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Is Puerto Rico on the Verge of Becoming the 51st State?

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In the midst of Tuesday's mad rush of election news from all 50 states, one contest was largely lost in the shuffle: Puerto Rico's referendum on statehood, which could potentially make the Caribbean island and U.S. territory the 51st state in the union. Now that the ballots have been tallied, it's clear that a majority of Puerto Ricans favor full statehood. What's the next step for Puerto Rico and the U.S. government? Could Puerto Rico really become the 51st state? Here's what you should know.

First off: What makes a U.S. territory different than a state?

There are a number of things, but essentially, though Puerto Ricans are considered U.S. citizens, they lack representation in the Electoral College. Indeed, the closest thing Puerto Rico has to representation in the federal government is a non-voting "Resident Commissioner" seat in the House of Representatives, which is currently held by Pedro Pierluisi (D) — a position "that has as much influence as a court jester," says David Minsky at the Miami New Times.

When did this arrangement begin?

In 1917, when Puerto Ricans were officially recognized as U.S. citizens, almost 20 years after the United States military acquired the Caribbean island in the Spanish-American War. Since then, three referendums have been held — in 1967, 1993, and 1998 — but statehood has remained elusive.

So what exactly happened in Puerto Rico on Election Day?

A majority of Puerto Ricans voted in favor of becoming America's 51st state. In a two-part referendum, 53 percent of voters said they didn't want to continue Puerto Rico's current 114-year relationship with the United States. In the second part, which offered several alternatives to current U.S.-Puerto Rico ties, 65 percent of voters favored statehood, 31 percent favored sovereign free association, and 4 percent favored full independence.

Does that mean Puerto Rico is on its way to statehood?

Not necessarily. It's certainly a possible step in that direction — but "don't start trying to fit a 51st star onto the U.S. flag just yet," says Abby Ohlehieser at Slate. Both the Senate and the House of Representatives would need to approve Puerto Rico's statehood by a two-thirds majority, and though President Obama has said he would be open to the possibility of Puerto Rico joining the union, it's not clear if Tuesday's vote is enough to convince the White House to forcefully take up the issue.

Any other hurdles in the way?

Several. If the United States were to admit Puerto Rico into the union, the island would potentially be expected to embrace English as the universal language of understanding — a tall order for the reported 85 percent of Puerto Ricans who speak very little English. And Puerto Rico, which has been hit hard by the economic downturn, might be considered by politicians to be too much of a burden on the national treasury. Plus, Election Day offered a new challenge: Puerto Rico's pro-statehood governor Luis Fortuno appears to have lost his re-election bid to challenger Alejandro Garcia Padilla, an advocate of the island's current national status.

Sources: Miami New Times (2) (3)Slate (2)Deustche Welle

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Afternoon Map
From Snoopy to Shark Bait: The Top Slang Word in Each State
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There’s a minute, and then there’s a hot minute. Defined as “a longish amount of time,” this unit of time is familiar to Alabamians but may stir up confusion beyond the state’s borders.

It’s Louisianans, though, who feel the “most misunderstood,” according to the results of a survey regarding regional slang by PlayNJ. Of the Louisiana residents surveyed, 72 percent said their fellow Americans from other states—even neighboring ones—have a hard time grasping their lingo. Some learned the hard way that ordering a burger “dressed” (with lettuce, tomato, pickles, and mayo) isn’t universally understood, nor is the phrase “to pass a good time” (instead of “to have” a good time).

After surveying 2000 people (with proportional numbers from each state), PlayNJ created a map showing the top slang word in each state. Many are words that are unlikely to be understood beyond state lines, but others—like California’s bomb (something you really like) and New York’s deadass (to be completely serious)—have spread well beyond their respective borders thanks to memes and internet culture.

Hawaiians are also known for their distinctive slang words, with 71 percent reporting that words like shaka (hello) and poho (waste of time) are frequently misunderstood. Shark bait, one of the state’s more colorful terms, refers to tourists who are so pale that they attract sharks.

