Sports Gambling in Nebraska: A Good Bet for the Good Life

I. Introduction II. Background ... A. History of Sports Betting ... B. Federal Intervention ... C. Professional and Amateur Sports Protection Act (PASPA) ... D. Murphy v. National Collegiate Athletic Association … 1. The Meaning of PASPA’s Authorization Provision ... 2. The Anticommandeering Doctrine ... 3. The Supremacy Clause and Preemption ... 4. The Severability Doctrine III. Sports Gambling in Nebraska ... A. Constitutional Referendum ... B. Interstate Pressure ... C. Reasons for Legalization ... 1. Economic Incentives ... 2. Public Support ... 3. Consumer Protection ... D. Proposed Oversight ... 1. Nebraska Gaming Commission ... 2. Nebraska Department of Revenue ... 3. Nebraska Gamblers Assistance Program IV. Conclusion Nebraska should legalize and regulate sports gambling. In May 2018, the Supreme Court struck down the Professional and Amateur Sports Protection Act (PASPA), a federal bill designed to ban sports gambling across the United States. Consequently, sports gambling became a state issue. Each state must now decide whether to continue prohibiting or to legalize and regulate sports gambling. The Supreme Court’s decision has sparked a state-by-state debate over the benefits of legalizing sports gambling. This Note examines those benefits and discusses how and why Nebraska should legalize and regulate sports gambling. Part II provides a background on sports gambling. It examines three distinct periods of sports gambling history: the early colonization of America, the turn of the nineteenth century, and the time between the mid-1930s and the present. Part II also examines the federal government’s attempt to regulate sports gambling, including the enactment of PASPA. Part II further discusses the Supreme Court’s holding that PASPA was unconstitutional. It examines the Supreme Court’s analysis in Murphy v. National Collegiate Athletic Association by discussing PASPA’s “authorization” provision and how it pertains to the anticommandeering doctrine, the Supremacy Clause, and the severability doctrine. In addition, Part II examines the fallout from the Supreme Court’s holding in Murphy and how each state must now choose prohibition or legalization and regulation. Part III discusses why and how Nebraska should legalize and regulate sports gambling. It looks at the economic benefits of legalization, including how new streams of revenue can offset Nebraska’s growing deficit. Moreover, it examines how public sentiment supports legalization efforts. In addition, legalization would increase employment opportunities. Part III also discusses key consumer protection components and why regulations should be implemented. Finally, Part III proposes statutory language for creating the Nebraska Gaming Commission and enabling it to regulate sports gambling. The newly created commission would be directly supervised by the Nebraska Department of Revenue. In addition, Part III prescribes the regulatory power and responsibilities for the Commission, including tax and enforcement powers, and the responsibility to support the Nebraska Gamblers Assistance Program. Lastly, Part III examines the various pathways for the legalization of sports gambling in Nebraska

Etude de la jonction neuromusculaire dans la sclérose latérale amyotrophique

Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disorder affecting motor neurons, usually leading to death in 3 to 5 years. The only treatment currently available, riluzole, has a modest effect on survival. Functional alterations of the neuromuscular junction (NMJ) have been reported in ALS, but their pathophysiological significance remains unknown. We studied the morphology of neuromuscular junctions in muscle samples collected from 11 ALS patients, using confocal and electron microscopy. Functional analysis of the NMJs was performed using surface-recording of compound motor action potentials after repetitive nerve stimulation at slow stimulus rate. A significant decrement (>10%), suggesting impairment of the neuromuscular transmission, was present in 45% of the patients. Morphological alterations of the NMJs were present in all ALS patients even at the early-stages. Beside denervation-induced morphological changes, one third of the NMJs showed abnormal spike-like areas of the outer edge of the postsynaptic primary gutter. A marked interposition of the terminal Schwann cell between the nerve terminal and the postsynaptic membrane, which was likely to alter synaptic transmission, was sometimes present. We found a significantly greater compensatory reinnervation in muscle from patients with slowly progressive ALS. Furthermore, we identified that the muscle molecular factor histone deacetylase 4 could play a key role in muscle reinnervation and disease progression in patients with ALS. This work has highlighted the presence of major morphological changes at the NMJs of ALS patients and identified potential new targets for future treatment.La Sclérose Latérale Amyotrophique (SLA) est une affection neurodégénérative touchant les motoneurones, habituellement mortelle en 3 à 5 ans. La cause de la maladie n'est pas connue et le seul traitement actuellement disponible ne permet qu'un allongement modeste de la survie. Des altérations fonctionnelles de la jonction neuromusculaire (JNM) ont été rapportées dans la SLA mais leur origine physiopathologique n'est pas connue. Nous avons étudié les JNM chez 11 patients atteints de SLA, en associant étude morphologique en microscopie confocale et analyse ultrastructurale. L'analyse fonctionnelle réalisée en EMG de surface retrouvait une anomalie de transmission neuromusculaire (décrément > 10%) chez 45% des patients. Des altérations morphologiques des JNM étaient visibles chez tous les patients, y compris au stade précoce de la maladie. Associé aux anomalies en rapport avec le phénomène de dénervation, nous avons observé un aspect anormal de spiculation de la gouttière primaire dans environ un tiers des cas. Une interposition marquée de la cellule de Schwann terminale entre la terminaison nerveuse et la membrane postsynaptique, pouvant altérer la transmission synaptique, était parfois visible. Nous avons objectivé une réinnervation compensatrice significativement plus importante chez les patients présentant une SLA d'évolution lente et montré que certains facteurs moléculaires musculaires comme l'histone déacétylase 4 pourraient jouer un rôle crucial dans la capacité de réinnervation. Ce travail a mis en évidence des altérations morphologiques majeures au niveau des JNM des patients atteints de SLA et a permis d'identifier des cibles thérapeutiques potentielles

