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.

Travel-Limiting Disabilities in the United States: Why Accessibility Matters?

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.

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.

Epidemiology of shoulder dislocations presenting to United States emergency departments:An updated ten-year study

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.

Unveiling transplantation research productivity of United States: A bibliometric analysis

BACKGROUND The United States has witnessed significant advancements in the field of organ transplantation over the course of the last five decades,as demonstrated by a notable increase in the quantity of academic research.The presence of a highly dynamic research environment necessitates continuous evaluations to maintain the integrity and progress of the field.AIM To evaluate the total output and thematic emphasis of transplant research conducted in the United States.METHODS On January 10,2023,we conducted a bibliometric search of United States research output in transplantation journals from the Web of Science database's Science Citation Index Expanded.We excluded editorials,meeting abstracts,and other non-article types.We analyzed annual trends,authors,institutions,articles,keywords,and countries collaborating with the United States,using VOSviewer 1.6.18 to create figures and tables.RESULTS The United States published 25956 papers(3078 reviews and 22878 articles)representing 37.7%of the world's scientific output.Canada emerged as the top collaborator with the United States,co-authoring 1263 articles.Leading institutions in United States transplantation research were the University of Pittsburgh(1749 articles),Mayo Clinic(1605 articles),Harvard Medical School(1549 articles),and Johns Hopkins University(1280 articles).The top three keywords with over 2000 occurrences were"recipients,""survival,"and"outcomes,"indicating a focus on graft and recipient outcome markers by United States researchers.CONCLUSION Our findings demonstrate the United States leadership in organ transplantation research,contributing significantly to the global scientific output in this field.However,opportunities exist for fostering expansive partnerships,particularly with developing countries.This study provides valuable insights into the transplantation research landscape in the United States,emphasizing the importance of ongoing evaluations to maintain and propel advancements in this critical medical discipline.The results may facilitate future collaborations,knowledge exchange,and the pursuit of innovative solutions in the realm of organ transplantation.

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.

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.

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.

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.

Soil carbon pools of six ecological regions of the United States

Mineralisable soil organic carbon(SOC)pools vary with ecosystem type in response to changes in climate,vegetation and soil properties.Understanding the effect of climate and soil factors on SOC pools is critical for predicting change over time.Surface soil samples from six ecoregions of the United States were analyzed for permanganate oxidizable C(KMnO4-C)and mineralizable C pools.Variations of SOC ranged from 7.9 mg g^-1(Florida site)to 325 mg g^-1(Hawaii site).Mineralisable C pools and KMnO4-C were highest in soils from the Hawaii site.Mean annual precipitation explains SOC and resistant C pool variations.Clay content was related to mineralisable active C pools and bacterial abundance.Mean annual precipitation and clay content are potential variables for predicting changes in SOC pools at large spatial scales.

History and evaluation of national-scale geochemical data sets for the United States

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.

A Comparison of Shale Gas Fracturing Based on Deep and Shallow Shale Reservoirs in the United States and China

China began to build its national shale gas demonstration area in 2012.The central exploration,drilling,and development technologies for medium and shallow marine shale reservoirs with less than 3,500m of buried depth in Changning-Weiyuan,Zhaotong,and other regions had matured.In this study,we macroscopically investigated the development history of shale gas in the United States and China and compared the physical and mechanical conditions of deep and shallow reservoirs.The comparative results revealed that themain reasons for the order-ofmagnitude difference between China’s annual shale gas output and the United States could be attributed to three aspects:reservoir buried depth,reservoir physical and mechanical properties,and engineering technology level.The current engineering technology level of China could not meet the requirements of increasing production and reducing costs for deep shale gas reservoirs;they had reached the beneficial threshold development stage and lacked the capacity for large-scale commercial production.We identified several physical and mechanical reasons for this threshold development stage.Deep shale reservoirs were affected by the bedding fracture,low brittleness index,low clay mineral content,and significant areal differences,as well as by the transformation from elasticity to plasticity,difficulty in sanding,and high mechanical and strength parameters.Simultaneously,they were accompanied by six high values of formation temperature,horizontal principal stress difference,pore pressure,fracture pressure,extension pressure,and closure pressure.The key to deep shale gas horizontal well fracturing was to improve the complexity of the hydraulic fracture network,formadequate proppant support of fracture surface,and increase the practical stimulated reservoir volume(SRV),which accompanied visual hydraulic discrete network monitoring.On this basis,we proposed several ideas to improve China’s deep shale gas development involving advanced technology systems,developing tools,and supporting technologies in shale gas exploration and development in the United States.These ideas primarily involved stimulation technologies,such as vertically integrated dessert identification and optimization,horizontal well multistage/multicluster fracturing,staged tools development for horizontal wells,fractures network morphology monitoring by microseismic and distributed optical fiber,shale hydration expansion,soak well,and fracturing fluid flow back.China initially developed the critical technology of horizontal well large-scale and high-strength volume fracturing with a core of“staged fracturing with dense cutting+shorter cluster spacing+fracture reorientation by pitching+forced-sand addition+increasing diameter perforating+proppant combination by high strength and small particle size particles”.We concluded that China should continue to conduct critical research on theories and technical methods of horizontal well fracturing,suitable for domestic deep and ultra-deep marine and marine-continental sedimentary shale,to support and promote the efficient development of shale gas in China in the future.It is essential to balance the relationship between the overall utilization degree of the gas reservoir and associated economic benefits and to localize some essential tools and supporting technologies.These findings can contribute to the flourishing developments of China’s deep shale gas.

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.

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.

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.