Rickets: Historical, Epidemiological, Pathophysiological, and Pathological Perspectives

Rickets was a common metabolic disease of bone a century ago in Europe, North America, and East Asia (mainly due to vitamin D deficiency) but was largely eradicated in growing children by use of cod liver oil and the introduction of vitamin D fortification of milk in the 1930s in the United States. Vitamin D deficiency (VDD) remains the most common form of metabolic bone disease that is entirely preventable and treatable. Historically, rickets has appeared in sporadic epidemics and, despite the introduction of numerous preventive strategies, VDD has remained a global health problem amongst children. Moreover, developed countries such as Canada, Australia, the United Kingdom, and the United States have not been exempt from this. The radiological and histological features of rickets are both distinctive and characteristic and they reflect the underlying pathophysiological issue of decreased mineralization of bone as a result of VDD. The radiological features include 1) metaphyseal cupping and fraying, 2) poor mineralization of epiphyseal centers, 3) irregular and widened epiphyseal plates, 4) increased distance between the end of shaft and epiphyseal center, 5) cortical spurs at right angles to the metaphysis, 6) coarse trabeculation, and 7) periosteal reactions. Fractures may also be evident. The histological features of rickets reflect the failure of cartilage to mineralize and undergo resorption. This results in 1) disordered proliferation of chondrocytes in the hypertrophic zone secondary to a lack of apoptosis, 2) loss of the columnar arrangement of chondrocytes that results in thickening and disorganization of the hypertrophic zone, 3) tongue-like projections of cartilage that extend into the spongiosa, 4) irregularity of the limit between the proliferative and hypertrophic zones, and 5) penetration of blood vessels into the hypertrophic zone. The case of a premature 3-month-old female infant, born in the winter months in the arctic region of Canada who died from a lobar pneumonia with an incidental finding of radiological and pathological evidence of rickets, is presented. The case is used to review the entity of rickets from historical, pathophysiological, radiological, and histological perspectives.

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A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States

Scientific Reports ◽

10.1038/s41598-019-56297-y ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 7

Author(s):

Jia Wei ◽

Anna Zhu ◽

John S. Ji

Keyword(s):

United States ◽

Older Adults ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Ethnic Minorities ◽

The United States ◽

Health Concern ◽

Lower Serum ◽

Severe Deficiency ◽

The Us

AbstractVitamin D deficiency is a common health concern worldwide. We aim to compare the prevalence of vitamin D deficiency among older adults (65+) in China and the United States (US). We used data from the 2011 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS) in China (n = 2180), and 2011–2014 National Health and Nutrition Examination Survey (NHANES) in the US (n = 2283). Serum 25-hydroxyvitamin D [25(OH)D] was measured and a level of under 30/50 nmol/L was defined as vitamin D severe deficiency/deficiency. Risk factors of vitamin D deficiency were examined by multivariate regression models. We found that the mean 25(OH)D concentration was lower in China than in the US (45.1 vs. 83.5 nmol/L), with Chinese elderly lower than American elderly for every age group. 70.3% in China and 17.4% in the US were considered as vitamin D deficiency (30.6% and 3.4% were considered as severe deficiency). Older age, females, ethnic minorities, higher household income, self-rated “very bad” health, and never drinkers, were statistically significant in predicting lower serum 25(OH)D levels in China. In the US, males, ethnic minorities, lower income, self-rated “very bad” health, physically inactive, overweight, and obese were related to lower serum 25(OH)D levels. Our findings suggest that different interventional strategies are needed to improve vitamin D deficiency and its associated negative health outcomes in China and the US.

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U.S. Arctic policy: the agenda of 2019

Право и политика ◽

10.7256/2454-0706.2020.1.30273 ◽

2020 ◽

pp. 25-37

Author(s):

Andrei Andreevich Kovalev

Keyword(s):

United States ◽

Arctic Region ◽

The United States ◽

Climatic Changes ◽

The Arctic ◽

Arctic Policy ◽

Defense Cooperation ◽

Relevant Consideration ◽

The Arctic Region

This article explores the key stages of the development of U.S. policy with regards to Arctic Region. The goal is set to outline the fundamental interests of the United States in the Arctic, as well as analyze the actions aimed at their achievement. The article examines the main priorities in U.S. Arctic policy, namely the protection and preservation of resources and ecosystem in the Arctic Region, scientific study of climatic changes, peculiarities of economic development of Alaska, and national security interests of the state. The questions of interaction of Arctic states with regards to defense cooperation become increasingly relevant. Consideration of the mid-term and long-term prospects of U.S. Arctic policy allowed the author focusing attention on the news aspects of U.S. government actions. Maritime capabilities of the United States in the Arctic waters are views in the context of modern tendencies. The author attempted to trace the prospects for expansion of U.S. influence in the Arctic Region based on the current agenda of 2019.

