies in the United States; however, increasingly, species of wildlife (e.g., bats, raccoons) are the main reservoirs. This report characterizes human rabies deaths, summarizes trends in rabies mortality, and highlights current rabies risks in the United States.Methods: Rabies trends in the United States during 1938-2018 were analyzed using national rabies surveillance data. Data from the Healthcare Cost and Utilization Project for 2006-2014 were used to estimate the number of postexposure prophylaxis (PEP) visits per 100,000 persons during 2017-2018. The Centers for Medicare & Medicaid Services' average sales price data were used to estimate PEP costs.Results: From 1960 to 2018, a total of 125 human rabies cases were reported in the United States; 36 (28%) were attributed to dog bites during international travel. Among the 89 infections acquired in the United States, 62 (70%) were attributed to bats. In 2018, approximately 55,000 persons sought PEP after contact with a potentially rabid animal.Conclusions and Comments: In the United States, wildlife rabies, especially in bats, continues to pose a risk to humans. Travelers also might be exposed to canine rabies in countries where the disease is still present; increased awareness of rabies while traveling abroad is needed. Vaccinating pets, avoiding contact with wildlife, and seeking medical care if one is bitten or scratched by an animal are the most effective ways to prevent rabies. Understanding the need for timely administration of PEP to prevent death is critical. [ABSTRACT FROM AUTHOR]

The article discusses the author's claim that the U.S. Supreme Court should repudiate the nation's constitutional avoidance and severability statutory interpretation legal doctrines, and it mentions the case Erie Railroad Co. v. Tompkins which deals with U.S. common law and legal positivism. The U.S. Patient Protection and Affordable Care Act cases National Federation of Independent Business v. Sebelius and King v. Burwell are assessed, along with a textualism legal interpretation doctrine.

Donald J. Trump is the forty-fifth President of the United States. The election of President Trump has ushered in a "renaissance" era of Islamophobia. People around the world-but most notably in America- publically cast a pervasive hatred towards Islam because of Trump's hardline rhetoric. Islamophobia began to take shape as a form of bigotry post-9/11 and is now being considerably driven by the discursive language of Trump. The heightened level offear of Muslim Americans, brought forth by both federal and state policy, has been a buttress for the racist stereotypes of Islam that are rife in today's society. Forcing the normalcy of this behavior endorses and emboldens the amplified development of formal governmental policy that characterizes Islam as an "extremist ideology." This Article examines President Trump's deployment of brash Islamophobic rhetoric as a political means of justifying the so-called "Muslim ban" by dressing up the potent animus in legal and political pretext. But, Trump's anti-Islamic temperament stemming beneath the surface is patently detectable. This Article further scrutinizes the ‘Trump v. Hawaii decision that gave the Trump administration its first big win, This Article also argues that, should the Supreme Court analyze this case under the First Amendment's Establishment Clause, instead of presidential authority, the Court will most likely rule that the Muslim ban is unconstitutional. As such, this Article pits President Trump's "Muslim ban" against the three principle tests of the First Amendment's Establishment Clause: the Lemon, Endorsement, and Coercion tests. Through Trump's policy proposals and executive actions, Muslim Americans are now subjected to a deepened and intensified level of animus and suspicion. The Islamophobic tropes that surged to the fore of the 2016 presidential campaign are deeply rooted in conventional American procedures and geopolitical policies. By analyzing the theoretical and abstract structure of Trump's widely dubbed "Muslim ban," this Article constructs an analytical foundation to scrutinize the ban under the Constitution's Establishment Clause and the rising contentions concerning Muslim Americans during the Trump Administration. [ABSTRACT FROM AUTHOR]

