Assessment of Wet Season Precipitation in the Central United States by the Regional Climate Simulation of the WRFG Member in NARCCAP and Its Relationship with Large-Scale Circulation Biases

Assessment of past-climate simulations of regional climate models(RCMs)is important for understanding the reliability of RCMs when used to project future regional climate.Here,we assess the performance and discuss possible causes of biases in a WRF-based RCM with a grid spacing of 50 km,named WRFG,from the North American Regional Climate Change Assessment Program(NARCCAP)in simulating wet season precipitation over the Central United States for a period when observational data are available.The RCM reproduces key features of the precipitation distribution characteristics during late spring to early summer,although it tends to underestimate the magnitude of precipitation.This dry bias is partially due to the model’s lack of skill in simulating nocturnal precipitation related to the lack of eastward propagating convective systems in the simulation.Inaccuracy in reproducing large-scale circulation and environmental conditions is another contributing factor.The too weak simulated pressure gradient between the Rocky Mountains and the Gulf of Mexico results in weaker southerly winds in between,leading to a reduction of warm moist air transport from the Gulf to the Central Great Plains.The simulated low-level horizontal convergence fields are less favorable for upward motion than in the NARR and hence,for the development of moist convection as well.Therefore,a careful examination of an RCM’s deficiencies and the identification of the source of errors are important when using the RCM to project precipitation changes in future climate scenarios.

Characteristics of patients with Wilson disease in the United States: An insurance claims database study

BACKGROUND Wilson disease(WD)is a progressive,potentially fatal degenerative disease affecting the liver and central nervous system.Given its low prevalence,collecting data on large cohorts of patients with WD is challenging.Comprehensive insur-ance claims databases provide powerful tools to collect retrospective data on large numbers of patients with rare diseases.AIM To describe patients with WD in the United States,their treatment and clinical outcome,using a large insurance claims database.METHODS This retrospective,longitudinal study was performed in the Clarivate Real-World Data Product database.All patients with≥2 claims associated with an Interna-tional Classification of Diseases 10(ICD-10)diagnostic code for WD(E83.01)between 2016 and 2021 were included and followed until death or study end.Patients were divided into two groups by whether or not they were documented to have received a specific treatment for WD.Clinical manifestations,hospital-isations,liver transplantation and death were documented.RESULTS Overall,5376 patients with an ICD-10 diagnostic code for WD were identified.The mean age at inclusion was 41.2 years and 52.0%were men.A specific WD treatment was documented for 885 patients(15.1%),although the number of patients taking zinc salts may be underestimated due to over the counter purchase.At inclusion,the mean age of patients with a documented treatment was 36.6±17.8 years vs 42.2±19.6 years in those without a documented treatment.During follow-up,273 patients(5.1%)died.Compared with the American general population,the standardised mortality ratio was 2.19.The proportion of patients with a documented WD-specific treatment who died during follow-up was 4.0%and the mean age at death 52.7 years.CONCLUSION Patients treated for WD in the United States had an excess early mortality compared with the American population.These findings indicate that there is a significant unmet need for effective treatment for WD in the United States.

Coping with the Impact of Climate Change: A Dive into Precision Agriculture in the United States

With the continued increase in the number of people that are food insecure globally, which could be increasing because of the ongoing Ukraine-Russia war, leading to reduction in international agribusinesses, coupled with drastic climate change exacerbating the problem of food insecurity, there is a constant need to come up with innovative approaches to solve this global issue. In this article, we articulated how precision agriculture can be a tool for ensuring food security in the United States. This study aims to reiterate the significance of precision agriculture in solving global food insecurity.

Evolution and impacts of the United States’Arctic strategy and China’s responses

On 7 October,2022,the Biden administration released an updated version of the National Strategy for the Arctic Region based on new developments in the Arctic region and global affairs.This strategy emphasizes traditional security issues in the Arctic,attaches great importance to climate governance in the region,and advocates for restoring American leadership through international cooperation.In view of the strong influence of the United States(U.S.)in the Arctic region,the changes of the U.S.Arctic strategy will inevitably have an impact on China’s scientific researchrights,economic interests,and governance rights in the Arctic region.To respond to the new situation brought about by the changes in the U.S.Arctic strategy,China should take the initiative to maintain positive relationships with all Arctic countries,and continue its active participation in Arctic affairs.