La Reconstrution Anatomique Ligamentaire Laterale de la Cheville par le Muscule Gracilis: Evaluation a Court Terme de la Chirurgie Percutane et Arthroscopique

Le but de ce travail prospectif de 15 cas, est de comparer la ligamentoplastie anatomique par mini-abord et sous arthroscopie d’une part et la ligamentoplastie classique dans la littérature d’autre part. Huit femmes et sept hommes, âgés de 19 à 71 ans, avec moyenne d’âge de 43 ans, ayant eu une reconstruction ligamentaire par greffe du muscle Gracilis (9 par Arthroscopie versus 6 mini-open) entre Juillet 2017 et Janvier 2018. Les patients sont revus à 6 semaines puis à 3 mois et à 6 mois. Les résultats subjectifs ont montré 93% de satisfaction, une patiente était moyennement satisfaite par le retard de la cicatrisation et de la raideur de la cheville (infection post opératoire). Le score de Kaïkkonen global moyen était de 83 % de satisfaction (85% mini-open versus 83 % sous arthroscopie). Tous les patients avaient des chevilles stables. La reprise du travail ou des activités s’est faite entre 2 et 3 mois pour 13 patients (87% des cas). Ces deux techniques semblent fiables en termes de reconstruction ligamentaire, avec avantage de l’arthroscopie pour le traitement des lésions associées. Et les résultats sont favorables par rapports aux reconstructions classiques utilisant le court fibulaire. The aim of this prospective work of 15 cases is to compare anatomical ligamentoplasty by mini-approach and under arthroscopy on the one hand and conventional ligamentoplasty in the literature on the other hand. Eight women and seven men, aged 19 to 71, with an average age of 43, had ligament reconstruction by Gracilis muscle graft (9 by Arthroscopy versus 6 mini-open) between July 2017 and January 2018. Patients are reviewed at 6 weeks, then at 3 months and 6 months. The subjective results showed 93% satisfaction, one patient was moderately satisfied with the delay in healing and ankle stiffness (postoperative infection). The mean overall Kaikkonen score was 83% satisfaction (85% mini-open versus 83% under arthroscopy). All patients had stable ankles. The resumption of work or activities took place between 2 and 3 months for 13 patients (87% of cases). These two techniques seem reliable in terms of ligament reconstruction, with the advantage of arthroscopy for the treatment of associated lesions. And the results are favorable compared to conventional reconstructions using the peroneus brevis

La Reconstrution Anatomique Ligamentaire Laterale de la Cheville par le Muscule Gracilis: Evaluation a Court Terme de la Chirurgie Percutane et Arthroscopique

