scholarly journals Epidemiologic Trends in Clostridium difficile Isolate Ribotypes in United States from 2010 to 2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S391-S391 ◽  
Author(s):  
David R Snydman ◽  
Laura A McDermott ◽  
Stephen G Jenkins ◽  
Ellie J C Goldstein ◽  
Robin Patel ◽  
...  
Keyword(s):  
United States ◽  
Medical Center ◽  
The United States ◽  
Surveillance Study ◽  
Surveillance Program ◽  
Phase 2 Trial ◽  
The Us ◽  
Grant Recipient ◽  
Over Time ◽  
Research Grant

Abstract Background Trends in the distribution of ribotypes for C. difficile associated diarrheal isolates obtained over time in the United States are lacking. As part of surveillance program for C. difficile susceptibility, we analyzed stool isolates for ribotype distribution from a phase 2 trial of surotomycin (2010–2011) (North America sites) as well as a national surveillance study from 2011–2014. Isolates for the surveillance study were referred from 6 geographically distinct medical centers. Methods C. difficile isolates or C. difficile toxin + stools from patients with C. difficile associated diarrhea (CDAD) were submitted for testing to Tufts Medical Center. Following isolation and confirmation as C. difficile, a random sample of isolates were ribotyped by PCR capillary gel electrophoresis. Results 673 isolates over the 5 years of the analysis have been ribotyped to date. There were 49 unique ribotype designations, and 16 ribotypes had more than 10 isolates. The ribotype distribution by year is shown in the table. Conclusion There has been a change in the frequency of ribotypes over time in the US. Of the most common ribotypes seen, 027 has decreased by over 50% while there has been an increase of 014-020, 002, and 106. 014-020 is now the most common ribotype seen in the US. These data suggest that there is a changing epidemiology of C. difficile in the US and continuous monitoring of the ribotype distributions and clinical implications is warranted. Disclosures D. R. Snydman, Merck: Consultant and Grant Investigator, Consulting fee and Research grant; Shire: Consultant, Consulting fee; Summit PLC: Consultant and Grant Investigator, Consulting fee and Research grant; BioK+: Consultant, Consulting fee; Actelion: Grant Investigator, Research grant; S. G. Jenkins, Cormedix: Consultant, Consulting fee; Bayer: Consultant, Consulting fee; Merck: Grant Investigator and Scientific Advisor, Research grant; E. J. C. Goldstein, Merck: Grant Investigator, Scientific Advisor and Speaker’s Bureau, Consulting fee and Grant recipient; Cubist: Grant Investigator, Scientific Advisor and Speaker’s Bureau, Consulting fee; Actelion: Grant Investigator, Grant recipient; Summit PLC: Grant Investigator and Scientific Advisor, Grant recipient; R. Patel, Curetis: Consultant, Grant Investigator and Speaker’s Bureau, Consulting fee and Research grant; Pocared: Grant Investigator, Research grant; nanoMR: Grant Investigator, Research grant; BioFire: Grant Investigator, Research grant; Check-Points: Grant Investigator, Research grant; 3M: Grant Investigator, Research grant; Cubist: Grant Investigator, Research grant; Merck: Grant Investigator, Research grant; S. Johnson, Bio-K+: Consultant, Consulting fee; D. N. Gerding, Merck, Shire, Cubist, Rebiotix, sanofi pasteur, Summit, DaVoltera, Actelion: Consultant, Consulting fee; CDC, US Dept of Veterans Affairs Research Service: Grant Investigator, Research grant

Abstract WMP60: Temporal Trends in Incidence, Prevalence and Epidemiological Characteristics of Cerebral Venous Thrombosis in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fadar Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cerebral Venous Thrombosis ◽  
The United States ◽  
P Value ◽  
Joinpoint Regression ◽  
The Us ◽  
Epidemiological Characteristics ◽  
Over Time ◽  
Age And Sex

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.

The Democratic Deficit of United States Federalism? Red State, Blue State, Purple?

