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The article discusses the Doolittle Raid that was an air raid by the U.S. in Japan with the aim to boost American morale. It reflects on the order made by U.S. President Franklin D. Roosevelt after the Japanese attack on Hawaii on December 7, 1941 to strike back at Japan. It notes that the Doolittle Raid was led by Navy captain Francis Low and Lieutenant Colonel Jimmy Doolittle who was a famous pre-ware military test pilot, civilian aviator, and aeronautical engineer.

U.S. exceptionalism informs most scholarship about early twentieth century U.S.- Japan relations, in that Japan is at least tacitly accepted as antithetical to the Wilsonian promotion of democracy against authoritarian imperialism. Reliance on a restrictive wartime binary, however, distorts the complex U.S. and Japanese political dynamics of the time, and obscures the limits of a Wilsonian democratic peace. Though Japan engaged in empire-building, its political system was pluralistic, and Japanese, like many people across the globe, were negotiating the growth of participatory government prior to the "Wilsonian Moment" of the late 1910s. The exceptionalist definition of democracy embraced by Americans marginalized non-European nations like Japan and implicitly advocated U.S. hegemony. The boundaries of contemporary U.S. political discourse permitted Woodrow Wilson's domestic opponents to depict such justifiable compromises with Japan as the Shandong cession as the appeasement of autocrats. Japanese interactions with the administration over immigration in 1913 and racial equality in 1919, moreover, highlight the centrality of white supremacism to Wilsonianism, especially when analyzed alongside African American appraisals. These examples challenge the innovativeness of a proposed Wilsonian world order that protected U.S. unilateralism, exclusive definitions of democracy, and racial segregation. [ABSTRACT FROM AUTHOR]

Biosimilar filgrastims are primarily indicated for chemotherapy-induced neutropenia prevention. They are less expensive formulations of branded filgrastim, and biosimilar filgrastim was the first biosimilar oncology drug administered in European Union (EU) countries, Japan, and the U.S. Fourteen biosimilar filgrastims have been marketed in EU countries, Japan, the U.S., and Canada since 2008, 2012, 2015, and 2016, respectively. We reviewed experiences and policies for biosimilar filgrastim markets in EU countries and Japan, where uptake has been rapid, and in the U.S. and Canada, where experience is rapidly emerging. U.S. regulations for designating biosimilar interchangeability are under development, and such regulations have not been developed in most other countries. Pharmaceutical substitution is allowed for new filgrastim starts in some EU countries and in Canada, but not Japan and the U.S. In EU countries, biosimilar adoption is facilitated with favorable hospital tender offers. U.S. adoption is reportedly 24%, while the second filgrastim biosimilar is priced 30% lower than branded filgrastim and 20% lower than the first biosimilar filgrastim approved by the U.S. Food and Drug Administration. Utilization is about 60% in EU countries, where biosimilar filgrastim is marketed at a 30%-40% discount. In Japan, biosimilar filgrastim utilization is 45%, primarily because of 35% discounts negotiated by Central Insurance and hospital-only markets. Overall, biosimilar filgrastim adoption barriers are small in many EU countries and Japan and are diminishing in Canada in the U.S. Policies facilitating improved U.S. adoption of biosimilar filgrastim, based on positive experiences in EU countries and Japan, including favorable insurance coverage; larger price discount relative to reference filgrastim pricing; closing of the "rebate trap" with transparent pricing information; formal educational efforts of patients, physicians, caregivers, and providers; and allowance of pharmaceutical substitution of biosimilar versus reference filgrastim, should be considered. IMPLICATIONS FOR PRACTICE: We reviewed experiences and policies for biosimilar filgrastims in Europe, Japan, Canada, and the U.S. Postmarketing harmonization of regulatory policies for biosimilar filgrastims has not occurred. Acceptance of biosimilar filgrastims for branded filgrastim, increasing in the U.S. and in Canada, is commonplace in Japan and Europe. In the U.S., some factors, accepted in Europe or Japan, could improve uptake, including acceptance of biosimilars as safe and effective; larger cost savings, decreasing "rebate traps" where pharmaceutical benefit managers support branded filgrastim, decreased use of patent litigation/challenges, and allowing pharmacists to routinely substitute biosimilar for branded filgrastim., Competing Interests: Disclosures of potential conflicts of interest may be found at the end of this article., (© AlphaMed Press 2019.)