Le but de ce travail prospectif de 15 cas, est de comparer la ligamentoplastie anatomique par mini-abord et sous arthroscopie d’une part et la ligamentoplastie classique dans la littérature d’autre part. Huit femmes et sept hommes, âgés de 19 à 71 ans, avec moyenne d’âge de 43 ans, ayant eu une reconstruction ligamentaire par greffe du muscle Gracilis (9 par Arthroscopie versus 6 mini-open) entre Juillet 2017 et Janvier 2018. Les patients sont revus à 6 semaines puis à 3 mois et à 6 mois. Les résultats subjectifs ont montré 93% de satisfaction, une patiente était moyennement satisfaite par le retard de la cicatrisation et de la raideur de la cheville (infection post opératoire). Le score de Kaïkkonen global moyen était de 83 % de satisfaction (85% mini-open versus 83 % sous arthroscopie). Tous les patients avaient des chevilles stables. La reprise du travail ou des activités s’est faite entre 2 et 3 mois pour 13 patients (87% des cas). Ces deux techniques semblent fiables en termes de reconstruction ligamentaire, avec avantage de l’arthroscopie pour le traitement des lésions associées. Et les résultats sont favorables par rapports aux reconstructions classiques utilisant le court fibulaire. The aim of this prospective work of 15 cases is to compare anatomical ligamentoplasty by mini-approach and under arthroscopy on the one hand and conventional ligamentoplasty in the literature on the other hand. Eight women and seven men, aged 19 to 71, with an average age of 43, had ligament reconstruction by Gracilis muscle graft (9 by Arthroscopy versus 6 mini-open) between July 2017 and January 2018. Patients are reviewed at 6 weeks, then at 3 months and 6 months. The subjective results showed 93% satisfaction, one patient was moderately satisfied with the delay in healing and ankle stiffness (postoperative infection). The mean overall Kaikkonen score was 83% satisfaction (85% mini-open versus 83% under arthroscopy). All patients had stable ankles. The resumption of work or activities took place between 2 and 3 months for 13 patients (87% of cases). These two techniques seem reliable in terms of ligament reconstruction, with the advantage of arthroscopy for the treatment of associated lesions. And the results are favorable compared to conventional reconstructions using the peroneus brevis

Increasing the Space Charge Limit and Other Effects of Cesium Seeding in Hydrogen Negative Ion Sources

The role of cesium seeding in increasing the negative ion current in volume sources is described. By a reduction in the local plasma potential the current of extracted electrons is vastly reduced. As a result, cesium increases the fraction of the transverse space charge limit available to the ions by as much as a factor of three. In addition, cesium can increase the total space charge limit by injection of Cs+ into the presheath-a newly recognized phenomenon consistent with experimental measurements and determined from application of a Double-Vlasov model for negative ion extraction

Prothèse Unicompartimentale du Genou : Résultats Préliminaires D’ostéointégration du Plateau Tibial Fixe sans vis ni Ciment à Propos de 146 cas au Centre Hospitalier de la Côte Basque (France)

Introduction : Les prothèses unicompartimentales du genou (PUC) ont été introduites à la fin des années 60 par Marmor, les progrès ont été faits sur la technique, les indications et sur les implants, actuellement le taux de survie des implants est en constante progression, nombreux chirurgiens ont évolués vers le plateau métal-back, c’est-à-dire avec une plaque de base métallique avec vis et ou ciment surmontée d’un insert en polyéthylène, c’est ainsi que nous nous proposons d’étudier un nouvel implant qu’on utilise avec un plateau tibial fixe sans ciment ni vis. Objectif de cette étude est d’évaluer les résultats de la survie à court terme de PUC à plateau tibial fixe sans vis ni ciment par le processus d’ostéointégration. Matériel et Méthode. Il s’agit d’une étude rétrospective continue sur une période de cinq (5) ans mono centrique bi opérateurs de 146 cas de PUC type genus uni, allant de Janvier 2016 au mois de mars 2020 avec un recul moyen de 20 mois (extrême de 3-52 mois). Le service de chirurgie orthopédie-traumatologie du centre hospitalier de Bayonne (France) a servi de cadre d’étude. Les patients ont été évalués selon les scores IKS fonction et genou. Résultats. 146 patients étaient inclus, d’âge moyen 64 ans (extrême 43-83 ans), le sexe masculin prédominait 87 hommes contre 59 femmes, trois atteintes bilatérales, l’arthrose fémoro-tibiale médiale était primitive pour 141 genoux latérale pour quatre genoux, un cas d’ostéonécrose. Nos résultats étaient excellents dans 69,86%, mauvais dans 5,47%. Conclusion : Cette étude malgré son faible recul montre la pertinence de l’utilisation du plateau tibial fixe sans ciment ni vis dans hémi arthroplastie du genou.   Introduction:Unicompartmental knee prostheses (PUC) were introduced at the end of the 60s by Marmor, progress has been made on the technique, indications and on implants, currently the survival rate of implants is constantly increasing, many surgeons have evolved towards the metal-back plate, that is to say with a metal base plate with screws and / or cement surmounted by a polyethylene insert, this is how we propose to study a new implant used with a fixed tibial plateau without cement or screws. The objective of this study is to evaluate the results of short-term survival of fixed tibial plateau PUC without screws or cement through the process of osteointegration. Material and method: This is a continuous retrospective study over a period of five (5) years monocentric bioperators of 146 cases of uni genus type UKA, from January 2016 to March 2020 with an average follow-up of 20 months (extreme 3-52 months). The orthopedic-traumatology surgery department of the Bayonne hospital center (France) served as the study setting. Patients were assessed according to IKS function and knee scores. Results:146 patients were included, mean age 64 years (extreme 43-83 years), male sex predominated 87 men against 59 women, three bilateral attacks, medial femoro-tibial osteoarthritis was primary for 141 knees lateral for four knees, a case of osteonecrosis. Our results were excellent in 69.86%, bad in 5.47%. Conclusion: This study, despite its small follow-up, shows the relevance of the use of the fixed tibial plateau without cement or screws in knee hemi arthroplasty