2018 ◽  
Vol 46 (4) ◽  
pp. 645-667
Author(s):  
Vicki C Jackson
Keyword(s):  
United States ◽  
State Legislatures ◽  
The United States ◽  
State Legislature ◽  
Democratic Deficit ◽  
The Us ◽  
The 1960S ◽  
Us Senate ◽  
The One ◽  
Over Time

Aspects of an entrenched constitution that were essential parts of founding compromises, and justified as necessary when a constitution was first adopted, may become less justifiable over time. Is this the case with respect to the structure of the United States Senate? The US Senate is hardwired in the Constitution to consist of an equal number of Senators from each state—the smallest of which currently has about 585,000 residents, and the largest of which has about 39.29 million. As this essay explains, over time, as population inequalities among states have grown larger, so too has the disproportionate voting power of smaller-population states in the national Senate. As a result of the ‘one-person, one-vote’ decisions of the 1960s that applied to both houses of state legislatures, each state legislature now is arguably more representative of its state population than the US Congress is of the US population. The ‘democratic deficit’ of the Senate, compared to state legislative bodies, also affects presidential (as compared to gubernatorial) elections. When founding compromises deeply entrenched in a constitution develop harder-to-justify consequences, should constitutional interpretation change responsively? Possible implications of the ‘democratic’ difference between the national and the state legislatures for US federalism doctrine are explored, especially with respect to the ‘pre-emption’ doctrine. Finally, the essay briefly considers the possibilities of federalism for addressing longer term issues of representation, polarisation and sustaining a single nation.

scholarly journals Evaluation of In Vitro Activity of Ceftaroline Tested against Streptococcus pneumoniae Isolates from United States Hospitals: Results from 7 Years of the AWARE Surveillance Program (2010–2016)

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S378-S378
Author(s):  
Michael A Pfaller ◽  
Rodrigo E Mendes ◽  
Leonard R Duncan ◽  
Robert K Flamm ◽  
Helio S Sader
Keyword(s):  
United States ◽  
The United States ◽  
Multidrug Resistant ◽  
Vitro Activity ◽  
Surveillance Program ◽  
In Vitro Activity ◽  
Amoxicillin Clavulanate ◽  
Infection Types ◽  
Research Grant

Abstract Background Ceftaroline (CPT) is a broad-spectrum cephalosporin with activity against S. pneumoniae (SPN), including multidrug-resistant (MDR) strains. CPT fosamil is approved for clinical use in the United States (US) to treat community-acquired bacterial pneumonia (CABP). The AWARE Program monitors the in vitro activity of CPT against clinical bacteria from various infection types. We evaluated the activity of CPT against isolated SPN clinical isolates from US hospitals collected in 2010 through 2016. Methods A total of 8,768 isolates were consecutively collected (1 per patient) from 47 medical centers in 2010–2016 and tested for susceptibility (S) to CPT and comparator agents using CLSI broth microdilution methods. Resistant subgroups included isolates that were nonsusceptible (NS) to penicillin (PCN), ceftriaxone (CRO), amoxicillin-clavulanate (AMC), erythromycin (ERY), clindamycin (CM), and levofloxacin (LEV) as well as MDR (NS to ≥3 classes of agents) and extensively drug resistant (XDR; NS to ≥5 classes). Results CPT inhibited 99.99% of SPN isolates at ≤0.5 mg/L (only 1 isolate had a CPT MIC of 1 mg/L) and remained active against all SPN-resistant (R) subgroups, including PCN-NS (8.7% at ≥4 mg/L), CRO-NS (6.9% at ≥2 mg/L), MDR (21.7%), and XDR (8.4%) strains. CPT activity remained stable against all R subgroups each year. MDR and XDR frequency decreased from 25.0% and 14.1% in 2011 to 17.8% and 3.2% in 2015, respectively; and S to PCN, CRO, AMC, CM, trimethoprim-sulfamethoxazole (TMX), and tetracycline (TET) increased in the same period (Table). The CPT-NS isolate had multiple substitutions in the penicillin binding proteins (PBP), mainly PBP2x, when compared with reference sequences, and showed 31 amino acid alterations in MurM. For MDR isolates, CPT (99.9%S), tigecycline (99.9%S), linezolid (100.0%S), and vancomycin (100.0%S) were the most active agents. Conclusion CPT demonstrated potent and consistent (2010–2016) activity against SPN, including several R phenotypes and the less S serotypes. SPN S to many antibiotics increased from 2011 to 2015, but remained stable in 2015–2016. Increases in S rates could be related to the anti-pneumococcal vaccine PVC-13 introduced in 2010. Disclosures M. A. Pfaller, Allergan: Research Contractor, Research grant; R. E. Mendes, Allergan: Research Contractor, Research grant; L. R. Duncan, Allergan: Research Contractor, Research grant; R. K. Flamm, Allergan: Research Contractor, Research grant; H. S. Sader, Allergan: Research Contractor, Research grant