Gammaherpesviruses (GHVs) are host specific DNA viruses that infect a large range of mammalian species. These viruses preferentially target host lymphocyte cell populations and infection may lead to morbidity or mortality in immunocompromised, co-infected, or non-adapted hosts. In this study, we tested for the presence of Lynx rufus gammaherpesvirus 1 (LruGHV1) in a northeastern United States population of wild bobcats (L. rufus). We estimated prevalence of infection and viral load in infected individuals using quantitative real-time PCR analysis of spleen DNA from 64 Vermont bobcats.We observed an overall prevalence of 64% using this methodology. Bobcat age was significantly positively associated with GHV infection status, and we noted a trend for higher viral loads in young animals, but prevalence and viral load were similar in male and female bobcats. A single LruGHV1 variant was identified from the sequencing of the viral glycoprotein B gene of Vermont bobcats. This gene sequence was 100% similar to that reported in Florida bobcats and slightly variant from other isolates identified in the Western USA. Our work suggests broad geographic distribution and high prevalence of LruGHV1 in bobcat populations across the United States with infection attributes that suggest horizontal transmission of the agent. Geographic differences in viral genotype may reflect historical migration and expansion events among bobcat populations. [ABSTRACT FROM AUTHOR]

The article discusses the changing face of the news media in the digital age and the resulting financial pressure on traditional media organizations, particularly local news organizations. Topics discussed include common law defamation system that governs the liability system for defendants in this area; constitutional protections in place for entities commenting on business services; and history of Better Business Bureau (BBB) organizations in their consumer-protection function.

The article discusses the role of equality and the rule of law to the collapse of egalitarianism. It cites that the U.S. is the only nation to be founded on the principle of human equality. The article also discusses on the explicit or implicit framework for every revolution including antislavery, women's rights, and civil rights movements in the U.S.

The article focuses on providing legal protections to entities providing information on business products and services in the U.S. Topics discussed include news media in the digital age; laws governing defamation system in the country; and history of Better Business Bureau organizations and for-profit companies. It also discusess Snyder v. Phelps court case on the same.

Established doctrine holds that customary international law ("GIL") arises from general and consistent state practice that is backed by a sense of legal obligation. Contemporary litigation requires federal courts to apply this doctrine to identify the contours of CIL in a diverse collection of cases ranging from civil actions under the Alien Tort Statute to criminal prosecutions under the Maritime Drug Law Enforcement Act. This Article provides an in-depth look at how federal judges carry out this task. Conducting a citation analysis of opinions published since the U.S. Supreme Court's 2004 decision in Sosa v. Alvarez-Machain, this Article analyzes the form, quality, and geographical origins of the authorities that tend to serve as evidence of custom; explores the implications of recent citation patterns; and offers ideas to help courts grapple more effectively with the challenge of finding custom. [ABSTRACT FROM AUTHOR]

Recent growth in the renewable energy industry has increased government support for alternative energy. In the United States, hydropower is the largest source of renewable energy and also one of the most efficient. Currently, there are 30,000 megawatts of potential energy capacity through small- and micro-hydro projects throughout the United States. Increased development of micro-hydro could double America's hydropower energy generation, but micro-hydro is not being developed at the same rate as other renewable sources. Micro-hydro is regulated by the Federal Energy Regulatory Commission and subject to the same regulation as large hydroelectric projects despite its minimal environmental impact. We studied two cases of micro-hydro projects in Logan, Utah, and Afton, Wyoming, which are both small rural communities. Both cases showed that the web of federal regulation is likely discouraging the development of micro-hydro in the United States by increasing the costs in time and funds for developers. Federal environmental regulation like the National Environmental Policy Act, the Endangered Species Act, and others are likely discouraging the development of clean renewable energy through micro-hydro technology. [ABSTRACT FROM AUTHOR]

Canine rabies virus variant has been eliminated in the United States and multiple other countries. Globally, however, dogs remain the principal source for human rabies infections. The World Health Organization recommends that when dogs cross international borders, national importing authorities should require an international veterinary certificate attesting that the animal did not show signs of rabies at the time of shipment, was permanently identified, vaccinated, or revaccinated, and had been subjected to a serologic test for rabies before shipment. On June 8, 2015, an adult female dog that had recently been picked up from the streets of Cairo, Egypt, and shipped by a U.S. animal rescue organization to the United States was confirmed to have rabies by the Virginia Department of General Services Division of Consolidated Laboratory Services (DCLS). This dog was part of a large shipment of dogs and cats from Egypt that rescue organizations had distributed to multiple states for adoption. During the investigation, public health officials learned that the rabies vaccination certificate used for entry of the rabid dog into the United States had intentionally been falsified to avoid exclusion of the dog from entry under CDC's current dog importation regulations. This report underscores the ongoing risk posed by U.S. importation of domestic animals that have not been adequately vaccinated against rabies. [ABSTRACT FROM AUTHOR]

