This study evaluates the distribution of travel-limiting disabilities across genders and geographic locations in the United States. This study aims to describe and compare the socioeconomic and demographic variables o...This study evaluates the distribution of travel-limiting disabilities across genders and geographic locations in the United States. This study aims to describe and compare the socioeconomic and demographic variables of the people with and without travel-limiting disabilities across geographic locations and gender. The study further evaluates the trip purpose and impact of Covid-19 fourth wave pandemic on the use of public transit and travel to physical workplace for the people with and without travel-limiting disabilities across gender and geographic locations. The study uses the 2022 weighted National Household Travel Survey dataset and employs descriptive statistics. Results reaffirm the findings from previous literature that there are more people with travel-limiting disabilities in urban areas and among women. Over 50 percent of people aged 65 and above have a form of travel-limiting disabilities. The most trip for people with travel-limiting disabilities is made for shopping and medical purposes. Across all categories, rural areas, urban areas, male and female for the people without travel-limiting disabilities, COVID-19 fourth wave did not change the pattern of trips made to physical workplace as pre-COVID-19 era. This pattern is also observable for the people with travel-limiting disabilities in rural and urban areas. Females with travel-limiting disabilities reported making less trips to physical workplaces while male reported doing the same as before COVID-19 era. The study concludes that the quantification of travel-limiting disabilities across geographic location and gender is vital in disability study and could drive policy implementation for improved accessibility for the vulnerable population.展开更多
BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this inj...BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.展开更多
Six national-scale,or near national-scale,geochemical data sets for soils or stream sediments exist for the United States.The earliest of these,here termed the 'Shacklette' data set,was generated by a U.S. Geologica...Six national-scale,or near national-scale,geochemical data sets for soils or stream sediments exist for the United States.The earliest of these,here termed the 'Shacklette' data set,was generated by a U.S. Geological Survey(USGS) project conducted from 1961 to 1975.This project used soil collected from a depth of about 20 cm as the sampling medium at 1323 sites throughout the conterminous U.S.The National Uranium Resource Evaluation Hydrogeochemical and Stream Sediment Reconnaissance(NUREHSSR) Program of the U.S.Department of Energy was conducted from 1975 to 1984 and collected either stream sediments,lake sediments,or soils at more than 378,000 sites in both the conterminous U.S.and Alaska.The sampled area represented about 65%of the nation.The Natural Resources Conservation Service(NRCS),from 1978 to 1982,collected samples from multiple soil horizons at sites within the major crop-growing regions of the conterminous U.S.This data set contains analyses of more than 3000 samples.The National Geochemical Survey,a USGS project conducted from 1997 to 2009,used a subset of the NURE-HSSR archival samples as its starting point and then collected primarily stream sediments, with occasional soils,in the parts of the U.S.not covered by the NURE-HSSR Program.This data set contains chemical analyses for more than 70,000 samples.The USGS,in collaboration with the Mexican Geological Survey and the Geological Survey of Canada,initiated soil sampling for the North American Soil Geochemical Landscapes Project in 2007.Sampling of three horizons or depths at more than 4800 sites in the U.S.was completed in 2010,and chemical analyses are currently ongoing.The NRCS initiated a project in the 1990s to analyze the various soil horizons from selected pedons throughout the U.S.This data set currently contains data from more than 1400 sites.This paper(1) discusses each data set in terms of its purpose,sample collection protocols,and analytical methods;and(2) evaluates each data set in terms of its appropriateness as a national-scale geochemical database and its usefulness for nationalscale geochemical mapping.展开更多
The United States is launching an all-out crackdown against China in the name of competition,which has posed increasingly severe challenges to development and security in China.The strategic competition between China ...The United States is launching an all-out crackdown against China in the name of competition,which has posed increasingly severe challenges to development and security in China.The strategic competition between China and the United States is becoming an essential part of once-in-a-century changes that is shaping the world today.Under such circumstances,the Communist Party of China applies a holistic approach to national security,which aims to balance development and security as well as opening up and security.Furthermore,it intends to implement the national rejuvenation strategy within the wider context of once-ina-century global changes.Managing China’s affairs well to achieve a dynamic balance and positive interaction among high-quality development,high-level security,and high-standard opening-up can provide the basis for realizing the rejuvenation of the Chinese nation and response to containment by the United States.While fostering a new development paradigm,China advances scientific and technological innovation and pursues common prosperity.Moreover,it defends national security through firm but flexible struggles and promotes safe development by accelerating domestic circulation.However,China needs to control the costs of its security investment,pay equal attention to the risks and gains brought about by its opening-up policy,and,thus,enhance its capability to compete with the United States in the long term.展开更多