The Adverse Consequences of the Politics of Agency Design for Presidential Management in the United States: The Relative Durability of Insulated Agencies

2004 ◽  
Vol 34 (3) ◽  
pp. 377-404 ◽  
Author(s):  
DAVID E. LEWIS
Keyword(s):  
United States ◽  
Public Policies ◽  
The United States ◽  
Executive Branch ◽  
Us Congress ◽  
The Us ◽  
Presidential Management ◽  
Agency Design ◽  
Over Time ◽  
Expected Duration

The US Congress has often sought to limit presidential influence over certain public policies by designing agencies that are insulated from presidential control. Whether or not insulated agencies persist over time has important consequences for presidential management. If those agencies that persist over time are also those that are the most immune from presidential direction, this has potentially fatal consequences for the president's ability to manage the executive branch. Modern presidents will preside over a less and less manageable bureaucracy over time. This article explains why agencies insulated from presidential control are more durable than other agencies and shows that they have a significantly higher expected duration than other agencies. The conclusion is that modern American presidents preside over a bureaucracy that is increasingly insulated from their control.

scholarly journals The Changing Shape of the World Automobile Industry: A Multilayer Network Analysis of International Trade in Components and Parts

2022 ◽  
Author(s):  
Margherita Russo ◽  
◽  
Fabrizio Alboni ◽  
Jorge Carreto Sanginés ◽  
Manlio De Domenico ◽  
...  
Keyword(s):  
United States ◽  
Network Analysis ◽  
Trade Agreement ◽  
The United States ◽  
Trade Network ◽  
Trade Relations ◽  
Automotive Components ◽  
The Us ◽  
The World ◽  
Over Time

In 2018, after 25 years of the North America Trade Agreement (NAFTA), the United States requested new rules which, among other requirements, increased the regional con-tent in the production of automotive components and parts traded between the three part-ner countries, United States, Canada and Mexico. Signed by all three countries, the new trade agreement, USMCA, is to go into force in 2022. Nonetheless, after the 2020 Presi-dential election, the new treaty's future is under discussion, and its impact on the automo-tive industry is not entirely defined. Another significant shift in this industry – the acceler-ated rise of electric vehicles – also occurred in 2020: while the COVID-19 pandemic largely halted most plants in the automotive value chain all over the world, at the reopen-ing, the tide is now running against internal combustion engine vehicles, at least in the an-nouncements and in some large investments planned in Europe, Asia and the US. The definition of the pre-pandemic situation is a very helpful starting point for the analysis of the possible repercussions of the technological and geo-political transition, which has been accelerated by the epidemic, on geographical clusters and sectorial special-isations of the main regions and countries. This paper analyses the trade networks emerg-ing in the past 25 years in a new analytical framework. In the economic literature on inter-national trade, the study of the automotive global value chains has been addressed by us-ing network analysis, focusing on the centrality of geographical regions and countries while largely overlooking the contribution of countries' bilateral trading in components and parts as structuring forces of the subnetwork of countries and their specific position in the overall trade network. The paper focuses on such subnetworks as meso-level structures emerging in trade network over the last 25 years. Using the Infomap multilayer clustering algorithm, we are able to identify clusters of countries and their specific trades in the automotive internation-al trade network and to highlight the relative importance of each cluster, the interconnec-tions between them, and the contribution of countries and of components and parts in the clusters. We draw the data from the UN Comtrade database of directed export and import flows of 30 automotive components and parts among 42 countries (accounting for 98% of world trade flows of those items). The paper highlights the changes that occurred over 25 years in the geography of the trade relations, with particular with regard to denser and more hierarchical network gener-ated by Germany’s trade relations within EU countries and by the US preferential trade agreements with Canada and Mexico, and the upsurge of China. With a similar overall va-riety of traded components and parts within the main clusters (dominated respectively by Germany, US and Japan-China), the Infomap multilayer analysis singles out which com-ponents and parts determined the relative positions of countries in the various clusters and the changes over time in the relative positions of countries and their specialisations in mul-tilateral trades. Connections between clusters increase over time, while the relative im-portance of the main clusters and of some individual countries change significantly. The focus on US and Mexico and on Germany and Central Eastern European countries (Czech Republic, Hungary, Poland, Slovakia) will drive the comparative analysis.

