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This article examines how Black communities in New York City and Atlanta responded to the crack epidemic of the 1980s and how their grassroots activism shaped the rise of order-maintenance policing. Although much scholarship attributes the development of order-maintenance policing to top-down neoliberal and conservative forces, we demonstrate that residents—facing daily violence, open-air drug markets, and social collapse—demanded more aggressive enforcement. Drawing on extensive archival research, including municipal records, police files, oral histories, and congressional testimony, this study analyzes the formation of Tactical Narcotics Teams in New York and Operation Red Dog in Atlanta. We find that community activism was both a catalyst for and a constraint on policing strategy. Ultimately, this article complicates dominant accounts of contemporary policing by showing how demands for authority and public order, forged from the ground up, helped pave the way for order-maintenance policing.
To assess the impact of a pharmacist-led anti-methicillin-resistant Staphylococcus aureus (MRSA) agents’ time-out and identify clinical areas most likely to benefit.
Stewardship pharmacists alerted physicians to reassess intravenous anti-MRSA therapy at 72 hours after its start. Monthly days of therapy per 1,000 patient-days (DOT) were compared between October 2017 to September 2022 and October 2022 to September 2024 after stratification by ward and department. Acceptance rate and therapeutic drug monitoring (TDM) tests were also assessed.
Results:
Hospital-wide DOT showed an immediate non-significant decrease (−19.23; 95% confidence interval [CI] −59.17 to 20.72; P = .35) and no significant trend change (+0.82; 95% CI −1.18 to 2.82; P = .42). In emergency medicine, DOT decreased in critical care (slope change −20.3; 95% CI −36.25 to −4.28; P = .01) and general wards (−31.6; 95% CI −61.4 to −1.79; P = .04). In emergency medicine critical care, vancomycin use decreased (level change −406.1; 95% CI −801.3 to −10.9; P = .04) with a reduced trend (slope change −24.5; 95% CI −41.2 to −7.8; P < .001). Acceptance was higher in critical care than in general wards (77.1% [27/35] vs 33.6% [40/119]). TDM tests per 1,000 patient-days decreased (8.47 ± 2.39 to 6.55 ± 1.18; P < .001), with no increase in length of stay or in-hospital mortality.
Conclusions:
Targeting an implementation to areas most likely to benefit from it may improve antimicrobial stewardship when resources are limited. Complementary strategies may be needed if acceptance is poor.
The escalating frequency and severity of disasters and the emergence of global health threats such as the COVID-19 pandemic have exposed vulnerabilities in hospital preparedness and response systems.
Objective
This study explores leaders’ perceptions of the SHEPA tool’s application in Saudi hospitals to enhance emergency preparedness.
Methods
A cross-sectional survey of 21 Health Emergency Operations Center (HEOC) leaders assessed familiarity, usefulness, ease of use, and impact using a Likert scale and open-ended questions. Logistic regression was used to analyze differences by occupation and experience.
Results
The study participants primarily consisted of mid-career professionals, with the majority (57.1%) falling within the 25-34 years age group. A significant gender imbalance was observed, with male participants (85.7%) vastly outnumbering their female counterparts (14.3%). Educationally, most participants held a Bachelor’s degree (61.9%). Most participants (71-81%) rated the tool highly useful and impactful, though ease of use received mixed reviews. Experienced professionals valued utility more but critiqued impact (OR = 5096 for usefulness; OR = 0.07 for impact). Given the small sample size (N = 21), these logistic regression findings should be interpreted as exploratory and hypothesis-generating rather than confirmatory. However, the consistent patterns suggested that both professional role and experience level meaningfully shaped how the SHEPA tool is perceived, with more senior and experienced staff showing both greater appreciation of its utility and critical assessment of its impacts.
Conclusions
This study highlighted the SHEPA tool’s potential to strengthen hospital emergency preparedness in Saudi Arabia, with strong endorsement from health emergency operations centers’ leaders. The tool’s perceived usefulness and ability to identify improvement areas align with national preparedness goals, though its ease of use and impact evaluation require refinement. The logistic regression findings are exploratory due to the limited sample size and require validation in larger, more diverse cohorts.