This article explores reform of the United Nations Security Council and the response of the Muslim-majority member states seeking greater participation in the organization.A variety of models and plans for Council ref...This article explores reform of the United Nations Security Council and the response of the Muslim-majority member states seeking greater participation in the organization.A variety of models and plans for Council reform have emerged since 2000.Within this debate,Muslim-majority member states have focused on the restriction/abolition of the veto,the inclusion of Egypt and Nigeria as permanent African/Muslim representatives,and instigating the procedural reforms.Despite this sentiment,the reform process has led to inter-state rivalry among these states and confusion about the best path to progress.As a result,there is little promise for Muslim states in gaining an increased level of participation in the Council.Muslim ambitions are hindered by an inability of these states to coordinate a unified reaction;inter-state rivalry;the reticence of existing Council members to approve permanent Muslim membership;the relatively weak bargaining position that these states hold in the negotiations,and the tendency for many to support one of the different reform models,some with mutually-exclusive perspectives.展开更多
AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt(TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part ...AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt(TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and Quality.RESULTS: Overall, 12.3% of patients died during hospitalization with downward trend in-hospitalmortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients(OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients(OR = 1.347 vs non-transferred, P < 0.001), emergency admissions(OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region(OR = 1.449 vs West, P < 0.001) had significantly higher odds of inhospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death(OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure(OR = 8.246), acute kidney failure(OR = 4.359), hepatic encephalopathy(OR = 2.217) and esophageal variceal bleeding(OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites(OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders(OR = 2.823), coagulopathy(OR = 2.016), and lymphoma(OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is steadily decreasing, though the length of stay has remained relatively constant. Specific patient ethnicity, location, transfer status, primary diagnosis and comorbidities correlate with increased odds of TIPS in-hospital death.展开更多
目前,我国正处于国家公园体制稳步推进,自然保护地体系转型重构的关键时期,明确国家公园的发展思路与理念是我们亟待解决的关键问题。National Parks:The American Experience一书较为全面地探讨了美国国家公园体系的发展历程及发展理...目前,我国正处于国家公园体制稳步推进,自然保护地体系转型重构的关键时期,明确国家公园的发展思路与理念是我们亟待解决的关键问题。National Parks:The American Experience一书较为全面地探讨了美国国家公园体系的发展历程及发展理念变迁,讲述了联邦政府、铁路公司和环保组织等利益团体围绕"国家公园该如何发展"这条主线展开的一系列博弈过程,涵盖了重要的历史事件、关键的推动性人物及相关开创性法案等内容。书中对推动美国国家公园发展的思潮和理念做了总结回顾,尤其是国家公园应该"保护什么"以及"如何保护"的思考,对完善我国国家公园体制、重构自然保护地体系具有一定的借鉴和启示意义。展开更多
文摘This study evaluates the distribution of travel-limiting disabilities across genders and geographic locations in the United States. This study aims to describe and compare the socioeconomic and demographic variables of the people with and without travel-limiting disabilities across geographic locations and gender. The study further evaluates the trip purpose and impact of Covid-19 fourth wave pandemic on the use of public transit and travel to physical workplace for the people with and without travel-limiting disabilities across gender and geographic locations. The study uses the 2022 weighted National Household Travel Survey dataset and employs descriptive statistics. Results reaffirm the findings from previous literature that there are more people with travel-limiting disabilities in urban areas and among women. Over 50 percent of people aged 65 and above have a form of travel-limiting disabilities. The most trip for people with travel-limiting disabilities is made for shopping and medical purposes. Across all categories, rural areas, urban areas, male and female for the people without travel-limiting disabilities, COVID-19 fourth wave did not change the pattern of trips made to physical workplace as pre-COVID-19 era. This pattern is also observable for the people with travel-limiting disabilities in rural and urban areas. Females with travel-limiting disabilities reported making less trips to physical workplaces while male reported doing the same as before COVID-19 era. The study concludes that the quantification of travel-limiting disabilities across geographic location and gender is vital in disability study and could drive policy implementation for improved accessibility for the vulnerable population.
文摘BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.
