Legally Ill: Is the Federal Health Insurance Mandate Constitutional?

This article explores the constitutionality of the individual mandate of the health care reform bill known as the Patient Protection and Affordable Care Act, as well as the economic penalty that is assessed to those who do not meet the mandate. A brief history of prior health reform initiatives in the United States will be examined to provide a historical context for the current political debate regarding the currently instituted reforms. The legal justifications of the proponents for the mandate will be analyzed regarding their constitutionality, and the legal fate of the mandate will be examined. Lastly, this article will explore other potential health care reform alternatives that are constitutionally sound

Alien Registration- Karter, Bolus (Waterville, Kennebec County)

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The distribution and population structure of Aloe pillansii in South Africa, in relation to climate and elevation

South Africa comprises almost 10% of known plant species and also has the only arid zone "hotspot" defined worldwide, namely the succulent Karoo. Anthropogenic climate change predictions for South Africa suggest rapid climate change in the next 50 years will have adverse effects on its vegetation biomes. This study shows how the aborescent succulent, Aloe pillansii, has a limited distribution due significantly to environmental and climatic variables and therefore it is potentially at risk given anthropogenic climate change predictions. The total South African A. pillansii population investigated is made up of 1202 individuals and is found in the Richtersveld, which is part of the Succulent Karoo. The A. pillansii individuals were sampled in terms of their height and geographical position and then defined into subpopulations by a distance of 2 kms of separation. The sub-populations were then evaluated in terms of their respective environmental and climatic variables acquired from a CCWR database for South Africa using Arc View 3.2. The sub-population size class distributions were also constructed so that population dynamics and recruitment could be investigated. The results show how the A. pillansii sub-populations are limited to a specific environmental and climatic range. The sub-populations group along similar environmental and climatic variables with the healthiest sub-populations found at lower elevation, higher temperatures and higher Potential Evapo-Transpiration. The climatic range of A. pillansii is also evident from the range of its environmental and climatic variables and the associated unhealthy sub-populations that lie on the extremes of this range. Recruitment was found to correlate strongly with the environmental and climatic variables, % winter rainfall and elevation, suggesting it is moisture limited. The evidence found in this study of A. pillansii 's specific environmental and climatic distribution may have negative implications for its future survival and conservation especially with present indications of anthropogenic climate change

Radiographic and ultrasonographic evaluation of the esophagus in the horse

The purpose of this study was to describe the radiographic and ultrasonographic appearance of the esophagus of ten healthy horses. Contrast radiography showed variations in the long-axis shape of the esophagus at the thoracic inlet. Administration of a large volume contrast medium by intubation showed stasis of contrast material for several minutes in two of the ten horses. The wall thickness of the non-distended esophagus on ultrasound was 2.6 +/- 0.3 mm with significant differences depending on the location. Distention of the esophagus by intubation or by a bolus of water or concentrate resulted in a decrease in wall thickness and it facilitated measuring with less variation. Stasis at the thoracic inlet was seen in five of the ten horses, when a water bolus was administered. Ultrasonographic evaluation of 100g spontaneously swallowed commercial concentrate was better than fluid (water bolus or 2.5mL/kg contrast medium) administration via intubation to assess esophageal motility at the thoracic inlet. Stasis seen at the thoracic inlet after bolus administration by intubation should not be regarded as an abnormal finding, and swallowing, with the subsequent peristaltic wave, has a positive influence on the bolus passage time

A fully resolved active musculo-mechanical model for esophageal transport

Esophageal transport is a physiological process that mechanically transports an ingested food bolus from the pharynx to the stomach via the esophagus, a multi-layered muscular tube. This process involves interactions between the bolus, the esophagus, and the neurally coordinated activation of the esophageal muscles. In this work, we use an immersed boundary (IB) approach to simulate peristaltic transport in the esophagus. The bolus is treated as a viscous fluid that is actively transported by the muscular esophagus, which is modeled as an actively contracting, fiber-reinforced tube. A simplified version of our model is verified by comparison to an analytic solution to the tube dilation problem. Three different complex models of the multi-layered esophagus, which differ in their activation patterns and the layouts of the mucosal layers, are then extensively tested. To our knowledge, these simulations are the first of their kind to incorporate the bolus, the multi-layered esophagus tube, and muscle activation into an integrated model. Consistent with experimental observations, our simulations capture the pressure peak generated by the muscle activation pulse that travels along the bolus tail. These fully resolved simulations provide new insights into roles of the mucosal layers during bolus transport. In addition, the information on pressure and the kinematics of the esophageal wall due to the coordination of muscle activation is provided, which may help relate clinical data from manometry and ultrasound images to the underlying esophageal motor function

In vivo investigation of the tissue response to commercial Teflon insulin infusion sets in large swine for 14 days: the effect of angle of insertion on tissue histology and insulin spread within the subcutaneous tissue.