An infant with junctional ectopic tachycardia developed tachycardia-induced cardiomyopathy requiring extracorporeal membrane oxygenation for circulatory failure. After oxygenation withdrawal became feasible following intravenous antiarrhythmics, tachycardia recurred with oral transition. Subsequent ivabradine administration resulted in heart rate control and improved cardiac function. We emphasise the role of ivabradine in heart rate control and cardiac function stabilisation in junctional ectopic tachycardia.
This article offers a new way to think about objects of memory, focusing on how a single item can take on various roles – from a cherished personal keepsake through a commercial product to a powerful political symbol. By examining the ‘Bring Them Home’ dog tags created in response to the October 7 Hamas attack on Israel in 2023, the article explores how these dog tags emerged as expressions of empathy for the hostages and their families, then evolved into a powerful symbol of the current historic moment, and eventually came to reflect diverse political positions on the conflict and even on broader human rights issues. Drawing from media reports, interviews, and visual evidence, the article highlights how these dog tags were worn during local protests, featured in international discussions, dominated the Israeli public space, and were integrated into everyday life, serving as a compact representation of both political identity and protest.
This article discusses cases of phonological abstractness and opacity and shows how they are eminently learnable, given certain assumptions about the innate cognitive endowment that learners bring to acquisition. I argue that opacity is not a learning problem but its solution. I propose that a distinction in patterning between two types of i in Inuit dialects is best explained by positing that surface [i] represents a merger of two underlying vowels. The apparently similar case of /i/ in Uyghur is shown to require a different type of solution. A review of contrasting approaches to prefix selection in Esimbi shows that opacity plays no role in evaluating their relative learnability. Though a celebrated case of opacity in Polish appears to have been misanalysed, an abstract analysis can still be motivated to account for alternations in certain lexemes. Uniting these cases is a preference for phonological analyses over diacritics or suppletion.
Dairy polar lipids have demonstrated anti-inflammatory properties and protective effects on intestinal integrity, potentially mitigating the adverse impacts of weaning in piglets by modulating microbiota composition and intermediary metabolism. This study evaluated a dairy by-product rich in polar lipids on the microbiome and plasma lipid mediators of weaned piglets. A total of 240 male piglets (21 days old; 6.3 ± 0.5 kg) received either a soybean lipid-based diet (SD) or a polar lipid-based diet (PD) from weaning to day 21, followed by a common diet until day 42. Within each diet, animals were provided with one of the three milk replacers (MRs) for the first 7 days: (1) Commercial MR (CO); (2) Polar lipid-based MR (PO); and (3) Soybean lipid-based MR (SO). Fecal and plasma samples were analyzed to assess microbial composition and lipid mediator profiles. Taxonomical distance between diets increased over time, whereas MR type had no effect. The PD diet significantly altered microbiota composition, increasing, for instance, the relative abundance of Firmicutes-belonging genera of the Lachnospiraceae family (Coprococcus, Roseburia), and increasing levels of ethanolamides (e.g., AEA, PEA, SEA, and DPEA). In contrast, the SD diet increased pro-inflammatory lipid mediators (e.g., 13-HODE, 13-KODE) derived from linoleic acid. Polar lipid supplementation in diet, but not in MRs, influenced microbiota diversity and lipid mediator profiles, suggesting a potential long-term impact on immune regulation and metabolism, highlighting their potential to enhance resilience during early-life stress. Future studies should explore these effects under traditional weaning conditions or other stress models.
Antibiotic overuse in community-acquired pneumonia (CAP) persists despite guidelines recommending 5-day treatment for uncomplicated cases. Our pilot quality improvement study aimed to address this problem via an antibiotic stewardship initiative.
Methods:
Adults admitted to a tertiary care center with uncomplicated CAP were identified using database query and manual chart review, with exclusions for intensive care needs, lack of clinical improvement, or concurrent infections. A 3-month baseline period was compared to a 3-month post-intervention period after provider-targeted interventions were implemented—in-person and email-based provider education on eligibility for the 5-day antibiotic course and pharmacist-driven outreach on day 3 of treatment to encourage guideline-based prescribing. Mean antibiotic duration was compared using Mann–Whitney test. The primary goal was to decrease antibiotic overuse by 25%.
Results:
Of 647 baseline patients, 222 met criteria with a mean antibiotic duration of 6.75 ± 1.75 days. After the interventions, 170 of 570 patients met criteria with a reduced antibiotic duration of 6.24 ± 1.47 days (P = .001). The antibiotic overuse decreased by 28.7%. Prolonged courses were primarily due to habitual use of traditional longer regimens, unaccounted inpatient or emergency department doses at discharge, and discrepancies between documentation and medication orders.
