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\"Upon signing the first U.S. arms agreement with Israel in 1962, John F. Kennedy assured Golda Meir that the United States had \"a special relationship with Israel in the Middle East,\" comparable only to that of the United States with Britain. After more than five decades such a statement might seem incontrovertible--and yet its meaning has been fiercely contested from the first. A Shadow over Palestine brings a new, deeply informed, and transnational perspective to the decades and the cultural forces that have shaped sharply differing ideas of Israel's standing with the United States--right up to the violent divisions of our day. Focusing on the period from 1960 to 1985, author Keith P. Feldman reveals the centrality of Israel and Palestine in postwar U.S. imperial culture. Some representations of the region were used to manufacture \"commonsense\" racial ideologies underwriting the conviction that liberal democracy must coexist with racialized conditions of segregation, border policing, poverty, and the repression of dissent. Others animated vital critiques of these conditions, often forging robust if historically obscured border-crossing alternatives. In this rich cultural history of the period, Feldman deftly analyzes how artists, intellectuals, and organizations--from the United Nations, the Black Panther Party, and the Association of Arab American University Graduates to James Baldwin, Daniel Patrick Moynihan, Edward Said, and June Jordan--linked the unfulfilled promise of liberal democracy in the United States with the perpetuation of settler democracy in Israel and the possibility of Palestine's decolonization. In one of his last essays, published in 2003, Edward Said wrote, \"In America, Palestine and Israel are regarded as local, not foreign policy, matters.\" A Shadow over Palestine maps the jagged terrain on which this came to be, amid a wealth of robust alternatives, and the undeterred violence at home and abroad that has been unleashed as a result of this special relationship. \"-- Provided by publisher.

Documentation of adverse drug reactions (ADRs) is a key factor in guiding future prescribing. However, incomplete documentation is common and often fails to distinguish implicated drugs as true allergies. This in turn leads to unnecessary avoidance of implicated drug classes and may result in sub-optimal prescribing. Pharmacovigilance (PV) programs utilize a systematic approach to clarify ADR documentation and are known to improve patient safety. Yet it remains unclear if PV alters prescribing. Or, if the existence of the ADR documentation itself continues to prompt avoidance of implicated drugs. To address this, our work presents a retrospective cohort study assessing if clarification of antibiotic ADRs by a hospital-wide PV team was associated with future, safe, re-prescribing at a freestanding pediatric hospital in the midwestern United States. First, we compared the likelihood of future prescribing in an antibiotic class with an active ADR, as compared to alternative drug classes, between PV-clarified and non-clarified patients. Second, we assessed differences in adverse event rates 30-days after future prescribing based on PV clarification status. For robustness, analyses were performed on patients with ADRs in four antibiotic classes: penicillin-based beta-lactams (n = 45,642), sulfonamides/trimethoprim (n = 5,329), macrolides (n = 3,959), and glycopeptides (n = 622). Results illustrate that clarification of an ADR by PV was associated with an increased odds of future prescribing in the same drug class (Odds Ratio [95%-CI]): penicillin-based beta-lactams (1.59 [1.36–1.89]), sulfonamides/trimethoprim (2.29 [0.89–4.91]), macrolides (0.77 [0.33–1.61]), and glycopeptide (1.85 [1.12–3.20]). Notably, patients clarified by PV experienced no increase in the rate of adverse events within 30-days following the prescribing of antibiotics in the same class as an active ADR. Overall, this study provides strong evidence that PV reviews safely increase the rate of re-prescribing antibiotics even in the presence of an existing implicated drug ADR.

The relationship between the Naranjo scaling system and pediatric adverse drug reactions (ADR) is poorly understood. We performed a retrospective review of 1,676 pediatric ADRs documented at our hospital from 2014–2018. We evaluated patient demographics, implicated medication, ADR severity, calculated Naranjo score, associated symptoms, and location within the hospital in which the ADR was documented. ADR severity was poorly correlated with Naranjo interpretation. Out of the 10 Naranjo scale questions, 4 had a response of “unknown” greater than 85% of the time. Cardiovascular and oncological/immunologic agents were more likely to have a probable or definite Naranjo interpretation compared to antimicrobials. Further strategies are needed to enhance the causality assessment of pediatric ADRs in clinical care.

Background Known colloquially as the “weekend effect,” the association between weekend admissions and increased mortality within hospital settings has become a highly contested topic over the last two decades. Drawing interest from practitioners and researchers alike, a sundry of works have emerged arguing for and against the presence of the effect across various patient cohorts. However, it has become evident that simply studying population characteristics is insufficient for understanding how the effect manifests. Rather, to truly understand the effect, investigations into its underlying factors must be considered. As such, the work presented in this manuscript serves to address this consideration by moving beyond identification of patient cohorts to examining the role of ICU performance. Methods Employing a comprehensive, publicly available database of electronic medical records (EMR), we began by utilizing multiple logistic regression to identify and isolate a specific cohort in which the weekend effect was present. Next, we leveraged the highly detailed nature of the EMR to evaluate ICU performance using well-established ICU quality scorecards to assess differences in clinical factors among patients admitted to an ICU on the weekend versus weekday. Results Our results demonstrate the weekend effect to be most prevalent among emergency surgery patients (OR 1.53; 95% CI 1.19, 1.96), specifically those diagnosed with circulatory diseases ( P <.001). Differences between weekday and weekend admissions for this cohort included a variety of clinical factors such as ventilatory support and night-time discharges. Conclusions This work reinforces the importance of accounting for differences in clinical factors as well as patient cohorts in studies investigating the weekend effect.

