Academic literature on the topic 'Mall, The (Washington, D.C.) – History'

Introduction: Venous thromboembolism (VTE) is a common cause of morbidity and mortality among patients with multiple myeloma (MM). Thromboprophylaxis is a safe and effective way to decrease VTE in other high-risk populations. Recently, a clinical prediction model was developed to identify patients with newly diagnosed MM starting chemotherapy at highest risk of VTE. The model, IMPEDE VTE, found the following clinical risk factors for VTE: immunomodulatory drugs, body mass index, recent pathologic fracture of the femur or hip, erythropoietin stimulating drugs, dexamethasone, doxorubicin, Asian ethnicity/race, history of VTE, tunneled line or central venous catheter, and existing use of aspirin or anticoagulation. External validation of the model has yielded a c-statistic for VTE risk prediction of 0.64 to 0.65. Laboratory parameters can predict VTE in some patients with cancer. Accordingly so, the addition of laboratory parameters to IMPEDE VTE has the ability to improve model performance. Thus, we sought to determine the association between soluble P-selectin and D-dimer with the development of VTE in patients with newly diagnosed MM starting chemotherapy. Methods: We identified 545 patients from the Washington University in St. Louis MM banking protocol, with available plasma from time of diagnosis (2007-2019). Thirty-eight cases of VTE were identified within 6 months following treatment initiation. An additional 137 patients were randomly selected as controls. D-dimer and soluble P-selectin ELISA assays were performed on the banked plasma by Eve Technologies, who was blinded to case vs. control status. Both assays were performed in duplicate and results averaged. All additional variables were collected through manual chart abstraction. IMPEDE VTE scores were calculated as we previously described (Sanfilippo et al.). The association of D-dimer and soluble P-selectin with VTE risk was assessed using Cox regression, adjusting for IMPEDE VTE score. Results: The median age of all 545 patients was 65 (range 32-79), 54% were male, and 85% were white. All patients received novel chemotherapy agents for first-line MM therapy and 66% underwent autologous stem cell transplant. Of the 38 cases with VTE, 20 patients had deep vein thrombosis, 17 had pulmonary emboli, and 1 patient had concurrent events. The median time from chemotherapy initiation to VTE was 51 days (range 4-193). The median IMPEDE VTE score was 5 (range -1 to 12). Each unit increase in IMPEDE VTE score was associated with a 21% increase in risk for VTE (HR 1.21; 95% CI 1.04-1.40; p = 0.01). Median D-dimer was 11,795 ng/mL (range 280-144,832). Each 1000 ng/mL unit increase in D-dimer was associated with a 2% increase risk for VTE after controlling for IMPEDE VTE score (aHR 1.02; 95% CI 1.01-1.04; p < 0.001). Patients in the highest quartile of D-dimer levels, above the 75th percentile, had a 2-fold increase in risk of VTE after adjusting for IMPEDE VTE score (aHR 2.04; 95% CI 1.03-4.02; p = 0.04). Median soluble P-selectin was 189 ng/ml (range 23-638). There was no association between soluble P-selectin level and VTE risk in patients with MM. Conclusions and Relevance: D-dimer is predictive of VTE in patients with MM starting chemotherapy. The combination of D-dimer and the IMPEDE VTE score can improve identification of patients at high risk of VTE and therefore allow for selection of primary thromboprophylaxis among patients with MM. Disclosures Sanfilippo: Bayer HealthCare Pharamceuticals: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Other: Travel Support for Investigator Meeting; Pfizer: Membership on an entity's Board of Directors or advisory committees; Covington & Burling LLP: Consultancy; Luther & Associates: Consultancy; Health Services Advisory Group: Consultancy; Amgen: Other: Trasfer of Value (food) during discussion of research.