Conclusions:
Our pilot study showed that a provider-focused pharmacist-driven strategy can reduce unnecessary antibiotic use in uncomplicated CAP. The intervention encouraged shorter, guideline-driven courses and reduced antibiotic overuse by 28.7%, meeting our primary goal of 25% reduction. Nevertheless, there are opportunities for further improvement in guideline adherence through enhanced discharge prescription stewardship, documentation accuracy checks, and continued provider education.
Rapid mass displacement can transform active conflict into a broader public health emergency by compressing shelter demand and continuity-of-care needs into a narrow time frame. The March 2026 escalation in Lebanon provides a timely case to examine these dynamics within a health system already operating under severe constraints. This paper analyzes the early response phase, focusing on how displacement reshaped shelter operations, access to primary care, continuity of medications, and referral pathways. Much of the resulting health risk emerges from treatment interruption and weakened linkage to essential services. Beyond being a humanitarian outcome, displacement should be understood as a health systems event that can amplify secondary morbidity. In fragile settings, preparedness must prioritize health-protective sheltering, continuity of care, and coordinated referral mechanisms under conditions of disruption.
Minimally invasive vertical right axillary thoracotomy offers an excellent cosmetic and functional alternative to standard median sternotomy for congenital heart repairs in children. We report the steps taken and challenges involved in building an emerging programmes and outcomes in repairing diverse CHDs.
Materials and Methods:
We performed a retrospective review of the first 152 paediatric patients who underwent repair of selected CHDs using the minimal invasive vertical right axillary thoracotomy approach between April 2022 and December 2025 at our institution and outline our multi-disciplinary team-building protocol.
Results:
Pre-commencement protocolar team teaching was implicated 2 months prior to the first case, using information gained through a combination of surgical site visits abroad by the surgeons, protocolar experience exchange with foreign experts, and multimedia educational platforms. The median age was 4.9 years (range: 4 months–13 years), and median weight was 16 kg (6–41 kg). The median lengths of ICU stay and hospital stay were 1.2 and 4.6 days, respectively. No in-hospital deaths or conversions to median sternotomy occurred. No late deaths or reoperations occurred during a median follow-up of 16 months (range 5 months–4 years).
Discussion:
The minimal invasive vertical right axillary thoracotomy can be safely introduced for a broad spectrum of CHDs. Educating all team members is critical to achieving excellent outcomes in a short-time frame. This approach provides excellent cosmetic results with a small “hidden” scar and stands as a good alternative to median sternotomy in selected paediatric patients.
Blade-vortex interaction (BVI) is a significant aerodynamic phenomenon for rapidly developed electric vertical takeoff and landing aircraft, which generates high-amplitude noise when a rotor blade passes tip vortices. In this work, we experimentally investigate effects of vortex dynamics on rotor aeroacoustics during BVI in edgewise flows at a low Reynolds number (Re) range from $3.9\times 10^4$ to $1.0\times 10^5$, and over a practical advance ratio ($\mu$) range from 0 to 0.5, using anechoic wind tunnel tests. Thrust and power coefficients exhibit a linear relationship with $\mu$. The BVI process can be categorized into three flow regimes based on difference in vortex dynamics, each with distinct tonal and broadband noise characteristics. In regime 1 ($\mu \lt 0.1$), the interaction between the vortex and the blade boundary layer is dominant, with viscous effects on the blade surface, resulting in multiple harmonics tones over a wide frequency range. Amplitudes of high-order tones reduce with increasing $\mu$ due to downstream convection of small-scale turbulence. In regime 2 ($0.1\lt \mu \lt 0.23$), the blade interacts with the vortex shear layer, and the pressure gradient due to the leading edge becomes a primary factor during BVI. In regime 3 ($\mu \gt 0.23$), the blade directly passes through the vortex centre. Here, BVI-related tones at the middle frequency range further increase with increasing $\mu$, while spectra exhibit a broadband nature at high frequencies. Across various flow regimes at low Re, the broadband noise can be scaled using the law of $\mu ^kM_{\mathit{tip}}^5$, where $k$ is a constant determined in different flow regimes and $M_{\mathit{tip}}$ is the tip Mach number.
