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This article argues that while reliant on Latinx stereotypes in character construction, Breaking Bad (2008–2013) ultimately uses them to problematise American racial categories and conquest mythology. Comparing stereotyped Latinx criminals to the main white character, Walter White (Bryan Cranston), who claims difference, reveals that they share traits. In its use of Latinx stereotypes to transfer focus from difference to sameness, Breaking Bad shifts the imperial gaze to offer a critical view of the regeneration through violence myth, so integral to American western expansionism and central in Walt’s story, in that he dies in his attempt to regenerate by killing his Latinx enemies.

Breaking Bad's creator and producer, Vince Gilligan, depicts how the past shapes the present in ways to which the show's characters often seem blind, specifically regarding interracial violence, wh...

For decarbonization of the building sector to happen at scale, net-zero energy levels of operational efficiency must be achieved. A global consensus is emerging around the Passive House energy performance level (15 kWh/m2/a thermal energy demand) as “net-zero energy ready”. Given the imperative to rapidly transform buildings and shortcomings of the traditional prescriptive approach, a growing number of building energy regulations are adopting the performance-based or outcome-based approach, seeking to mandate net-zero energy performance with ambitious timelines. Some such regulations are based on the Reference Building Approach (RBA) where the energy performance of a building is assessed based on a hypothetical building of the same design but meeting a set of minimum prescriptive requirements. More commonly, performance targets are defined in absolute terms, based on energy intensity metrics. Although the European version of the RBA reconciles the absolute and relative performance targets through mandatory statistical performance baselines, the RBA in North America is used as an independent alternative to absolute energy use/demand intensity metrics (kWh/m2/a). This paper examines the North American Reference Building Approach, focussing on its implementation in the British Columbia Energy Step Code as an instructive example. It is shown that the RBA has serious flaws. Most importantly, by creating a sliding scale, the RBA does not deliver net-zero energy performance, while incentivizing inefficient designs and poor energy modeling practices. Despite the regional focus of the data, conclusions are applicable to the RBA in general. Based on the results, it is recommended that the use of the RBA in building energy codes and standards be discontinued.

Scholars place the penny press among the most important developments in U.S. journalism. Although few of its publishers had long-term financial success, the style of journalism they practiced had a...

It was the crime of the century. On a cold, wet night in March of 1932 Charles and Anne Lindbergh, staying at their estate in Hopewell, New Jersey, discovered their ill son, Charles Lindbergh Jr., missing from his crib-kidnapped. A note left on the radiator underneath an open window in the second-floor bedroom instructed them to await contact regarding ransom. The distraught parents quickly called the police. Upon searching the grounds investigators found a homemade ladder with a broken rung stashed in the woods but few other clues. A nationwide manhunt began, and the American public anxiously followed the investigation in the press.1For more than two months Charles Lindbergh and the police chased leads, remaining optimistic the child was alive. Then, on May 12, 1932, two truck drivers chanced upon the decomposing body of a toddler in a shallow grave beside a road in Mount Rose, New Jersey, near the Lindberghs' home. Charles and his son's Jr. nurse, The Betty autopsy Gow, revealed identified the the boy body had as that died of from Charles head Lindbergh trauma, likely incurred the night of the kidnapping, possibly because the broken ladder rung caused the kidnapper to drop the child while exiting the nursery window. People around the globe sent their condolences for the loss suffered by the hero they called "Lindy" and his wife.2From the start the Lindbergh kidnapping was a media spectacle. As the nation's most famous couple, Charles and Anne already received overwhelming attention from the press. Generally the press portrayed them positively, and in the initial kidnapping reports papers described the Lindberghs in sympathetic terms, as a family torn apart by the scourge of kidnapping that plagued the nation as a result of organized crime's seemingly unchecked power. Then, after the third day, with the Lindberghs under close scrutiny because of the investigation's unprecedented coverage due to their celebrity and the intense debate over how to address the nation's kidnapping problem, politicians, law enforcement officials, public figures, and the papers began publicly critiquing some of the Lindberghs' actions before, during, and after the night of the kidnapping. Was it right for them to pay the ransom, offer not to press charges if the kidnappers returned their son, or hire gangsters to assist with the search? Had Anne been an inattentive mother the night her son was kidnapped? Had Charles put his son in danger by moving his family to a secluded house with inadequate security? As participants in this critique of the Lindberghs, the papers served as a forum for assessing whether they should be deemed good parents, and the ensuing debate exposed gender and class tensions resulting from recent social and economic changes that threatened to undermine the parenting standards embraced by the era's dominant culture. The Lindberghs' critics and defenders hashed out what it meant to be a good family protector and what it took to be an attentive caretaker of one's children. The Lindberghs were doing everything they could to rescue their child, but some wondered if the ways in which they were using their wealth and influence to do so would make combatting crime more difficult. And while the Lindberghs seemed to be devoted parents, some questioned whether they had inadequately supervised their son, perceived as a common problem in both poor and wealthy families. Ultimately the controversy was short lived. Developments in the case and new information altered perceptions of some of the Lindberghs' actions or drew attention away from questions raised about them as parents. Yet this discourse about the Lindberghs was important, because in publicizing the various opinions about their actions the papers reinforced society's high expectations for fathers and mothers and conveyed the message that the consequences for not parenting properly could be dire. At the same time, the papers demonstrated that even the nation's most beloved parents could not escape the scrutiny brought on by this high-profile kidnapping unscathed. …