Objective: Selective serotonin reuptake inhibitors (SSRIs) are the first line of treatment for depression. Among the SSRIs, paroxetine has strong anticholinergic properties and may lead to increased risk of adverse cognitive outcomes among elderly patients. This study evaluated the comparative risk of dementia associated with use of paroxetine and other SSRIs among elderly nursing home patients.Methods: A retrospective cohort study using propensity score matching was conducted with 2007-2010 Minimum Data Set-linked Medicare data. The study population included elderly nursing home patients with depression who were new users of SSRIs. Patients were followed for a maximum of two years after index SSRI use. The risk of dementia was modeled by using a robust Cox proportional hazards model to account for clustering within matched users of paroxetine and other SSRIs.Results: The unmatched cohort included 19,952 new users of SSRIs; 1,898 used paroxetine, and 18,054 used other SSRIs. In the propensity-matched cohort of 3,796 patients, the unadjusted incidence of dementia was 7.5% for users of paroxetine and 8.6% for users of other SSRIs. There was no difference in the risk of dementia for users of paroxetine or other SSRIs. These study findings remained robust in multiple sensitivity analyses involving various measures of dementia.Conclusions: Compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression. Future studies are needed to evaluate the impact of paroxetine on other cognition measures. [ABSTRACT FROM AUTHOR]

Several empirical studies have estimated a negative relationship between the share of an area's elderly population and per-pupil education spending. These findings have often been interpreted as evidence that an aging population has hindered the growth in per-pupil expenditures. We offer a reinterpretation of these oft-cited estimates and demonstrate that the population has aged in a way not reflected in these earlier studies’ empirical designs. After fully accounting for actual U.S. population trends, we demonstrate that a rise in the elderly share of the population has resulted in a rise in per-pupil education spending, not a decline. [ABSTRACT FROM AUTHOR]

The article discusses the legal aspects of emergency contraceptives and "abortion-inducing" drugs in America as of 2014, focusing on the apparent efforts to empower women to make informed decisions about issues such as abortion, pregnancy, and abortifacients. Employer-mandated health insurance coverage for certain contraceptive drugs and devices is addressed in relation to the U.S. Patient Protection and Affordable Care Act. U.S. abortion laws and drug-related religious objections are examined.

A traditional view in legal scholarship holds that the U.S. Constitution assigns the president exclusive power to carry on official diplomatic communications with foreign governments. But in fact, Congress and its members routinely engage in communications of their own. Congress, for example, receives heads of state and maintains official contacts with foreign parliaments. And individual members of the House and Senate frequently travel overseas on congressional delegations ("CODELs") to confer with foreign leaders, investigate problems that arise, promote the interests of the United States and constituents, and even represent the president. Moreover, many of these activities have occurred ever since the Founding. Together, they comprise an understudied field of legislative diplomacy. This Article has two purposes: The first is to use State Department cables from WikiLeaks, a recent compilation of public reports, and original historical sources to provide a uniquely detailed, descriptive account of legislative diplomacy. The second is to develop theories about the practice's constitutionality. Text, original meaning, and customary practice suggest that the separation of diplomacy powers is more complicated than commonly assumed and that those powers do not belong exclusively to the president. The analysis undermines the "sole organ" metaphor, serves as a counterpoint to the widely held view that authority over foreign affairs belongs overwhelmingly to the executive, and carries practical implications for the execution of U.S. foreign relations. [ABSTRACT FROM AUTHOR]

The article discusses a study that evaluates the success of the Effective Practices in Community Supervision model in targeting and changing antisocial attitudes in the U.S. Study participants came from one of four regional parole departments in one large Midwestern state. Data was gathered by University of Cincinnati Corrections Institute staff. A table is shown that outlines demographic attributes of participants by officer training status.