Objective: This study investigated the effects of the inflammatory tissue response (ITR) to an insulin infusion set (IIS) on insulin bolus spread over wear time, as well as the effect of cannula insertion angle on the ITR, bolus shape, and pump tubing pressure. Research design and methods: Angled or straight IISs were inserted every other day for 14 days into the subcutaneous tissue of 11 swine and insulin was delivered continuously. Prior to euthanasia, a 70 µL bolus of insulin/X-ray contrast agent was infused while recording a pressure profile (peak tubing pressure, pmax; area under the pressure curve, AUC), followed by the excision of the tissue-catheter specimen. Bolus surface area (SA) and volume (V) were assessed via micro-CT. Tissue was stained to analyze total area of inflammation (TAI) and inflammatory layer thickness (ILT) surrounding the cannula. Results: A bolus delivered through an angled IIS had a larger mean SA than a bolus delivered through a straight cannula (314.0±84.2 mm2 vs 229.0±99.7 mm2, p\u3c0.001) and a larger volume (198.7±66.9 mm3 vs 145.0±65.9 mm3, p=0.001). Both decreased significantly over wear time, independent of angle. There was a significant difference in TAI (angled, 9.1±4.0 mm2 vs straight, 14.3±8.6 mm2, p\u3c0.001) and ILT (angled, 0.7±0.4 vs straight, 1.2±0.7 mm, p\u3c0.001). pmax (p=0.005) and AUC (p=0.014) were lower using angled IIS. As ILT increased, pmax increased, while SA and V decreased. Conclusions: The progression of the ITR directly affected bolus shape and tubing pressure. Although straight insertion is clinically preferred, our data suggest that an angled IIS elicits lower grades of ITR and delivers a bolus with lower tubing pressure and greater SA and V. The subcutaneous environment plays a crucial role in IIS longevity, and the insertion angle needs to be considered in future IIS designs and clinical trials

Mathematical Modeling of Transport and Degradation of Feedstuffs in the Small Intestine

We describe a mathematical modeling of the digestion in the small intestine. The main interest of our work is to consider, at the same time, different aspects of the digestion i.e. the transport of the bolus all along the intestine, feedstuffs degradation according to the enzymes and local physical conditions, and nutrients absorption. A system of coupled ordinary differential equations is used to model these phenomena. The major unknowns of this system are the position of the bolus and its composition. This system of equations is solved numerically. We present different numerical computations for the degradation, absorption and transport of the bolus with acceptable accuracy with experimental data. The main feature and interest of this model are its generality. Even if we are at an early stage of development, our approach can be adapted to treat any kind of feedstuffs in any non-ruminant animal to predict the composition and velocity of bolus in the small intestine

Economic Reforms and the Agricultural Situation in Russia

The Russian Federation, like other countries of Eastern Europe, is undergoing a complicated period of transition from centralized to democratic methods of management. The main goal of this period is the transition to market relations within the entire national economy. Specifically, the goal of agricultural land reform is to convert the legal structure as it relates to land in order to create favorable conditions for competition among all forms of ownership

INTERPRETATION OF NARROW BEAM SONAR ECHOS USING A VARIABLE IMPEDANCE SUBBOTTOM MODEL

An underwater antenna consisting of an acoustic paraboloid reflector with a 12 kHz transducer mounted at its focus was designed and built for remote sensing of the subbottom {1}. Surveys taken with the 3 degree half-power beamwidth projector operating in a 1/2 ms pulsed mode indicated horizontal and vertical resolutions of less than 1 m with penetration into the sediments of up to 20 m at 20 m of depth. The image detail was substantially increased over that taken with a conventional 30 degree profiler. The data was interpreted using a physical model of the subbottom consisting of plane parallel layers of variable impedance overlying those of monotonically increasing impedance to a basement of granite {2,3}. A signal processing technique, extracting both phase and amplitude information of the acoustic echos, was used to simulate the data. The magnitude and phase angle of the boundary reflection coefficients were calculated allowing determination of positive or negative changes in the characteristic acoustic impedance of the respective layers. Relative impedance profiles, plotted over a region where facsimile graphs indicated a continuous subbottom layer, showed a consistent decrease of impedance at that depth before increasing again as expected