To develop a software application for planning and monitoring the nutritional content and cost of humanitarian food assistance, provided by food or cash transfers.
Design:
Development of software.
Setting:
Humanitarian emergencies
Subjects:
Food rations or cash transfers provided to beneficiaries
Results:
NutVal v5 is an Excel application for calculation of the macro and micronutrient content of food assistance, and comparison with the requirements of 14 different population groups, including the population averaged requirements, child and adult sub-groups, and people in detention. The criteria for nutrient inclusion and the calculation of population group requirements are presented. Market costs can be entered for calculation of a cash-transfer equivalent value and different food rations can be saved and compared over time.
Conclusions:
The NutVal application has been widely used by humanitarian organisations to plan and monitor food transfers. The enhancements in version 5 should allow for its continued use in food assistance programmes where cash and voucher transfers are increasingly common.
Our aim in this article is to establish new characterizations of hyperplanes in Euclidean space via mild constraints on the higher-order anisotropic mean curvatures of an immersed complete hypersurface. Our approach is based on the study of the behavior of the height and angle functions naturally attached to a hypersurface, jointly with the use of appropriate maximum principles dealing with the notions of convergence at infinity and polynomial volume growth. In this context, we also obtain lower estimates for the minimum anisotropic relative null index of an immersed complete hypersurface, which can be regarded as a measure of how close such a hypersurface is to being flat.
Understanding the American Revolution requires moving beyond a simple “Americans vs. Britain” narrative and viewing it within a global context. The conflict was part of a larger, global war between European colonial powers, which saw alliances formed based on international strategic interests rather than just a new nation’s ideals. As the United States approaches its 250th anniversary in July 2026, the question of who secured American independence from Britain is an important but complex one. Traditional narratives focus on patriots and George Washington, which is particularly misleading. The American Revolution would likely have failed without the support of a diverse coalition of nations and peoples. Its victory was fueled by assistance from French, Spanish, and other Europeans, Native Americans, and enslaved and free Black Americans. Acknowledging the financial and military contributions of European powers, the scouting, intelligence, and military power provided by members of Indigenous nations, and the manpower offered by Black Americans does not weaken the story of 1776. It strengthens it. After 250 years, it is time to learn about and embrace the whole story, with all its complexities. Doing so lends true meaning to the U.S.’s national motto: “Out of the many, one,” or E Pluribus Unum.
Flumioxazin is a preemergence herbicide that is widely used pretransplant on conventional sweetpotato hectarage as part of weed management programs in North Carolina; despite this, some growers have concerns that flumioxazin may be injurious to sweetpotato, even at recommended rates if rain falls near application. Thus, field studies were conducted in 2021 and 2022 in Clinton, North Carolina, to evaluate the performance of flumioxazin under several simulated rain conditions. Studies evaluated a complete factorial arrangement of treatments with three flumioxazin rates and three simulated rain treatments. Herbicide treatments included no herbicide, and two rates of flumioxazin (107 g ai ha−1 and 214 g ai ha−1). Irrigation treatments included 1.9 cm of simulated rain applied before flumioxazin, 1.9 cm applied after flumioxazin, and no simulated rain. No visual injury from herbicide or rain treatments was observed. Yields of No. 1 and marketable sweetpotatoes were reduced by 25% and 14%, and total yield was reduced by 11% when the higher rate flumioxazin (214 g ha−1) was applied compared to the no-herbicide treatment. However, the lower (registered) rate of flumioxazin (107 g ha−1) did not lead to a reduction in yield compared with yield from the no-herbicide treatment. No interactions between irrigation timing and herbicide were observed, and irrigation timing alone did not affect sweetpotato yield. Average length-width ratio (LWR) was calculated for No. 1 sweetpotato storage roots as a metric of root shape. In 2021, herbicide did not affect LWR. In 2022, compared with the no-herbicide treatment, the LWR of No. 1 sweetpotato was smaller after the higher rate of flumioxazin (214 g ha−1) was applied compared with LHR of the no-herbicide treatment, resulting in rounder sweetpotato roots. Flumioxazin applied at 107 g ha−1 did not reduce LWR compared with the no-herbicide treatment. The results of this study highlight both the safety of flumioxazin when applied at registered rates and the importance of appropriate application procedures to prevent overapplication.