The broad diversity in physicians’ judgments on controversial health care topics may reflect differences in religious characteristics, political ideologies, and moral intuitions. We tested an existing measure of moral intuitions in a new population (U.S. physicians) to assess its validity and to determine whether physicians’ moral intuitions correlate with their views on controversial health care topics as well as other known predictors of these intuitions such as political affiliation and religiosity. In 2009, we mailed an 8-page questionnaire to a random sample of 2000 practicing U.S. physicians from all specialties. The survey included the Moral Foundations Questionnaire (MFQ30), along with questions on physicians’ judgments about controversial health care topics including abortion and euthanasia (no moral objection, some moral objection, strong moral objection). A total of 1032 of 1895 (54%) physicians responded. Physicians’ overall mean moral foundations scores were 3.5 for harm, 3.3 for fairness, 2.8 for loyalty, 3.2 for authority, and 2.7 for sanctity on a 0–5 scale. Increasing levels of religious service attendance, having a more conservative political ideology, and higher sanctity scores remained the greatest positive predictors of respondents objecting to abortion (β = 0.12, 0.23, 0.14, respectively, each p<0.001) as well as euthanasia (β = 0.08, 0.17, and 0.17, respectively, each p<0.001), even after adjusting for demographics. Higher authority scores were also significantly negatively associated with objection to abortion (β = −0.12, p<0.01), but not euthanasia. These data suggest that the relative importance physicians place on the different categories of moral intuitions may predict differences in physicians’ judgments about morally controversial topics and may interrelate with ideology and religiosity. Further examination of the diversity in physicians’ moral intuitions may prove illustrative in describing and addressing moral differences that arise in medical practice. [ABSTRACT FROM AUTHOR]

The article discusses alcoholism among soldiers at Fort Hays in Kansas in the mid-to-late nineteenth century. It comments for reasons for alcoholism, including boredom and loneliness. The author considers ways in which soldiers obtained alcohol, including on base and at saloons. He reflects on consequences of drunkenness, including absence, desertion, and violence, and examines punishments, including court-martial, solitary confinement, and forced labor. Alcoholism among regimental band members is also addressed.

Based on prior research on political business cycles, we investigate the manipulation of state budgets in battleground states. The state-based winner-take-all Electoral College system in the United States makes certain states extremely politicized during presidential elections. We hypothesize that budgets will target specific groups of swing voters in these battleground states. We test the impact of competitive state status in presidential elections on state budgets from 1982 to 2005 by creating a cross-sectional time-series regression model of state budget priorities from Jacoby and Schneider. While controlling for known determinants of budgets, we find strong support for our hypothesis. [ABSTRACT FROM PUBLISHER]

Background: Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density [BMD] have not previously been investigated. Methods: This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (⩾2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI. Results: Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval [CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake. Conclusion: These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use. [ABSTRACT FROM AUTHOR]

In the sports industry, collusion has typically manifested itself on the team owner side of the equation, with numerous historical examples of management collectively moving to suppress player movement and/or salaries for pecuniary reasons. Such collusion is now prohibited in the league-union collective bargaining agreements ("CBAs") that govern all prominent North American team sports. However, the language in sports league CBAs is not always reciprocal. CBAs in the National Basketball Association ("NBA") and National Football League do not expressly prohibit player-level "reverse collusion." Using the recent decision (pun intended) of LeBron James and other basketball stars to create "super-teams" in the NBA through collective action as an anecdotal example, we posit that the omission of reciprocal language in such CBAs has created loopholes that should be closed for competitive balance reasons and general considerations such as sports league integrity and transparency. [ABSTRACT FROM AUTHOR]

The article presents case reports of rabies acquired in the U.S. but with symptoms onset, medical management and diagnosis abroad. One incident involves a U.S. resident who was admitted to a hospital in Dubai, United Arab Emirates who acquired rabies from contact with a bat in California. Fluorescent antibody testing of brain tissue confirmed a rabies diagnosis. Another incident involves a U.S. resident who died in Switzerland from rabies.