Check out the full list below and test your knowledge of regional slang words with PlayNJ’s online quiz.

A chart showing the top slang words in each state
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The Body
10 Facts About the Appendix
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Illustration by Mental Floss / Images: iStock

Despite some 500 years of study, the appendix might be one of the least understood structures in the human body. Here's what we know about this mysterious organ.

1. THE ANCIENT EGYPTIANS CALLED IT THE "WORM" OF THE BOWEL.

The human appendix is small, tube-shaped, and squishy, giving ancient Egyptians, who encountered it when preparing bodies for funerary rites, the impression of a worm. Even today, some medical texts refer to the organ as vermiform—Latin for "worm-like."

2. THE APPENDIX SHOWS UP IN LEONARDO DA VINCI’S DRAWINGS.

The earliest description of a human appendix was written by the Renaissance physician-anatomist Jacopo Berengario da Carpi in 1521. But before that, Leonardo da Vinci is believed to drawn the first depiction of the organ in his anatomical drawings in 1492. Leonardo claimed to have dissected 30 human corpses in his effort to understand the way the body worked from mechanical and physiological perspectives.

3. IT'S ABOUT THE SIZE OF A PINKY FINGER.

The appendix is a small pouch connected to the cecum—the beginning of the large intestine in the lower right-hand corner of your abdomen. The cecum’s job is to receive undigested food from the small intestine, absorb fluids and salts that remain after food is digested, and mix them with mucus for easier elimination; according to Mohamad Abouzeid, M.D., assistant professor and attending surgeon at NYU Langone Medical Center, the cecum and appendix have similar tissue structures.

4. CHARLES DARWIN THOUGHT IT WAS A VESTIGIAL ORGAN …

The appendix has an ill-deserved reputation as a vestigial organ—meaning that it allegedly evolved without a detectable function—and we can blame Charles Darwin for that. In the mid-19th century, the appendix had been identified only in humans and great apes. Darwin thought that our earlier ancestors ate mostly plants, and thus needed a large cecum in which to break down the tough fibers. He hypothesized that over time, apes and humans evolved to eat a more varied and easier-to-digest diet, and the cecum shrank accordingly. The appendix itself, Darwin believed, emerged from the folds of the wizened cecum without its own special purpose.

5. … BUT THE APPENDIX PROBABLY EVOLVED TO HELP IMMUNE FUNCTION.

The proximity and tissue similarities between the cecum and appendix suggest that the latter plays a part in the digestive process. But there’s one noticeable difference in the appendix that you can see only under a microscope. “[The appendix] has a high concentration of the immune cells within its walls,” Abouzeid tells Mental Floss.

Recent research into the appendix's connection to the immune system has suggested a few theories. In a 2015 study in Nature Immunology, Australian researchers discovered that a type of immune cells called innate lymphoid cells (ILCs) proliferate in the appendix and seem to encourage the repopulation of symbiotic bacteria in the gut. This action may help the gut recover from infections, which tend to wipe out fluids, nutrients, and good bacteria.

For a 2013 study examining the evolutionary rationale for the appendix in mammal species, researchers at Midwestern University and Duke University Medical Center concluded that the organ evolved at least 32 times among different lineages, but not in response to dietary or environmental factors.

The same researchers analyzed 533 mammal species for a 2017 study and found that those with appendices had more lymphatic (immune) tissue in the cecum. That suggests that the nearby appendix could serve as "a secondary immune organ," the researchers said in a statement. "Lymphatic tissue can also stimulate growth of some types of beneficial gut bacteria, providing further evidence that the appendix may serve as a 'safe house' for helpful gut bacteria." This good bacteria may help to replenish healthy flora in the gut after infection or illness.

6. ABOUT 7 PERCENT OF AMERICANS WILL GET APPENDICITIS DURING THEIR LIFETIMES.

For such a tiny organ, the appendix gets infected easily. According to Abouzeid, appendicitis occurs when the appendix gets plugged by hardened feces (called a fecalith or appendicolith), too much mucus, or the buildup of immune cells after a viral or bacterial infection. In the United States, the lifetime risk of getting appendicitis is one in 15, and incidence in newly developed countries is rising. It's most common in young adults, and most dangerous in the elderly.