Strategic Planning for Drug Regulatory Science in the United States and Its Enlightenments to China

Objective To study the strategic planning of drug regulatory science,the effectiveness and role of policy implementation in the United States so as to gain insights and make suggestions for further improving the strategic planning of drug regulatory science in China.Methods Literature research method and comparative research method were used to compare and analyze the strategic planning of regulatory science in China and the United States.Results and Conclusion Drawing on the US experience,China should set goals based on mission and vision and identify problems,knowledge gaps,and key areas,then concrete measures can be taken to advance regulatory science.

A Comparative Study of the Value Orientations of Foreign Language Education Policies in China and the United States in the 21st Century

Since the 21 st century, both Chinese Mainland and the United States have formulated foreign language education policiesbased on their national needs. This paper makes a comparative study of the value orientations of foreign language education poli-cies in Chinese Mainland and the United States in the 21 st century and finds that both China and the United States have regardedtheir national interests as the essential value orientation of their foreign language education policies. To be specific,the core valueorientation of foreign language education policies in China is to enhance its cultural soft power.In contrast,the core value orienta-tion of foreign language education policies in the United States is to safeguard its national security. Through the comparison of thedifferent value orientations of foreign language education policies of the two countries, the paper provides some reference for the for-eign language education policy-making in Chinese Mainland.

Dr. Ralph Coan: a hero in establishing acupuncture as a profession in the United States

1 Introduction Dr. Ralph Coan is not well known to the general public. Originally, we had wanted to interview him as he was the medical director of the first acupuncture center in the United States that opened in the early 1970s. We wanted to know more about that center＇s history. Prior to visiting Dr. Coan, we found an article written by Dr. Sherman Cohn that mentioned Dr. Coan. The article noted that Dr. Coan was the founder of the American Association of Acupuncture and Oriental Medicine, which is the national association of acupuncturists and Chinese medicine practitioners in the United States.

Introduction to Urban and Community Forestry in the United States of America: History, Accomplishments, Issues and Trends

The urban and community forestry movement in the United States has matured over the last 20 years from managing street trees, to understanding the benefits of trees in urban ecosystems, and now to managing urban green infrastructure. This paper introduced the history, development, and major accomplishments of the urban and community forestry movement, highlighted the economic, ecological, environmental, and social values of forests and trees to communities, and discussed issues and trends of the urban and community forestry program in the United States.

An overview of emergency ultrasound in the United States

BACKGROUND:As emergency ultrasound use explodes around the world,it is important to realize the path its development has taken and learn from trials and tribulations of early practitioners in the field.METHODS:Approaches to education,scanning,documentation,and organization are also described.RESULTS:Machines have reduced in price and once purchased further material costs are low.Staffing costs in terms of training,etc have yet to be assessed,but indications from elsewhere are that these are low.Length of stay in the emergency department dramatically decreases,thus increasing patient satisfaction while maintaining an even higher standard of care.CONCLUSION:Emergency screening ultrasound is now a nationally accepted tool for the rapid assessment of the emergency patient.

Multitarget stool DNA for colorectal cancer screening:A review and commentary on the United States Preventive Services Draft Guidelines

Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).The United States Preventive Services Task Force(USPSTF) October 2015 draft recommendation for CRC screening included mt-s DNA as an "alternative" screening test that "may be useful in select clinical circumstances",despite its very high sensitivity for early stage CRC.The evidence supporting mt-s DNA for routine screening use is robust.The clinical efficacy of mt-s DNA as measured by sensitivity,specificity,life-years gained(LYG),and CRC deaths averted is similar to or exceeds that of the other more specifically recommended screening options included in the draft document,especially those requiring annual testing adherence.In a population with primarily irregular screening participation,tests with the highest point sensitivity and reasonable specificity are more likely to favorably impact CRC related morbidity and mortality than those depending on annual adherence.This paper reviews the evidence supporting mt-s DNA for routine screening and demonstrates,using USPSTF's modeling data,that mt-s DNA at three-year intervals provides significant clinical net benefits and fewer complications per LYG than annual fecal immunochemical testing,high sensitivity guaiac based fecal occult blood testing and 10-year colonoscopy screening.

Factors associated with nursing students' willingness to care for older adults in Korea and the United States

Objective: Elderly health care needs increase and nurses' role for elderlies is vital.It is significant to identify nursing students' intention to care for elderlies.Thus,this study investigated nursing students' willingness to care for elderlies in Korea and the United States.Methods: The study was conducted with 437 undergraduate nursing students from Korea and the United States from May 25 to 31,2018.Participants completed a survey including frequency and quality of contact,anxiety about aging,empathy,attitude toward elderly,and willingness to care.Results: Study findings from the entire group showed that nursing students' willingness to care for the elderly was positively associated with contact quality (β =0.22,P<0.001) and empathy (β =0.12,P 0.009) but negatively associated with anxiety about aging (β =0.23,P < 0.001) and attitude toward the elderly (β =0.14,P =0.004).Contact quality (β=0.30,P < 0.001) was positively associated with the willingness to care in Korean students,whereas extended family living type (β =-0.15,P=0.012) and attitude toward the elderly (β =-0.18,P=0.005) negatively associated in US students.Conclusion: This study suggested that nursing educators reinforce contact quality and empathy but reduce anxiety about aging and attitude toward elderly to enhance future nurses' care quality.