scholarly journals Cross-National Outcomes of a Digital Weight Loss Intervention in the United States, Canada, United Kingdom and Ireland, and Australia and New Zealand: A Retrospective Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Qiuchen Yang ◽  
Ellen Siobhan Mitchell ◽  
Annabell S. Ho ◽  
Laura DeLuca ◽  
Heather Behr ◽  
...  
Keyword(s):  
United States ◽  
Weight Loss ◽  
United Kingdom ◽  
New Zealand ◽  
Mixed Models ◽  
Linear Mixed Models ◽  
The United States ◽  
Weight Loss Intervention ◽  
The Us ◽  
Over Time

Mobile health (mHealth) interventions are ubiquitous and effective treatment options for obesity. There is a widespread assumption that the mHealth interventions will be equally effective in other locations. In an initial test of this assumption, this retrospective study assesses weight loss and engagement with an mHealth behavior change weight loss intervention developed in the United States (US) in four English-speaking regions: the US, Australia and New Zealand (AU/NZ), Canada (CA), and the United Kingdom and Ireland (UK/IE). Data for 18,459 participants were extracted from the database of Noom's Healthy Weight Program. Self-reported weight was collected every week until program end (week 16). Engagement was measured using user-logged and automatically recorded actions. Linear mixed models were used to evaluate change in weight over time, and ANOVAs evaluated differences in engagement. In all regions, 27.2–33.2% of participants achieved at least 5% weight loss by week 16, with an average of 3–3.7% weight loss. Linear mixed models revealed similar weight outcomes in each region compared to the US, with a few differences. Engagement, however, significantly differed across regions (P &lt; 0.001 on 5 of 6 factors). Depending on the level of engagement, the rate of weight loss over time differed for AU/NZ and UK/IE compared to the US. Our findings have important implications for the use and understanding of digital weight loss interventions worldwide. Future research should investigate the determinants of cross-country engagement differences and their long-term effects on intervention outcomes.

scholarly journals THE COMPETITIVENESS OF INDONESIA'S EXPORT TO UNITED STATES, 1986-2003: A SHIFT-SHARE ANALYSIS

2007 ◽  
Vol 8 (1) ◽  
pp. 36
Author(s):  
Ahmad Helmy Fuady
Keyword(s):  
United States ◽  
Economic Crisis ◽  
The United States ◽  
The Other ◽  
Republic Of Korea ◽  
Single Digit ◽  
The Us ◽  
Asian Economies ◽  
Changes Over Time ◽  
Over Time

The objective of this paper is to examine the competitiveness of Indonesia's exports to the United States (US) market, compared to other Asian economies, namely Thailand, Malaysia, Singapore, China, Republic of Korea and India, over the period of 1986-2003. A shift-share method is applied to single digit SITC US imports data from those countries. It found that the competitiveness of Indonesia's exports changes over time. The Indonesia's exports reached its best performance in the period 1992-1997. However, after the 1997 economic crisis, Indonesia faces a serious problem, since none of its export has competitiveness in the US market, compared to the reference economy. The analysis also shows that China has consistently posed a serious pressure not only for Indonesia, but also for the other Asian economies.