Moses Yale Beach, publisher of the New York Sun, and James Gordon Bennett, publisher of the New York Herald, promoted the Mexican-American War through illustrations that linked conquest with the fulfillment of certain masculine ideals. Both were expansionists who wanted the United States to take Mexican land as spoils of war. But they differed in opinion on how much territory the United States should claim. Beach believed it best to take only the sparsely populated northern portion, whereas Bennett advocated conquering Mexico in its entirety. Consequently, there are important differences in the types of illustrations they published with their war reports that reflect their positions on land acquisition and its connection to the fulfillment of masculine ideals.

The authors present a case of bilateral femoral emphysematous osteomyelitis caused by Escherichia coli in a 60-year-old woman with rheumatoid arthritis who was receiving long-term prednisone therapy. The infection in both femoral shafts was eradicated with surgical debridement, followed by insertion of intramedullary rods composed of culture-specific antibiotic cement into the femoral canals in conjunction with 6 weeks of intravenous antibiotics. The rods were subsequently removed, and no signs of further osteomyelitis were recognized at follow-up. To the authors' knowledge, this is the first case of its kind reported in the orthopedic literature. Emphysematous osteomyelitis, a rare and dangerous entity, can be successfully managed by intramedullary antibiotic delivery in the subacute setting. [ Orthopedics . 2019; 42(1):e128–e130.]

Orthopaedics contributes a significant benefit to the Missouri economy. Economic modeling and data quantified the direct and indirect impact within Missouri. Multipliers were applied to direct expenditures to calculate the indirect impact attributable to initial spending. Nearly $1.8 billion can be attributed to the output of orthopaedic related services. The related physical therapy industry increases this figure to nearly $2.3 billion. It is clear that orthopaedics benefits Missouri with both medical services and economic growth.

Since the Institute of Medicine’s release of the report To Err is Human in 1999, which estimated that up to 98,000 individuals die of preventable medical errors per year in the United States,1 it has been clear that medical education must be reenvisioned. In response, the Accreditation Council for Graduate Medical Education (ACGME) introduced 6 domains of clinical competency for all residency programs, worked to limit resident work hours, and has most recently introduced the Next GME Accreditation System.2

