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America is still a global force, says the Opinion columnist Carlos Lozada. But Trump’s desire to “wield superpowers” without behaving like a superpower is putting its reputation as a reliable leader for peace at risk.

On the Friday before Martin Luther King Jr. Day, Washington Post global opinions editor Karen Attiah will speak with Mayor Steven L. Reed, Montgomery, Ala., and Mayor Randall Woodfin, Birmingham, Ala. Their cities were central battlegrounds in the civil rights era. Reed and Woodfin are part of a new wave of Black mayors elected in Southern Black cities in the past decade. Tune in Friday, Jan. 15 at 11:00 a.m. ET, for a conversation about the arc of history and where we are today.

Abstract Background and aims The treatment benefit of thrombectomy vary across ischemic stroke patients. MR PREDICTS is an 11-variable clinical/imaging model, using last-seen-well (LSW) to-groin-puncture-time as one of its variables, to provide individualized treatment benefit predictions of thrombectomy in the early window (0-6 hours). However, its performance in the late window (6-24 hours) has not been tested. Moreover, for unknown stroke onset, first-noticed-symptoms (FNS) to-groin-puncture time may perform better than LSW. We aimed to externally validate MR PREDICTS in the late-treatment window and additionally compare its performance using FNS in place of LSW. Methods We used data from the MR CLEAN-LATE trial. Treatment benefit of thrombectomy was defined as the difference in probability of functional independence with and without thrombectomy (modified Rankin Scale (mRS) 0-2 at 90 days). Model performance was evaluated by discrimination and calibration. We additionally examined performance by replacing time-from-LSW-to-groin-puncture with FNS. Results MR PREDICTS yielded moderate discriminative power (C-statistic) 0.78(95%CI:0.73-0.83), but poor calibration in the late window (17% functional independence predicted versus 37% observed), indicating systematic underestimation of the treatment benefit. Using FNS-to-groin time (median: 265 minutes; IQR:185-437) instead of LSW (median:735 minutes; IQR:576-936), the C-statistic remained similar, while calibration improved substantially (33% functional independence predicted versus 37% observed). Using FNS-to-groin-puncture-time, median treatment benefit of thrombectomy is 8.0% (IQR: 3.1-12.9). Conclusions MR PREDICTS shows limited performance in late-presenting patients. Replacing LSW with FNS, substantially improved model performance, indicating that FNS time might be more accurate in guiding patient selection for thrombectomy in the late window. Conflict of interest Le Nguyen: nothing to disclose

President Trump listed a slew of misleading economic statistics during his annual State of the Union address on Feb. 5.

Celem artykułu jest ukazanie problematyki związanej z sakralizacją i desakralizacją przestrzeni w miastach, na przykładzie Krakowa i Lwowa. Przez setki lat były to miasta położone w obrębie Polski, doświadczone rozbiorami, a rozdzielone – w zakresie przynależności państwowej – po II wojnie światowej. Lwów włączono do ZSRR, zaś Kraków pozostał w Polsce. Po roku 1990 Lwów stał się jednym z ważniejszych miast niepodległego państwa ukraińskiego. Kilkadziesiąt lat socjalizmu w wydaniu radzieckim (Lwów) i w wydaniu PRL (Kraków) wpłynęło mocno na oblicze „uświęconych” przestrzeni, w tym powstawania nowych i dewastacji już istniejących. Analiza historii przestrzeni miejskich Krakowa i Lwowa wykazała, że zachodzi ciągły proces sakralizacji, desakralizacji i resakralizacji niektórych obszarów, w zależności od aktualnie obowiązującej ideologii bądź doktryny społeczno-politycznej czy religijnej. Jednocześnie, na przykład w Krakowie, istnieją na niejako miejsca „święte”, których nie naruszyły burzliwe zawieruchy dziejowe. Aby pokazać czym jest sacrum przestrzeni miejskich, autorzy podjęli próbę wypracowania naukowej metodyki wskazywania takich miejsc.The paper's objective is to shed light on the issue of sacralisation and desacralisation of space in cities with Kraków and Lviv as examples. The cities had been part of Poland for hundreds of years. They jointly suffered from the Partitions of Poland and were separated politically after the Second World War. Lviv joined the USSR and Kraków remained a Polish city. After 1990, Lviv became a major city of independent Ukraine. Several decades of Soviet (Lviv) socialism and Polish communist (Kraków) socialism have left a profound impression on their ‘sacred’ spaces, including the creation of new and the devastation of existing ones. The historical analysis of Kraków's and Lviv's urban spaces exhibited a continuous process of sacralisation, desacralisation, and sacralisation of some areas according to the current prevailing ideology or sociopolitical or religious doctrine. At the same time, a city, Kraków for example, can have certain ‘holy’ places that have remained unaffected by times of turmoil. To demonstrate what an urban sacred space is, the authors attempted to propose a scientific methodology for identifying such places.