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Some issues of cooperation between Russia and China in the Arctic

Izvestia of Saratov University New Series Series Sociology Politology ◽

10.18500/1818-9601-2021-21-3-335-339 ◽

2021 ◽

Vol 21 (3) ◽

pp. 335-339

Author(s):

Elena S. Novikova ◽

◽

Anna V. Kripak ◽

Keyword(s):

United States ◽

Arctic Region ◽

The United States ◽

The Arctic ◽

Economic Relations ◽

The Relationship ◽

The Arctic Region

The article is devoted to the consideration of the reasons and a number of areas of cooperation between Russia and China in the Arctic region. The importance of this region for Russia and China is analyzed. The advantages of the Arctic for the two countries in terms of territory, economy, and politics are revealed. The conclusion is made about the relationship between the COVID-19 pandemic and the exacerbation of the crisis of political and economic relations between China, Russia, and the United States.

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Vitamin D status in the United States, 2011–2014

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz037 ◽

2019 ◽

Vol 110 (1) ◽

pp. 150-157 ◽

Cited By ~ 44

Author(s):

Kirsten A Herrick ◽

Renee J Storandt ◽

Joseph Afful ◽

Christine M Pfeiffer ◽

Rosemary L Schleicher ◽

...

Keyword(s):

United States ◽

At Risk ◽

Vitamin D ◽

Dietary Intake ◽

Vitamin D Deficiency ◽

The United States ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Hispanic Origin ◽

Medicare Part B

ABSTRACT Background Vitamin D is important for bone health; in 2014 it was the fifth most commonly ordered laboratory test among Medicare Part B payments. Objectives The aim of this study was to describe vitamin D status in the US population in 2011–2014 and trends from 2003 to 2014. Methods We used serum 25-hydroxyvitamin D data from NHANES 2011–2014 (n = 16,180), and estimated the prevalence at risk of deficiency (<30 nmol/L) or prevalence at risk of inadequacy (30–49 nmol/L) by age, sex, race and Hispanic origin, and dietary intake of vitamin D. We also present trends between 2003 and 2014. Results In 2011–2014, the percentage aged ≥1 y at risk of vitamin D deficiency or inadequacy was 5.0% (95% CI: 4.1%, 6.2%) and 18.3% (95% CI: 16.2%, 20.6%). The prevalence of at risk of deficiency was lowest among children aged 1–5 y (0.5%; 95% CI: 0.3%, 1.1%), peaked among adults aged 20–39 y (7.6%; 95% CI: 6.0%, 9.6%), and fell to 2.9% (95% CI: 2.0%, 4.0%) among adults aged ≥60 y; the prevalence of at risk of inadequacy was similar. The prevalence of at risk of deficiency was higher among non-Hispanic black (17.5%; 95% CI: 15.2%, 20.0%) than among non-Hispanic Asian (7.6%; 95% CI: 5.9%, 9.9%), non-Hispanic white (2.1%; 95% CI: 1.5%, 2.7%), and Hispanic (5.9%; 95% CI: 4.4%, 7.8%) persons; the prevalence of at risk of inadequacy was similar. Persons with higher vitamin D dietary intake or who used supplements had lower prevalences of at risk of deficiency or inadequacy. From 2003 to 2014 there was no change in the risk of vitamin D deficiency; the risk of inadequacy declined from 21.0% (95% CI: 17.9%, 24.5%) to 17.7% (95% CI: 16.0%, 19.7%). Conclusion The prevalence of at risk of vitamin D deficiency in the United States remained stable from 2003 to 2014; at risk of inadequacy declined. Differences in vitamin D status by race and Hispanic origin warrant additional investigation.

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NEW THREATS TO RUSSIA’S NATIONAL SECURITY IN THE ARCTIC: PROBLEMS OF COUNTERACTION

Научные труды Вольного экономического общества России ◽

10.38197/2072-2060-2020-226-6-85-98 ◽

2020 ◽

Vol 226 (6) ◽

pp. 85-98

Author(s):

VALERY P. ZHURAVEL ◽

Keyword(s):

United States ◽

National Security ◽

Russian Federation ◽

Arctic Region ◽

Armed Forces ◽

Early Warning Systems ◽

The United States ◽

The Arctic ◽

The Status ◽

The Russian Federation

The article reveals real and potential threats to the national security of the Russian Federation in the Arctic region by the NATO. According to the author, these include: the strengthening of the military presence in the Arctic of the Arctic Ocean coastal States and other NATO countries; the increase in the combat capabilities of groups of coalition and national Armed Forces (Navy) of the United States and NATO; the development of naval-based missile defences and early warning systems; the expansion of the United States military satellite constellation to the Arctic; increased activity by the special services of foreign states in conducting intelligence activities in the Arctic and in the frontier territory of the Russian Federation; conduct of multinational military exercises and transfer of combat training areas to the Arctic; the desire of a number of foreign countries to give the Northern Sea Way the status of an international transport highway, and of the Norwegian leadership to change the status of Spitsbergen, to reduce and eventually completely displace the Russian Federation from the archipelago; increasing attempts to discredit the activities of the Russian Federation in the Arctic. The article discusses the measures of the Russian Federation to strengthen the defensive capability in the Arctic direction, paying special attention to the protection of its sovereignty and territorial integrity.