On May 13, 1846, the United States declared war on Mexico over the building border dispute along the Rio Grande after the United States' annexation of Texas and rebuffed attempts by the U.S. government to purchase territory from Mexico. The war lasted nearly two years and divided the nation as supporters and opponents argued its merits. One issue debated in Congress was how much territory the United States should take from Mexico as spoils of war. Some Democrats thought the United States should acquire all of Mexico. Other Democrats believed it best to take only the country's sparsely populated northern portion, desiring to limit the number of Mexicans brought into the U.S. through conquest. Whigs generally opposed the war altogether, wanting neither Mexicans nor more territory, which they feared would be open to slavery, thus shifting the balance of power in Congress to the slave states.' In the end, the United States acquired 500,000 square miles, including California, the Great Basin region, and New Mexico.'Newspaper publishers weighed in on this debate about land acquisition over the course of the war in editorials and also in the manner in which they covered the war. This study compares and analyzes how two newspaper publishers, Moses Yale Beach and James Gordon Bennett Sr., expressed their political views through their war coverage. Beach, publisher of the New York Sun, through most of the war expressed the opinion as a moderate northern Democrat that the United States should take only the territory of northern Mexico. He wanted to see the United States extend its territorial control to California but did not favor incorporating a large Mexican population into the U.S. or acquiring a significant amount of territory that would be open to slavery. Late in the war, he became receptive to the United States acquiring more land, although he still had strong reservations about bringing Mexicans within the nation's borders. ' Bennett, publisher of the rival New York Herald and a fellow Democrat, though one supporting the southern faction of the party, favored taking all of Mexico and creating slave states from the conquered territory. Like Beach, he reconsidered his views on land acquisition late in the war because he, too, had reservations about adding a significant number of Mexicans to the U.S. population; however, he quickly changed back to his original position.4While both publishers did waver on the question of how much Mexican land to take, generally they maintained differing opinions on the matter that influenced their war coverage. One way in which this influence is apparent is through their portrayal of Mexicans in illustrations they published in their papers. Both used racial stereotypes that highlighted either the Native American, African, or European ancestry of the Mexican people, choosing which component to emphasize in different illustrations in order to make specific points about Mexico and Mexicans. They both imposed stereotypes about Native Americans, Africans, and Europeans on Mexicans to depict Mexicans as an inferior race. Bennett used this perceived inferiority to make the case that Mexico was an easy target from which the United States could, and should, acquire land. Beach insinuated through his illustrations' nuances that the United States would be better off limiting its territorial ambitions to bring as few Mexicans within its borders as possible. Beach also published a much higher proportion of images containing Mexicans than Bennett, possibly because both recognized that such illustrations had the potential to discourage support for land acquisition by reminding Americans that land taken from Mexico would come with Mexicans, and thus published a greater or lesser number based on what they felt best served their specific political agenda.5 Because publishing illustrations was very expensive, requiring labor-intensive woodcuts, few newspapers in the United States at this time did so. As the proprietors of two of the widest-circulating papers in the largest market in the nation, Beach and Bennett had the financial resources to publish more illustrations than other papers. …

Background: Integral to an orthopaedic surgeon-patient informed consent discussion is the assessment of patient comprehension of their medical care. However, little is known about how to optimize patient comprehension of an informed consent discussion. The purpose of our study was to evaluate three time-controlled informed consent discussion methods to determine which optimized patient comprehension immediately after the discussion. Methods: Sixty-seven consecutive patients with knee osteoarthritis who were considered medically appropriate for a knee corticosteroid injection were enrolled in our trial. Participants were randomized and were allocated into one of three groups in a parallel fashion and 1:1:1 ratio. Our three groups varied by sensory input and included verbal (hearing), verbal and video (hearing and sight), and verbal and model (hearing, sight, and touch). Each participant listened to a 10-minute scripted lecture given by a researcher; this lecture was based on content from the American Academy of Orthopaedic Surgeons patient education web site OrthoInfo. Patient comprehension was assessed after the lecture using a validated questionnaire called the Nkem test. Our primary outcome evaluated patient comprehension utilizing a pairwise comparison of mean comprehension scores between the groups. The primary outcome was analyzed using a one-way analysis of variance with the least significant difference calculated post hoc and a 95% confidence interval (95% CI). The health-care staff, study participants, and outcome assessor were each blinded to group assignments. Results: The mean comprehension scores were 84% (95% CI, 79% to 88%) for the verbal and model group, 74% (95% CI, 63% to 80%) for the verbal and video group, and 71% (95% CI, 61% to 80%) for the verbal group. The omnibus analysis of variance was significant and showed a difference among the groups (p = 0.019). The pairwise comparison of the groups using the least significant difference calculated post hoc showed that the verbal and model group outperformed the verbal group (p = 0.01) and the verbal and video group (p = 0.023). Conclusions: Multisensory patient education incorporating OrthoInfo and an anatomic model optimized patient comprehension immediately after a time-controlled informed consent discussion. This finding could play an important role in improving surgeon-patient communication in the field of orthopaedic surgery.