Abstract: Context: Debates persist about the relevance of “dignity” as an ethical concept in U.S. health care, especially in end-of-life care. Objectives: To describe the attitudes and beliefs regarding the usefulness and meaning of the concept of dignity and to examine judgments about a clinical scenario in which dignity might be relevant. Methods: Two thousand practicing U.S. physicians, from all specialties, were mailed a survey. Main measures included physicians'' judgments about an end-of-life clinical scenario (criterion variable), attitudes about the concept of dignity (predictors), and their religious characteristics (predictors). Results: Responses were received from 1032 eligible physicians (54%). Nine (90%) of 10 physicians reported that dignity was relevant to their practice. After controlling for age, gender, region, and specialty, physicians who judged that the case patient had either some dignity or full dignity, and who agreed that dignity is given by a creator, were all positively associated with believing that the patient''s life was worth living (odds ratio [OR] 10.2, 95% confidence interval [CI] 5.8–17.8, OR 20.5, 95% CI 11.4–36.8, OR 4.7, 95% CI 3.1–7.0, respectively). Respondents who strongly agreed that “all living humans have the same amount of dignity” were also more likely to believe that the patient''s life was worth living (OR 1.8, 95% CI 1.2–2.7). Religious characteristics also were associated with believing that the case patient''s life was worth living (OR 4.1, 95% CI 2.4–7.2, OR 3.2, 95% CI 1.6–6.3, OR 9.2, 95% CI 4.3–19.5, respectively). Conclusion: U.S. physicians view the concept of dignity as useful. Those views are associated with their judgments about common end-of-life scenarios in which dignity concepts may be relevant. [Copyright &y& Elsevier]

Osteoarthritis is a common indication for hip and knee arthroplasty. An accurate assessment of current trends in healthcare utilization as they relate to arthroplasty may predict the needs of a growing elderly population in the United States. First, incidence data was queried from the United States Nationwide Inpatient Sample from 1993 to 2009. Patients undergoing total knee and hip arthroplasty were identified. Then, the United States Census Bureau was queried for population data fromthe same study period as well as to provide future projections. Arthroplasty followed linear regression models with the population group >64 years in both hip and knee groups. Projections for procedure incidence in the year 2050 based on these models were calculated to be 1,859,553 cases (hip) and 4,174,554 cases (knee). The need for hip and knee arthroplasty is expected to grow significantly in the upcoming years, given population growth predictions. [ABSTRACT FROM AUTHOR]

Avanafil is a medication that was recently approved by the US Food and Drug Administration for the management of erectile dysfunction. Avanafil is a new phosphodiesterase type 5 inhibitor similar to sildenafil and tadalafil. Avanafil was studied in over 1300 patients during clinical trials, including patients with diabetes mellitus and those who had undergone radical prostatectomy, and was found to be more effective than placebo in all men who were randomized to the drug. The medication was studied with on-demand dosing that may occur after food and/or alcohol. Avanafil is dosed as 50 mg, 100 mg, or 200 mg tablets. Avanafil may differentiate itself from the other phosphodiesterase type 5 inhibitors with its quicker onset and higher specificity for phosphodiesterase type 5 versus other phosphodiesterase subtypes, but may lead to complications of therapy. [ABSTRACT FROM AUTHOR]

Objectives. We sought to develop a detailed description of the variety of jail release patterns and to learn what factors affect the length of stay (LOS). Methods. The main data set for the study came from a biennial Bureau of Justice Statistics survey on felony defendants in large urban counties. Results. The median LOS for the felony defendants was 7 days. One quarter of the jails had a median LOS of less than 2 days; median LOS for 75% of the jails was less than 15 days. Median regression showed that male gender, previous arrests, and violent charges were predictive of longer LOS. Conclusions. The diversity in release patterns among jails has not been previously described. A public health intervention feasible in one jail may not be feasible in another because of the heterogeneity of release patterns. Individual inmate characteristics could predict a slower rate of release. [ABSTRACT FROM AUTHOR]

The article discusses the petition stage of cases involving abused and neglected children in the U.S. It refers to the petition clause of the First Amendment which reveals the fundamental right of children to petition courts to access court proceedings while protecting them being subject to the executive branch's voluntary dismissal. Also explored are the doctrine of parens patriae and Supreme Court jurisprudence related to the protection of the child's interests.

The article discusses the effectiveness of the judicial-disqualification proposals to prevent unbiased judicial ruling in the U.S. It says that most Americans believed that a judge should be disqualified from hearing a trial that involves a party who had contributed to his or her judicial election campaign. The author relays that this attitude is reflected on the growing concern about the assumption that money is manipulating the judicial system of the country.