ObjectiveTo develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR.MethodsThis international multidisciplinary initiative included four phases: (1) Phase I, criteria generation by surveys and literature review; (2) Phase II, criteria reduction by modified Delphi and nominal group technique exercises; (3) Phase III, criteria definition, further reduction with the guidance of real-world patient scenarios, and weighting via consensus-based multicriteria decision analysis, and threshold identification; and (4) Phase IV, validation using independent adjudicators’ consensus as the gold standard.ResultsThe 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody (aPL) test within 3 years of identification of an aPL-associated clinical criterion, followed by additive weighted criteria (score range 1–7 points each) clustered into six clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and two laboratory domains (lupus anticoagulant functional coagulation assays, and solid-phase enzyme-linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti–β2-glycoprotein I antibodies). Patients accumulating at least three points each from the clinical and laboratory domains are classified as having APS. In the validation cohort, the new APS criteria vs the 2006 revised Sapporo classification criteria had a specificity of 99% vs 86%, and a sensitivity of 84% vs 99%.ConclusionThese new ACR/EULAR APS classification criteria were developed using rigorous methodology with multidisciplinary international input. Hierarchically clustered, weighted, and risk-stratified criteria reflect the current thinking about APS, providing high specificity and a strong foundation for future APS research.

El presente artículo trata de ilustrar el concepto de ciudad entendido como espacio de significación implícito en las primeras propuestas teóricas urbanas de Juan Navarro Baldeweg al comienzo de su trayectoria, poniendo de manifiesto la relevancia de un nuevo modo intervención sobre la ciudad, alejada de metodologías de carácter formalista o funcionalista, que darían lugar a intervenciones menos legibles, pero que trataban de transcender al medio físico y dotar a un entorno urbano de cierta identidad y significación. En estas propuestas plantearía, en primer lugar, la incorporación al medio urbano de un sistema de símbolos o imágenes lo suficientemente variado como para representar en tiempo real procesos que podían tener lugar en el ámbito social. En segundo lugar, la generación de una estructura que permitía la participación voluntaria de los miembros de la comunidad en la conformación del espacio urbano. En tercer lugar, el desarrollo de sistemas artificiales autónomos que incorporaban procesos de retroalimentación, haciendo visibles a través de medios tecnológicos las relaciones entre la realidad física con la que se operaba y los símbolos que la dotaban de significación. Y por último, la superación de concepciones preestablecidas en las metodologías de intervención urbana a través de la apertura a una nueva semántica variada, dinámica y de carácter efímero.PALABRAS CLAVE: Navarro Baldeweg, ciudad, urbanismo, medio ambiente, comunicación e información.The present article tries to illustrate the concept of the city understood as a significant environment implicit in Juan Navarro Baldeweg’s first theoretical urban proposals developed during the first years of his professional career. It reveals the importance of a new way to intervene on the city far away from formal or functional methodologies that uses less legible interventions to go beyond the physical reality providing the urban environment of certain identity and significance. In all these proposals, first of all, he proposes adding the urban environment a system of symbols or images sufficiently varied to represent real time processes that could take place in the society. Secondly, the creation of a structure that allows the voluntary participation of the members of the community in the conformation of the urban space. Thirdly, the development of autonomous artificial systems that incorporates feedback, making visible through technology the relationships between the physical reality and the symbols that provides it with significance. And finally, the overcoming of pre-established conceptions in methodologies of urban intervention through the opening of a new, dynamic and ephemeral semantic.KEYWORDS: Navarro Baldeweg, city, urbanism, environment, communication and information