In 1887 William Randolph Hearst took over the San Francisco Examiner and made it a New Journalism paper, imitating the techniques of earlier New Journalism publishers in major British and US cities. Because of the competition they faced from Hearst, the other publishers of daily newspapers in San Francisco—Michael de Young and Claus Spreckles—implemented New Journalism techniques in their papers. By the end of the century, San Francisco had become the first US city of its size in which all of the daily newspapers practiced New Journalism. At that time, eight other US cities had populations similar in size to that of San Francisco, and in all of them there were at least two differing journalistic styles practiced by the daily newspapers. However, through the early decades of the twentieth century, four of those cities joined San Francisco in having all of their daily newspapers practice New Journalism.

To examine the relationship of choroidal thickness with axial length (AL) and myopia in young adult eyes in the ethnically diverse Correction of Myopia Evaluation Trial (COMET) cohort.Cross-sectional, multicenter study.In addition to measures of myopia by cycloplegic autorefraction and AL by A-scan ultrasonography, participants underwent optical coherence tomography imaging of the choroid in both eyes at their last visit (14 years after baseline). Using digital calipers, 2 independent readers measured choroidal thickness in the right eye (left eye if poor quality; n = 37) at 7 locations: fovea and 750, 1500, and 2250 μm nasal (N) and temporal (T) to the fovea.Choroidal thickness measurements were available from 294 of 346 (85%) imaged participants (mean age: 24.3 ± 1.4 years; 44.9% male) with mean myopia of -5.3 ± 2.0 diopters and mean AL of 25.5 ± 1.0 mm. Overall, choroidal thickness varied by location (P.0001) and was thickest at the fovea (273.8 ± 70.9 μm) and thinnest nasally (N2250, 191.5 ± 69.3 μm). Multivariable analyses showed significantly thinner choroids in eyes with more myopia and longer AL at all locations except T2250 (P ≤ .001) and presence of peripapillary crescent at all locations except T1500 and T2250 (P ≤ .0001). Choroidal thickness varied by ethnicity at N2250 (P.0001), with Asians having the thinnest and African Americans the thickest choroids.Choroids are thinner in longer, more myopic young adult eyes. The thinning was most prominent nasally and in eyes with a crescent. In the furthest nasal location, ethnicity was associated with choroidal thickness. The findings suggest that choroidal thickness should be evaluated, especially in the nasal regions where myopic degenerations are most commonly seen clinically.

