Shaping the Security Environment

Newport Paper No. 29, Shaping the Security Environment, edited by Derek S. Reveron, makes an important contribution to an unfolding debate on the global role of U.S. military forces in an era of transnational terrorism, failed or failing states, and globalization. Reveron, professor of national security decision making at the Naval War College, looks beyond the current conflicts in which the United States is involved to raise fundamental questions concerning the regional diplomatic roles of America’s combatant commanders (COCOMs) and, more generally, the entire array of non-warfighting functions that have become an increasingly important part of the day-to-day life of the American military as it engages a variety of partners or potential partners around the world.https://digital-commons.usnwc.edu/usnwc-newport-papers/1027/thumbnail.jp

Review Essay

Spurred by the 9/11 terrorist attacks, the poor analysis of Iraq’s weapons of mass destruction programs, and numerous studies, the Intelligence Reform and Ter- rorism Prevention Act of 2004 created the Office of Director of National Intelli- gence (ODNI). Run by former ambassador John Negroponte, ODNI is an independent agency meant to oversee U.S. government intelligence activities and to transform the American intelligence commu- nity

The “cushion effect” revisited:

Background: It is known the pattern and severity of injuries sustained during a motor vehicle accident depend on many variables. An interesting avenue for research is obesity as a positive or negative modifier for injury distribution patterns in MVA. We hypothesize that body mass index (BMI) will influence MVC related injury patterns. Methods: We queried STRAC data for DHR - Edinburg for the years 2014 to 2018 using CPT codes for MVC/MVA, IS \u3e 8, age 15 - 64. Interactions between injury location, BMI, seatbelt and gender were analyzed. Results: We had 191 detailed crashes, we found increasing age to be protective for abdomen and pelvis (OR .94), increasing BMI to be predisposing for extremity injuries (OR 1.06) and increasing BMI and female gender together to be protecting for head and neck injury (OR .98). Patient without abdominal injuries were younger with lower BMI. However sample size small (46). Conclusion: BMI seems to have an exacerbating effect on extremity injuries and a protective effect for head and neck injuries driven predominantly by females. We believe this likely due to increase in momentum effect of each appendage and a decrease in torque of neck. Age seems to be a protective and we believe this is primarily due to hormonal deposition of adipose tissue. Overall it remains important to maintain a high index of suspicion when dealing with MVC triage patients and treat each individually

Optimization-based framework for low-voltage grid reinforcement assessment under various levels of flexibility and coordination

The rapid electrification of residential heating and mobility sectors is expected to drive the existing distribution grid assets beyond their planned operating conditions. This change will also reveal new potentials through sector coupling, flexibilities, and the local exchange of decentralized generation. This paper thus presents an optimization framework for multi-modal energy systems at the low voltage (LV) distribution grid level. In this, we focus on the reinforcement requirements of the grid and the techno-economic assessment of flexibility components and coordination between agents. By employing a multi-level approach, computational complexity is reduced, and various levels of coordination and flexibilities are implemented. We conclude the work with a case study for a representative rural grid in Germany, in which we observe high economic potential in the flexible operation of buildings, majorly thanks to better integration of photovoltaics. Across all paradigms barring a best-case benchmark, grid reinforcement based on a mix of passive and active measures was necessary. A synergy effect is observed between flexibilities and coordination, as their combination reduces the peaks to the extent of completely avoiding grid reinforcement. The presented framework can be applied with a wide range of grid and component types to outline the broad landscape of future LV distribution grids

Complications and Comorbidities in Hispanic Patients Who Develop Traumatic and Nontraumatic Acute Compartment Syndrome

Acute compartment syndrome (ACS) is a medical emergency that remains under-recognized and understudied. This study aimed to identify risk factors for the traumatic and non-traumatic presentation of ACS within a majority Hispanic population. A four-year retrospective analysis of medical records in a single institution revealed 26 with traumatic and 21 non-traumatic patients presenting with ACS. Traumatic ACS occurred in younger males following fractures, as previously described in the field. After controlling for age differences, non-traumatic ACS occurred in older patients with multiple comorbidities, increased use of statins, and anticoagulants as compared to the traumatic ACS group. A large proportion (80%) of the nontraumatic ACS group also presented with hypertension. Patients taking anticoagulants and statins should be carefully monitored for ACS development after non-traumatic qualifying events and advanced age. Further studies should identify how statins interact with the patients\u27 racial/ethnic profile and the incidence of comorbidities to promote earlier identification and reduce morbidities

A Venezuelan anatomist cited in the human anatomy treatise Testut-Latarjet

Le traité d'anatomie Testut-Latarjet (The human anatomy Testut-Latarjet treatise) published in 1887, is considered one of the most complete on human anatomy, with detailed descriptions of the human body and anthropological concepts, accompanied by philosophical and anthropological concepts. This anatomy treatise is still a very useful teaching tool in many Latin American and European Medical Faculties. In 1902, this anatomical treatise won the Saintour Prize, awarded by the French Academy of Medicine and since 1910 it has been translated into Spanish, Italian, German and other languages. The Testut-Latarjet treatise on human anatomy consists of four volumes with a total of 4,935 pages in its 1960 Spanish edition, as well as 4,144 highly detailed illustrations in color. The 1960 Spanish edition of Testut-Latarjet treatise in its volume IV included a citing of the doctoral thesis: El elemento nervioso en el apendice libre. Sus aplicaciones quirurgicas (External innervation of the cecal appendix: its surgical applications) written in 1943 by Rubén Rodríguez Escovar, M. D., a Venezuelan anatomist and surgeon, who held the Department of Human Anatomy at the Universidad Central de Venezuela, distinguishing himself as teacher and researcher over a period of 40 years. Certainly, Rubén Rodriguez Escovar is not in the greatest group of prominent anatomists mentioned in the Treatise. Nevertheless, on merit alone for his research about meso-appendicular region’s innervations, he was cited into Testut-Latarjet‘s treatise. As far as the present author knows, Rubén Rodriguez Escovar is the sole Non-European anatomist to be mentioned in the outstanding Testut-Latarjet Human Anatomy Treatise

Theodor Kocher (1841-1917) and his outstanding contributions to surgery

Theodor Kocher (1841-1917), an exceptional Swiss surgeon who described a technique for the safe removal of enlarged thyroid unraveled the true function of this endocrine gland but also made significant contributions to many other fields of surgery. Kocher was the first surgeon awarded the Nobel prize in Physiology and Medicine in 1909 for his work on the physiology, pathology, and surgery of the thyroid gland. He was  professor and clinical director at Insel Hospital during 45 years. Kocher created the prominent Surgeon's School in Bern. He was the first president of the International Society of Surgery in 1903 and the founding president of the Swiss Society of Surgery in 1913