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China’s Arctic Policy: Challenges to Regional Security (1990s – 2020s)

Mìžnarodnì zv’âzki Ukraïni: naukovì pošuki ì znahìdki ◽

10.15407/mzu2021.30.377 ◽

2021 ◽

pp. 377-388

Author(s):

Oleksandr Horobets ◽

Keyword(s):

United States ◽

Large Scale ◽

Arctic Region ◽

The United States ◽

The Arctic ◽

Regional Security ◽

The World ◽

Arctic Policy ◽

The Arctic Region

The article analyzes the evolution of China's Arctic policy, which has expanded over three decades from individual polar research to observer status in the Arctic Council and the existence of a state Arctic strategy. China and Russia have established mutually beneficial cooperation in the Arctic region in such conditions, when in many areas there are fundamental contradictions between the countries. The West did not have a long-term strategy capable of responding to current security challenges, including in the Arctic. When Russia tried to regain lost positions on the world stage in 2007-2008, China became an increasingly influential player in the world. If before the Arctic had been outside the lines of rivalry for decades, the question of the Far North as an arena of military competition began to take first place. China has become a long-term threat to both the United States and Russia. In previous years, with the help of the China, Moscow had the opportunity to receive the necessary investments and technologies for large-scale Arctic projects. The more Beijing attempts to establish itself as an influential player in the Arctic, the more the threat to other Arctic countries will grow. The Russian Federation has positioned itself as a leader in the region. The country's policy was aimed at strengthening this status through regional control and expansion of the military presence. This led to a response from the United States and NATO countries. In Russia it was assessed as a threat. The question arises as to what the strategy of the United States should be, and whether it will be possible to resist the costly arms race. If not, then the competition will be concentrated in the political and economic spheres. A particular aspect is the rapid militarization of the Arctic region after 2014, primarily due to changes in Russia's military strategy, which extends to the North. This has led to the tensions between the United States and Russia. China has not yet resorted to expand its military power in the Arctic. China's policy of economic and infrastructural influence is opposed to military methods. The effectiveness of Chinese non-military methods of influence is assessed

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Serum Vitamin D Deficiency among African American Women in the United States

Value in Health ◽

10.1016/j.jval.2016.03.1452 ◽

2016 ◽

Vol 19 (3) ◽

pp. A173

Author(s):

G Alem ◽

MK Maneno ◽

EB Ettienne ◽

L Wingate

Keyword(s):

United States ◽

Vitamin D ◽

African American ◽

African American Women ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

The United States ◽

American Women ◽

Serum Vitamin D

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Russia, NATO and the Arctic: Rivalry, Security, Possible Scenarios of Geopolitical Competition

Vestnik RUDN International Relations ◽

10.22363/2313-0660-2021-21-4-758-771 ◽

2021 ◽

Vol 21 (4) ◽

pp. 758-771

Author(s):

Igor A. Arzhanov

Keyword(s):

United States ◽

Arctic Region ◽

The United States ◽

The Arctic ◽

The Usa ◽

Northern Territories ◽

The One ◽

Key Aspects ◽

Military Activity ◽

The Arctic Region

The article is devoted to the analysis of key aspects of the geopolitical struggle for the Arctic region. The relevance of the research stems from the fact that due to climate change and the reduction of ice cover in the Northern Hemisphere, the Arctic is of increasing interest to world powers, which are competing for control over new deposits of natural resources and strategic dominance in the region. It is emphasized that the Arctic has become a region where leading states are trying to implement various geopolitical strategies. On the one hand, the four members of the Arctic Five under the auspices of NATO are trying to implement a scenario in which the polar zone is divided into stable zones of influence. On the other hand, there are the interests and position of Russia, which is concerned about the increased military activity of the United States and NATO in the region. The purpose of the article is to study the problems of the Arctic militarization, which will make it possible to identify challenges and threats in this region for Russias national strategy. The research methodology is based on theoretical analysis and dialectical method. In addition, the study used formal logical methods and various approaches to information processing (analysis, synthesis, induction, deduction). The forecasting method helped to determine the range of possible military and political trends in the region. The article identifies the potential interests of Russia, the United States and NATO in the context of increased attention to the Arctic region in recent years. The study reflects a comparative analysis of the policies and interests of the member states of the Arctic Five and NATO, namely Denmark, Canada, Norway and the USA, their practical steps in the High North. The author describes possible prospects for interaction and dialogue on countering the main threats to international security within the framework of a comprehensive strategy. Considering the role and rivalry between Russia and NATO in the Arctic, the article highlights the authors forecasts of further military and political presence of NATO in the Arctic and the necessary actions for Russia to defend its northern territories.

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