文摘Six national-scale,or near national-scale,geochemical data sets for soils or stream sediments exist for the United States.The earliest of these,here termed the 'Shacklette' data set,was generated by a U.S. Geological Survey(USGS) project conducted from 1961 to 1975.This project used soil collected from a depth of about 20 cm as the sampling medium at 1323 sites throughout the conterminous U.S.The National Uranium Resource Evaluation Hydrogeochemical and Stream Sediment Reconnaissance(NUREHSSR) Program of the U.S.Department of Energy was conducted from 1975 to 1984 and collected either stream sediments,lake sediments,or soils at more than 378,000 sites in both the conterminous U.S.and Alaska.The sampled area represented about 65%of the nation.The Natural Resources Conservation Service(NRCS),from 1978 to 1982,collected samples from multiple soil horizons at sites within the major crop-growing regions of the conterminous U.S.This data set contains analyses of more than 3000 samples.The National Geochemical Survey,a USGS project conducted from 1997 to 2009,used a subset of the NURE-HSSR archival samples as its starting point and then collected primarily stream sediments, with occasional soils,in the parts of the U.S.not covered by the NURE-HSSR Program.This data set contains chemical analyses for more than 70,000 samples.The USGS,in collaboration with the Mexican Geological Survey and the Geological Survey of Canada,initiated soil sampling for the North American Soil Geochemical Landscapes Project in 2007.Sampling of three horizons or depths at more than 4800 sites in the U.S.was completed in 2010,and chemical analyses are currently ongoing.The NRCS initiated a project in the 1990s to analyze the various soil horizons from selected pedons throughout the U.S.This data set currently contains data from more than 1400 sites.This paper(1) discusses each data set in terms of its purpose,sample collection protocols,and analytical methods;and(2) evaluates each data set in terms of its appropriateness as a national-scale geochemical database and its usefulness for nationalscale geochemical mapping.
文摘The United States is launching an all-out crackdown against China in the name of competition,which has posed increasingly severe challenges to development and security in China.The strategic competition between China and the United States is becoming an essential part of once-in-a-century changes that is shaping the world today.Under such circumstances,the Communist Party of China applies a holistic approach to national security,which aims to balance development and security as well as opening up and security.Furthermore,it intends to implement the national rejuvenation strategy within the wider context of once-ina-century global changes.Managing China’s affairs well to achieve a dynamic balance and positive interaction among high-quality development,high-level security,and high-standard opening-up can provide the basis for realizing the rejuvenation of the Chinese nation and response to containment by the United States.While fostering a new development paradigm,China advances scientific and technological innovation and pursues common prosperity.Moreover,it defends national security through firm but flexible struggles and promotes safe development by accelerating domestic circulation.However,China needs to control the costs of its security investment,pay equal attention to the risks and gains brought about by its opening-up policy,and,thus,enhance its capability to compete with the United States in the long term.
文摘This article explores reform of the United Nations Security Council and the response of the Muslim-majority member states seeking greater participation in the organization.A variety of models and plans for Council reform have emerged since 2000.Within this debate,Muslim-majority member states have focused on the restriction/abolition of the veto,the inclusion of Egypt and Nigeria as permanent African/Muslim representatives,and instigating the procedural reforms.Despite this sentiment,the reform process has led to inter-state rivalry among these states and confusion about the best path to progress.As a result,there is little promise for Muslim states in gaining an increased level of participation in the Council.Muslim ambitions are hindered by an inability of these states to coordinate a unified reaction;inter-state rivalry;the reticence of existing Council members to approve permanent Muslim membership;the relatively weak bargaining position that these states hold in the negotiations,and the tendency for many to support one of the different reform models,some with mutually-exclusive perspectives.
文摘AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt(TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and Quality.RESULTS: Overall, 12.3% of patients died during hospitalization with downward trend in-hospitalmortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients(OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients(OR = 1.347 vs non-transferred, P < 0.001), emergency admissions(OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region(OR = 1.449 vs West, P < 0.001) had significantly higher odds of inhospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death(OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure(OR = 8.246), acute kidney failure(OR = 4.359), hepatic encephalopathy(OR = 2.217) and esophageal variceal bleeding(OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites(OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders(OR = 2.823), coagulopathy(OR = 2.016), and lymphoma(OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is steadily decreasing, though the length of stay has remained relatively constant. Specific patient ethnicity, location, transfer status, primary diagnosis and comorbidities correlate with increased odds of TIPS in-hospital death.
文摘目前,我国正处于国家公园体制稳步推进,自然保护地体系转型重构的关键时期,明确国家公园的发展思路与理念是我们亟待解决的关键问题。National Parks:The American Experience一书较为全面地探讨了美国国家公园体系的发展历程及发展理念变迁,讲述了联邦政府、铁路公司和环保组织等利益团体围绕"国家公园该如何发展"这条主线展开的一系列博弈过程,涵盖了重要的历史事件、关键的推动性人物及相关开创性法案等内容。书中对推动美国国家公园发展的思潮和理念做了总结回顾,尤其是国家公园应该"保护什么"以及"如何保护"的思考,对完善我国国家公园体制、重构自然保护地体系具有一定的借鉴和启示意义。