scholarly journals Comments on Luke Nottage's Paper

2005 ◽  
Vol 36 (4) ◽  
pp. 859
Author(s):  
Meredith Kolsky Lewis
Keyword(s):  
United States ◽  
The United States ◽  
Good Faith ◽  
Narrow Scope ◽  
Doing Business ◽  
The Us ◽  
International Sale Of Goods ◽  
Uncertainty Of Outcome ◽  
Over Time

The author comments on Luke Nottage's paper found in this volume (Luke Nottage "Who's Afraid of the Vienna Sales Convention (CISG)? A New Zealander's View from Australia and Japan" (2005) 36 VUWLR 815). The author first identifies additional factors as to why the Convention on Contracts for the International Sale of Goods ('CISG') may be opted out of in the United States: its lack of a duty of good faith, its narrow scope, and its uncertainty of outcome. However, the author argues that we should be more optimistic about the use of the CISG in the US. First, the US is an original signatory. Secondly, Americans may come to accept the CISG more as their exposure to it grows. Thirdly, a lack of reported US cases involving the CISG does not necessarily mean it is not being used – it purely indicates a lack of litigation. Fourthly, the CISG not being used may speak more about who the US are doing business with. Finally, the numbers show that the CISG is being used frequently. The author therefore concludes that we should be optimistic about the use of the CISG in the United States, and expects its use will increase over time.

Blackness, Jazz, and Globalization

2021 ◽  
Author(s):  
Bruce Johnson
Keyword(s):  
United States ◽  
Popular Culture ◽  
The United States ◽  
World Music ◽  
Race Politics ◽  
Pan African ◽  
The Us ◽  
The World ◽  
Historical Trajectory ◽  
Over Time

The globalization of jazz was also the globalization of black US popular culture. This essay discloses, and provides a model for, the ambiguous dynamics of popular music migrations and the race politics that frame them. In diasporic destinations, those politics are generated by cultural histories very different from that of the United States, and which also exhibit their own synchronic and diachronic heterogeneities, thus introducing distinctive local complexities. In the context of the black-centered jazz canon, these circumstances have produced regional jazz narratives that are derived from the US model, but with often radically different inflections from place to place, and over time. Apart from documenting the perennial ubiquity of the blackness/jazz nexus, the study identifies a broad historical trajectory, in which the focus shifted from African American blackness to a pan-African model that anticipated the World Music phenomenon.

scholarly journals Latinos’ deportation fears by citizenship and legal status, 2007 to 2018

2020 ◽  
Vol 117 (16) ◽  
pp. 8836-8844 ◽  
Author(s):  
Asad L. Asad
Keyword(s):  
United States ◽  
Latin American ◽  
Presidential Election ◽  
Legal Status ◽  
The United States ◽  
Racial Group ◽  
Policy And Practice ◽  
The Us ◽  
Us Presidential Election ◽  
Over Time

Deportation has become more commonplace in the United States since the mid-2000s. Latin American noncitizens—encompassing undocumented and documented immigrants—are targeted for deportation. Deportation’s threat also reaches naturalized and US-born citizens of Latino descent who are largely immune to deportation but whose loved ones or communities are deportable. Drawing on 6 y of data from the National Survey of Latinos, this article examines whether and how Latinos’ deportation fears vary by citizenship and legal status and over time. Compared with Latino noncitizens, Latino US citizens report lower average deportation fears. However, a more complex story emerges when examining this divide over time: Deportation fears are high but stable among Latino noncitizens, whereas deportation fears have increased substantially among Latino US citizens. These trends reflect a growing national awareness of—rather than observable changes to—deportation policy and practice since the 2016 US presidential election. The article highlights how deportation or its consequences affects a racial group that the US immigration regime targets disproportionately.

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