Objective: Kendo is a Japanese martial art analogous to fencing, which is becoming increasingly popular worldwide. The large number of participants creates a need to assess injury patterns to better train them. The purpose of this study is to describe current injury rates in kendo and compare these rates to other martial arts. Methods: This retrospective study used an online questionnaire sent to 500 active members of the All United States Kendo Federation and World Kendo Federation. The questionnaire, based on the NCAA Injury Surveillance System, contains questions regarding location and type of injuries sustained during competition and practice, time lost to training, and competitor demographics. Statistical analyses between competitor demographics and injury rates are provided. Injury rates are expressed as injury rates/minute of competition or practice and by athlete exposures. 95% CIs were calculated. Results: Responses from 307 of 500 kendo players were received (response rate = 61.4%). 41 (18%) male and 13 (16%) female participants reported injury to only one body region, while 16 (7%) men and one (1%) woman reported no injuries. 166 (74%) males and 70 (83%) females reported injuries to two or more body regions. The most common sites of injury involved the foot/ankle (65.1%), wrist/hand (53.5%) and elbow/forearm (48.8%). Most injuries occurred during practice (87.9% foot/ankle, 89.9% wrist/hand, elbow/forearm 92.2%). The most common injuries were contusions, abrasions, and sprains/strains. Injury rates were 121/1000 A-E (0.025 injuries/min) in tournaments versus 20.5/1000 A-E (0.011 injuries/min) in training. 26% of injuries resulted in time off of participation, with an average recovery time of 15 days (range = 1 day–1 year). Conclusions: Although more total injuries occurred in practice than in competition, there was a lower injury rate in kendo than in taekwondo and western-style fencing. This study demonstrates that kendo is a relatively safe sport compared to other martial arts sports.

Study design The clinical study conducted was a prospective, randomized, double-blind, placebo-controlled trial. Objectives The purpose of this study was to evaluate the effect of combined magnetic fields on the healing of primary noninstrumented posterolateral lumbar spine fusion. Summary of background data Combined magnetic fields, a new type of biophysical stimulus, have been shown to act by stimulating endogenous production of growth factors that regulate the healing process. This is the first placebo-controlled study to assess the effect of an electromagnetic stimulus on primary noninstrumented posterolateral lumbar spine fusion surgery as well as the first evaluation of combined magnetic fields as an adjunctive stimulus to lumbar spine fusion. Methods This multicenter investigational study was conducted at 10 clinical sites under an Investigational Device Exemption from the United States Food and Drug Administration. Eligible patients had one-level or two-level fusions (between L3 and S1) without instrumentation, either with autograft alone or in combination with allograft. The combined magnetic field device used a single posterior coil, centered over the fusion site, with one 30-minute treatment per day for 9 months. Randomization was stratified by site and number of levels fused. Evaluation was performed 3, 6, and 9 months after surgery and 3 months after the end of treatment. The primary endpoint was assessment of fusion at 9 months, based on radiographic evaluation by a blinded panel consisting of the treating physician, a musculoskeletal radiologist, and a spine surgeon. Results Of 243 enrolled patients, 201 were available for evaluation. Among all patients with active devices, 64% healed at 9 months compared with 43% of patients with placebo devices: a significant difference (P = 0.003 by Fisher's exact test). Stratification by gender showed fusion in 67% of women with active devices, compared with 35% of those with placebo devices (P = 0.001 by Fisher's exact test). By contrast, there was not a statistically significant effect of the active device in this male study population. In the overall population of 201 patients, repeated measures analyses of fusion outcomes (by generalized estimating equations) showed a main effect of treatment, favoring the active treatment (P = 0.030). In a model with main effect and a time by treatment interaction, the latter was significant (P = 0.024), indicating acceleration of healing. Performed in the full sample of 243 patients, results of the intent-to-treat analysis were qualitatively the same as in the evaluable sample of 201 patients. Discussion This investigational study demonstrates that combined magnetic field treatment of 30 min/d increases the probability of successful spine fusion, and statistical analysis using the generalized estimating equations model suggests an acceleration of the healing process. This is the first randomized clinical trial of noninstrumented primary posterolateral lumbar spine fusion, with evaluation by a blinded, unbiased panel. This is the first double-blind study performed to date assessing noninstrumented fusion outcome with extremely critical radiographic criteria. The lower overall fusion rates in this study are attributed to the high-risk patient group with an average age of 57 years, the use of noninstrumented technique with posterolateral fusion only, and the reliance on extremely critical radiographic and clinical criteria and blinded panel for fusion assessment without surgical confirmation. Conclusions In conclusion, the adjunctive use of the combined magnetic field device was statistically beneficial in the overall patient population, as has been shown in previous studies of adjunctive bone growth stimulation for spine fusion. For the first time, stratification of fusion success data by gender demonstrated that the female study population responded positively to the adjunctive combined magnetic field treatment, with no statistically significant effect observed in the male study population. Adjunctive use of the combined magnetic field device significantly increased the 9-month success of radiographic spinal fusion and showed an acceleration of the healing process.