The Future of Disability Policy and Vocational Rehabilitation in the United States

This article focuses on current and future disability public policy having potential implications for the Rehabilitation Act and vocational rehabilitation services in the United States. It explores several models of disability reflected in public policy, important historical legislation, and the relationship of the Workforce Investment Act (WIA) to the Rehabilitation Act. Competing issues and conflicts between the WIA and the state vocational rehabilitation agencies are discussed. A framework for analyzing disability policy is identified to project the future of disability policy, as well as, how these issues and conflicts may impact the survival of the rehabilitation profession.

Comparison of water resources management between China and the United States

As the world’s top two economies,the United States(U.S.)and China face a number of similar water resources problems.Yet,few studies have been done to systematically compare policies and approaches on water resources management between China and the U.S.This study compares water resources policies of China and the U.S.in the areas of national authority,water supply,water quality,and ecosystem use of the water to draw lessons learned and shed light on water resources management in China,the U.S.,and the rest of the world.The lessons learned from the comparison include six aspects.1)New paradigms of people-water harmony and a water-saving society are urgently needed to address the pressing water crisis and achieve the United Nations Sustainable Development Goals(UN SDGs).2)A comprehensive,consistent,forward-looking national policy is necessary to achieve sustainable use of water resources.3)Empowerment of river basin commissions with comprehensive authority over the integrative management of air,land,water,and biological resources in the river basin could significantly enhance the benefits and effectiveness of economic development and environmental protection.4)Expansion of water exchange through market mechanisms among water users promotes efficient and beneficial water uses.5)Use of water for ecosystem services should be an integral part of water resources management.China has set up a national blueprint for achieving ecological civilization;maintaining appropriate amounts of flow in rivers and lakes for maintenance of wildlife and fisheries and ecosystems should be institutionalized as part of this national strategy as well.6)By sharing their rich experiences and lessons in water resources management,economic development,and ecological protection with other countries,China and the U.S.can help the world to achieve global human-water harmony and the UN SDGs.

Impacts of the COVID-19 pandemic on the dairy industry: Lessons from China and the United States and policy implications

The purposes of this study are to assess the COVID-19 pandemic’s impacts on the dairy industries in China and the United States and to derive policy recommendations for enhancing the diary industries’resilience to pandemics and other market shocks.Specifically,data from the two nations are used to analyze and compare the mechanisms through which the pandemic has affected their dairy industries and to discuss potential lessons from their experiences.The findings suggest that this pandemic has heavily affected the dairy industries in both China and the United States through similar mechanisms,such as decreased farmgate milk prices,disruption and difficulties of moving milk within the supply chains,worker shortages,increased production costs,and lack of operating capital.There were also significant differences in the affecting mechanisms between the two nations,including transportation difficulties from widespread road closures and significant reduction in holiday sales of dairy products in China,and the shutdown of many dairy processors in the United States due to the closing of schools,restaurants,and hotels.While government financial reliefs are highly needed to help many dairy farms and processors survive this pandemic in the short term,the dairy industries and governments need to work together to develop long-term strategies and policies to balance the industries’efficiency and flexibility,product specialization and diversification,supply chain integration and local food systems,and market mechanisms and policy regulations and interventions.

Perceptions of emergency medicine residents on the quality of residency training in the United States and Saudi Arabia

BACKGROUND: We compare educational environments(i.e. physical, emotional and intellectual experiences) of emergency medicine(EM) residents training in the United States of America(USA) and Saudi Arabia(SA).METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure(PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales(autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance.RESULTS: A total of 219 surveys were returned for 260 residents across six programs(3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%–100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries(P=0.243); however, role autonomy(P<0.001) and teaching(P=0.005) were better in USA programs. There were no significant differences by post-graduate training year.CONCLUSION: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

Review of the United States Refractories Industry

Factors affecting the U.S. refractories industry, such as decreasing demand, mergers , and decreased education are discussed, along with manufacturing statistics (i. e. , annual value and product trends ) , indicating that the U.S. market has declined for five straight years. Research activities have changed, with more emphasis on practical, applied projects , which have continued to produce important advances. Many challenges and opportunities remain, based on the current and future business requirements .