When infected, the appendix swells up as pus fills its interior cavity. It can grow several times larger than its average 3-inch size: One inflamed appendix removed from a British man in 2004 measured just over 8 inches, while another specimen, reported in 2007 in the Journal of Clinical Pathology, measured 8.6 inches. People with appendicitis might feel generalized pain around the bellybutton that localizes on the right side of the abdomen, and experience nausea or vomiting, fever, or body aches. Some people also get diarrhea.

7. APPENDECTOMIES ARE ALMOST 100 PERCENT EFFECTIVE FOR TREATING APPENDICITIS.

Treatment for appendicitis can go two ways: appendectomy, a.k.a. surgical removal of the appendix, or a first line of antibiotics to treat the underlying infection. Appendectomies are more than 99 percent effective against recurring infection, since the organ itself is removed. (There have been cases of "stump appendicitis," where an incompletely removed appendix becomes infected, which often require further surgery.)

Studies show that antibiotics produce about a 72 percent initial success rate. “However, if you follow these patients out for about a year, they often get recurrent appendicitis,” Abouzeid says. One 2017 study in the World Journal of Surgery followed 710 appendicitis patients for a year after antibiotic treatment and found a 26.5 percent recurrence rate for subsequent infections.

8. AN INFECTED APPENDIX DOESN’T ACTUALLY BURST.

You might imagine a ruptured appendix, known formally as a perforation, being akin to the "chestbuster" scene in Alien. Abouzeid says it's not quite that dramatic, though it can be dangerous. When the appendix gets clogged, pressure builds inside the cavity of the appendix, called the lumen. That chokes off blood supply to certain tissues. “The tissue dies off and falls apart, and you get perforation,” Abouzeid says. But rather than exploding, the organ leaks fluids that can infect other tissues.

A burst appendix is a medical emergency. Sometimes the body can contain the infection in an abscess, Abouzeid says, which may be identified through CT scans or X-rays and treated with IV antibiotics. But if the infection is left untreated, it can spread to other parts of the abdomen, a serious condition called peritonitis. At that point, the infection can become life-threatening.

9. SURGEONS CAN REMOVE AN APPENDIX THROUGH A TINY INCISION.

In 1894, Charles McBurney, a surgeon at New York's Roosevelt Hospital, popularized an open-cavity, muscle-splitting technique [PDF] to remove an infected appendix, which is now called an open appendectomy. Surgeons continued to use McBurney's method until the advent of laparoscopic surgery, a less invasive method in which the doctor makes small cuts in the patient's abdomen and threads a thin tube with a camera and surgical tools into the incisions. The appendix is removed through one of those incisions, which are usually less than an inch in length.

The first laparoscopic appendectomies were performed by German physician Kurt Semm in the early 1980s. Since then, laparoscopic appendectomies have become the standard treatment for uncomplicated appendicitis. For more serious infections, open appendectomies are still performed.

10. AN APPENDIX ONCE POSTPONED A ROYAL CORONATION.

When the future King Edward VII of Great Britain came down with appendicitis (or "perityphlitis," as it was called back then) in June 1902, mortality rates for the disease were as high as 26 percent. It was about two weeks before his scheduled coronation on June 26, 1902, and Edward resisted having an appendectomy, which was then a relatively new procedure. But surgeon and appendicitis expert Frederick Treves made clear that Edward would probably die without it. Treves drained Edward's infected abscess, without removing the organ, at Buckingham Palace; Edward recovered and was crowned on August 9, 1902.

11. THE WORLD'S LONGEST APPENDIX MEASURED MORE THAN 10 INCHES.

On August 26, 2006, during an autopsy at a Zagreb, Croatia hospital, surgeons obtained a 10.24-inch appendix from 72-year-old Safranco August. The deceased currently holds the Guinness World Record for "largest appendix removed."

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