The paper examines the way in which imaging systems are limited by physical and technological constraints. In particular, problems associated with imaging in the infrared waveband are discussed and the different ways in which these problems can be overcome considered, either by the use of unconventional sensor systems or advanced processing techniques.

Tuberculosis (TB) has been around since the beginning of time but for the past decade has experienced an increasing prevalence. TB starts in the lungs but can travel to any organ or structure of the body. The vertebrae are the most often afflicted sites of extra-pulmonary lesions. Pott's disease is the name given to TB of the spine. There are interventions that can enable a person with Pott's disease to return to an optimal level of functioning, and nurses have a pivotal role in helping the patient attain that level. A case study with diagnostic findings and interventions is presented in this article.

To use the Gompertz function to estimate the age and the amount of myopia at stabilization and to evaluate associated factors in the Correction of Myopia Evaluation Trial (COMET) cohort, a large ethnically diverse group of myopic children.The COMET enrolled 469 ethnically diverse children aged 6 to younger than 12 years with spherical equivalent refraction between -1.25 and -4.50 diopters (D). Noncycloplegic refraction was measured semiannually for 4 years and annually thereafter. Right eye data were fit to individual Gompertz functions in participants with at least 6 years of follow-up and at least seven refraction measurements over 11 years. Function parameters were estimated using a nonlinear least squares procedure. Associated factors were evaluated using linear regression.In total, 426 participants (91%) had valid Gompertz curve fits. The mean (SD) age at myopia stabilization was 15.61 (4.17) years, and the mean (SD) amount of myopia at stabilization was -4.87 (2.01) D. Ethnicity (P0.0001) but not sex or the number of myopic parents was associated with the age at stabilization. Ethnicity (P = 0.02) and the number of myopic parents (P = 0.01) but not sex were associated with myopia magnitude at stabilization. At stabilization, African Americans were youngest (mean age, 13.82 years) and had the least myopia (mean, -4.36 D). Participants with two versus no myopic parents had approximately 1.00 D more myopia at stabilization. The age and the amount of myopia at stabilization were correlated (r = -0.60, P0.0001).The Gompertz function provides estimates of the age and the amount of myopia at stabilization in an ethnically diverse cohort. These findings should provide guidance on the time course of myopia and on decisions regarding the type and timing of interventions.

Twenty-one consecutive patients (27 lumbar discs) were treated by percutaneous discectomy for lumbar herniated disc disease from July 1988 through March 1989. Twenty-six discs in 20 patients were evaluated with preoperative and postoperative magnetic resonance images graded by a neuroradiologist blinded to the clinical and prior imaging results. Fifteen patients were treated by one-level percutaneous discectomy and six patients by two-level percutaneous discectomy. The disc herniations were graded with respect to size, type, location, and hydration status on the magnetic resonance image scans. The postoperative magnetic resonance images were obtained 2-6 months after percutaneous discectomy. Early clinical outcomes after percutaneous discectomy were compared with the various magnetic resonance imaging parameters. Overall, treatment for thirteen patients (62%) was considered clinically successful (decrease or elimination of pain) after percutaneous discectomy, whereas treatment for eight (38%) patients was considered to clinically fail (persistence of pain) with follow-up ranging from 1 to 6 months postoperatively. Three of the patients in whom treatment failed have been subsequently treated successfully by laminotomy and discectomy. On the average, there is a small absolute decrease (5% of the anteroposterior diameter of the spinal canal) in the size of disc herniations when treated by percutaneous discectomy. Although this study is limited by a small sample size and lacks statistical significance, it appears that an early clinical success after percutaneous discectomy may be related to a few magnetic resonance imaging parameters.(ABSTRACT TRUNCATED AT 250 WORDS)