Challenges of agriculture and food systems issues in China and the United States

China and the United States are the two most significant nations in the contemporary global food and agricultural network.In addition,they are two of the most important innovators with respect to the development of new crop varieties,agro-technologies,farm products,markets and consumer issues,such as consumer resistance to genetically modified foods,among others.In the face of an ever-complex web of interactions,technologies and products among producers and consumers in both nations,there are far more structural similarities than differences in the food and agriculture sectors of these two nations.This essay,adopting some of the themes of the Sino-American Symposium on Future Issues Affecting Quality of Life,presents a limited but representative comparative assessment of three of the most important shared challenges impacting the agricultural sectors of China and the United States for the period from 2000 to the present including 1)environmental challenges related to agricultural water supply,2)declines in farm labor and rural population,and 3)growing food-related concerns and challenges.For both nations,excessive and unsustainable groundwater consumption has lowered water tables and limited crop production.Rural populations and farm workforces in both nations are also declining,leading to labor challenges in both nations.Finally,concerns regarding food safety are also very similar with major challenges to the farm sector associated with consumer resistance to genetically modified food crops and sanitation issues linked to lengthening supply chains.All of these issues threaten the development of sustainable agricultural production systems.

Drought and Associated Impacts in the Great Plains of the United States—A Review

The Great Plains region of the United States is susceptible to drought of all kinds including meteorological/climatological, agricultural, hydrological, and socioeconomic. Drought conditions in the region span varying spatial and temporal scales and the causes include: 1) certain synoptic conditions that favor drought such as mid-tropospheric ridging over the drought-affected area and a weak low-level jet;2) sea surface temperature anomalies and associated teleconnections;3) land-atmosphere coupling;and 4) anthropogenic effects. While drought can span as few as a couple of months, the most severe droughts can occur at the decadal scale such as the 1930s Dust Bowl, the worst drought in recent history from a societal standpoint. Such droughts in the Great Plains have widespread impacts on agriculture, water resources, human health, and the economy.

Machine learning models for predicting non-alcoholic fatty liver disease in the general United States population:NHANES database

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease,affecting over 30% of the United States population.Early patient identification using a simple method is highly desirable.AIM To create machine learning models for predicting NAFLD in the general United States population.METHODS Using the NHANES 1988-1994.Thirty NAFLD-related factors were included.The dataset was divided into the training(70%)and testing(30%)datasets.Twentyfour machine learning algorithms were applied to the training dataset.The bestperforming models and another interpretable model(i.e.,coarse trees)were tested using the testing dataset.RESULTS There were 3235 participants(n=3235)that met the inclusion criteria.In the training phase,the ensemble of random undersampling(RUS)boosted trees had the highest F1(0.53).In the testing phase,we compared selective machine learning models and NAFLD indices.Based on F1,the ensemble of RUS boosted trees remained the top performer(accuracy 71.1%and F10.56)followed by the fatty liver index(accuracy 68.8% and F10.52).A simple model(coarse trees)had an accuracy of 74.9% and an F1 of 0.33.CONCLUSION Not every machine learning model is complex.Using a simpler model such as coarse trees,we can create an interpretable model for predicting NAFLD with only two predictors:fasting C-peptide and waist circumference.Although the simpler model does not have the best performance,its simplicity is useful in clinical practice.

Undergraduate nursing education in the United States

Nursing education in the United States began in the 1870s with hospital training schools modeled after the Nightingale plan. Presently there are three educational paths that students may take to become a registered nurse (RN). These are the baccalaureate degree (BS), the associate degree (AD) and the diploma. Accelerated nursing programs are also available for people who have a baccalaureate degree in another field. Nursing education and nursing practice in the United States is regulated by each of the 50 states. The focus of nursing education is the preparation of nurses who use critical thinking skills to provide comprehensive patient-centered care to a variety of clients. It is expected that nurses will function using evidence-based practice in a culturally competent, safe manner. Nursing schools must be approved by the state in which they exist. In addition to this, most nursing schools are also accredited, a voluntary process that is done by a non-governmental association. All graduates take the same licensing exam, a computer adaptive test that is from 75 to 265 items long. In 2008 almost 120,000 US educated graduates were first time test takers; 85.5% passed the exam. Trends in nursing education include a focus on evidence based practice, an emphasis on safety and quality, patient education and management of chronic conditions, genetics and genomics and the use of simulation in nursing education.