Emerging evidence implicates common genetic variation - aggregated into polygenic scores (PGS) - in the onset and phenotypic presentation of rare diseases. Here, we comprehensively map individual polygenic liability for 1102 open-source PGS in a cohort of 3059 probands enrolled in the Genomic Answers for Kids (GA4K) rare disease study, revealing widespread associations between rare disease phenotypes and PGSs for common complex diseases and traits, blood protein levels, and brain and other organ morphological measurements. Using this resource, we demonstrate increased polygenic liability in probands with an inherited candidate disease variant (VUS) compared to unaffected carrier parents. Further, we show an enrichment for large-effect rare variants in putative core PGS genes for associated complex traits. Overall, our study supports and expands on previous findings of complex trait associations in rare diseases, implicates polygenic liability as a potential mechanism underlying variable penetrance of candidate causal variants, and provides a framework for identifying novel candidate rare disease genes. Polygenic scores aggregate the effects of common genetic variants and have been shown to underly certain rare diseases. Here, the authors conduct a large-scale association analysis of rare disease phenotypes and open-source polygenic scores and apply this information to rare variant interpretation and disease gene discovery

This introductory essay considers the critical purchase of “relationality” in current scholarly debates in Comparative Ethnic Studies and Comparative Literature. It foregrounds Blackness and/as incommensurability as they are treated in these fields' distinct and overlapping institutional locations, historical developments, and epistemic investments.

From medication usage to the time of day, a number of external factors are known to alter human body temperature (BT), even in the absence of underlying pathology. In select cases, clinical guidance already suggests the consideration of clinical and demographic factors when interpreting BT, such as a decreased threshold for fever as age increases. Recent work has indicated factors impacting BT extend to environmental conditions including ambient temperature. However, the effect sizes of these relationships are often small, and it remains unclear if such relationships result in a meaningful impact on real-world health care practices. Temperature remains a common element in public health screening efforts. Leveraging the unique testing and reporting infrastructure developed around the COVID-19 pandemic, this paper uses a unique resource of daily-level statewide testing data to assess the relationship between ambient temperatures and positivity rates. As fever was a primary symptom that triggered diagnostic testing for COVID-19, this work hypothesizes that environmentally mediated BT increases would not reflect pathology, leading to decreased COVID-19 test positivity rates as temperature rises. Statewide COVID-19 polymerase chain reaction testing data curated by the California Department of Public Health were used to obtain the daily number of total tests and positivity rates for all counties across the state. These data were combined with ambient temperature data provided by the National Centers for Environmental Information for a period of 133 days between widespread testing availability and vaccine approval. A mixed-effects beta-regression model was used to estimate daily COVID-19 test positivity rate as a function of ambient temperature, population, and estimates of COVID prevalence, with nested random effects for a day of the week within unique counties across the state. Considering over 19 million tests performed over 4 months and across 45 distinct counties, adjusted model results highlighted a significant negative association between daily ambient temperature and testing positivity rate (P<.001). Results of the model are strengthened as, using the same testing data, this relationship was not present in a sensitivity analysis using random daily temperatures drawn from the range of observed values (P=.52). These results support the underlying hypothesis and demonstrate the relationship between environmental factors and BT can impact an essential public health activity. As health care continues to operate using thresholds of BT as anchor points (ie, ≥100.4 as fever) it is increasingly important to develop approaches to integrate the array of factors known to influence BT measurement. Moreover, as weather data are not often readily available in the same systems as patient data, these findings present a compelling case for future research into when and how environmental context can best be used to improve the interpretation of patient data.

I've had Nina Simone's “sinnerman” on repeat for months. The propulsive force of Simone's 1965 live version of this gospel song drives its ten-minute ferocity straight into the contemporary American zeitgeist. As she tells her audience in the lead-up to a lesser-known performance of the song, recorded in 1961, Simone learned “Sinnerman” when she was a “little bitty girl in revival meetings. It happened when my mother and lots more like her tried to save souls.” The song's judgment-day tale of redemption's refusal is told doubly, both by the sinner—“I cried rock / don't you see I need you, rock”—and by those from whom the sinner begs, if not forgiveness, then simply some measure of mercy from the divine justice to come: “Oh sinnerman, where you gonna run to?” The break in the middle of the 1965 recording strips the song down to Simone's handclaps on the second and fourth beats. All that remains is the tenuous intensity of the time neither of redemption nor of damnation but merely of “accompaniment” in the in-between (Tomlinson and Lipsitz). Called forth from that time, in all of Simone's live recordings, and missing from those of Les Baxter or the Weavers just a few years earlier, comes the insurgent cry for “Power!” over and over, to the point of near exhaustion.