Abstract Abstract 4143 Introduction: The use of vitamins and dietary supplements is a common health practice in many parts of the world, in part because of the belief that they will prevent diseases, including cancer. However, results of epidemiologic studies regarding their efficacy in reducing the risk of any cancer, particularly hematologic malignancies, are inconsistent and are mostly limited to case-control studies. Materials: Participants were male and female members of the VITamins And Lifestyle (VITAL) cohort. Between 2000 and 2002, 64,839 men and women, aged 50 to 76 years, who lived in the region of Washington State covered by the Surveillance, Epidemiology, and End Results (SEER) registry, were recruited. Participants were excluded if they had any cancer prior to baseline other than non-melanoma skin cancer and were censored at the time of diagnosis of a non-hematologic malignancy during follow-up; after exclusions, there were 64,839 participants available for study. Incident cases of hematologic malignancies were identified through December 2008 by linkage to the SEER registry. Participants answered questions on the frequency (days/week), duration (years), and dose per day of their supplemental use of vitamins, including A, B3, B6, B12, C, D, E, multivitamin compounds, and folic acid; minerals, including calcium, selenium, iron, magnesium, chrome, and zinc during the 10 years before baseline. For the non-vitamin, non-mineral “specialty” supplements, garlic, ginseng, and fish oil, only frequency and duration were ascertained. Use of vitamin and mineral supplements was categorized into non-users and tertiles of use, such that the highest category was greater than could be achieved only by use of a common multivitamin (Centrum Silver). 10-year average use of specialty supplements was categorized into: non-user; low use, <4 days/week or <3 years; and high use, ≥4 days/week and ≥3 years. Multivariable-adjusted Cox proportional hazards models were used to estimate hazards ratios (HR) and 95% confidence intervals (95% CI) of the use of dietary supplements with the risk of total hematologic malignancies. Models were adjusted for age, sex, race/ethnicity (white/hispanic/other), education, smoking, self-rated health, physical activity, history of anemia in the year before baseline, and family history of leukemia or lymphoma. Results: A total of 577 case of hematological malignancies were identified including MDS [n=54], AML [n=36], myeloproliferative disorders [n=46], CLL/SLL [n=88] and other non-Hodgkin lymphomas [n=235], Hodgkin lymphomas [n=22], plasma cell disorders [n=66], mature NK/T cell neoplasms [n=17], and other entities [n=13]). None of the vitamin 10-year average intakes were associated with decreased risk of incident hematologic malignancies There was no evidence that high use of vitamins A (HR=0.79, 95% CI: 0.58–1.08; p-trend=0.28), B12 (HR=0.98, 95%CI: 0.73–1.31; p-trend=0.26), C (HR=0.97, 95% CI: 0.77–1.22; p-trend=0.99), D (HR=0.90, 95% CI: 0.62–1.31; p-trend=0.45), or folic acid (HR=1.00, 95% CI: 0.73–1.39; p-trend=0.19) was associated with the risk of blood cancer. Among specialty supplements, only high 10-year average use of garlic was significantly associated with a reduced risk of development of blood cancers (HR=0.64,95% CI: 0.42–0.98); however the association was not linear (p-trend=0.14). Conclusions: We observed no reduction in the risk of incident hematologic malignancies with dietary supplement and vitamin use with the exception of garlic when used at a high amount (≥4 days/week for ≥ 3 years). Disclosures: No relevant conflicts of interest to declare.

Approximately 600 elms on the National Mall in Washington D. C. were surveyed for 6 years for symptoms of bacterial leaf scorch caused by Xylella fastidiosa. The mean disease incidence over the course of the study was 30% and increased by approximately 10% over 6 years. Twenty-eight percent of the affected trees had symptoms in more than 25% of their crowns. Symptom severity fluctuated from year to year. Of the trees first detected with symptoms in 1986 only 18% had a higher symptom rating after 6 years, while 51 % had fewer or no symptoms. Trees 20-30 cm dbh were the most affected, while those in the 1-10 cm class were the least affected. Affected trees occurred throughout the planting.

During the 1930s the neighborhood shopping center emerged as an important phenomenon in the development of retail facilities in the United States. Prior to that decade, the type was limited to a modest number of examples built as components of planned residential subdivisions for the well-to-do. By the eve of World War II, the neighborhood shopping center was seen as an advantageous means of meeting the routine needs of people in outlying urban areas generally. During the 1930s, the neighborhood center also became one of the first common building forms to experience a basic reconfiguration to accommodate patterns of widespread automobile usage. Washington, D. C., was the initial and by far the most intensive proving ground for this work at its formative stage. The results were influential nationwide in the shopping center's transformation from a novelty to a ubiquitous feature of the American landscape.

Pendant la Seconde Guerre mondiale, la capitale étatsunienne connaît une croissance sans précédent et acquiert une position incontestée de quartier général des Alliés. La Washington de 1945 n'a plus rien à voir avec le paysage urbain peuplé mais somnolent de 1939. Suite à la guerre, que va-t-il advenir du District de Columbia ? Nombre d'acteurs de différents types et niveaux veulent avoir leur mot à dire dans le futur de la capitale. La plupart d'entre eux espèrent utiliser la ville pour promouvoir des intérêts particuliers.Au cours des années d'après-guerre, le District est le théâtre de nombreuses joutes symboliques, qui voient s'affronter l'ensemble des acteurs politiques, économiques et sociaux du pays. Les enjeux sont locaux, nationaux ou internationaux, ils concernent l'administration locale, le droit de vote, la ségrégation, les conditions de logement, etc., ils rejaillissent sur Washington à la fois en tant que ville-symbole et que ville habitée. Ces affrontements et leurs résultats incarnent la capitale et dessinent son futur tout à la fois. Nous étudions ici pourquoi et comment ces évolutions se produisent. Le combat pour l'égalité entre Noirs et Blancs dans le District, par exemple, ouvre la voie à des progrès sur le plan national. La lutte contre les taudis se déroule dans le cadre des programmes de redéveloppement urbain souvent associés au déclin des centres-villes. La lutte pour l'autodétermination et les efforts fournis pour développer les rôles national et international de Washington sont d'autres exemples des dynamiques à l'œuvre dans la capitale entre 1945 et 1955. Après une première partie consacrée à la situation dans le District à la fin de la guerre, afin d'exposer les enjeux qui se posent en 1945, nous examinons les spécificités et implications de son rôle de capitale, tant sur le plan national que sur le plan international. La troisième partie porte sur les évolutions urbaines et sociales dans la ville d'après-guerre.