Traitement Des Fractures Thalamiques Du Calcanéus Par Enclouage Verrouillé À Foyer Fermé « Type Calcanail » : Résultats Clinique, Fonctionnel Et Radiologique À Propos De 16 Cas Au Centre Hospitalier De La Côte Basque (France)

  Les fractures du calcanéum sont peu fréquentes et s’accompagnent souvent des séquelles graves. Nous rapportons une série de 16 cas, tous traités par clou verrouillé dans le service de traumatologie orthopédie du centre hospitalier de Bayonne (France). L’objectif de ce travail rétrospectif continu était d’évaluer les résultats cliniques, fonctionnel et radiologique du traitement chirurgical des fractures articulaires du calcanéum, à travers notre série de 16 patients opérés et suivis sur une période de 5 ans, et les comparer aux données de la littérature. L’âge moyen dans notre série était de 43 ans, tous nos patients avaient bénéficié d’une réduction à foyer fermé par distraction et une ostéosynthèse par clou verrouillé. Le recul moyen était de 18 mois et les résultats fonctionnels ont été évalués selon le score de Kitaoka, excellant dans 68,75%, Bon 18,75%, moyen 6,25% un mauvais cas 6,25%. Calcaneal fractures are infrequent and often have serious sequelae. We report a series of 16 cases all treated with a locked nail in the orthopedic traumatology department of the Bayonne hospital center (France). The objective of this continuous retrospective work was to evaluate the clinical, functional and radiological results of the surgical treatment of articular fractures of the calcaneus, through our series of 16 patients operated and followed over a period of 5 years, and to compare them with the data. of literature. The mean age in our series was 43 years, all of our patients had undergone distraction, closed reduction and locked nail osteosynthesis. The mean follow-up was 18 months and the functional results were evaluated according to the Kitaoka score, excelling in 68.75%, Good 18.75%, average 6.25% a bad case 6.25%

NADPH oxidase 4 inhibition is a complementary therapeutic strategy for spinal muscular atrophy

IntroductionSpinal muscular atrophy (SMA) is a fatal neurodegenerative disorder, characterized by motor neuron (MN) degeneration and severe muscular atrophy and caused by Survival of Motor Neuron (SMN) depletion. Therapies aimed at increasing SMN in patients have proven their efficiency in alleviating SMA symptoms but not for all patients. Thus, combinational therapies are warranted. Here, we investigated the involvement of NADPH oxidase 4 (NOX4) in SMA-induced spinal MN death and if the modulation of Nox4 activity could be beneficial for SMA patients.MethodsWe analysed in the spinal cord of severe type SMA-like mice before and at the disease onset, the level of oxidative stress and Nox4 expression. Then, we tested the effect of Nox4 inhibition by GKT137831/Setanaxib, a drug presently in clinical development, by intrathecal injection on MN survival and motor behaviour. Finally, we tested if GKT137831/Setanaxib could act synergistically with FDA-validated SMN-upregulating treatment (nusinersen).ResultsWe show that NOX4 is overexpressed in SMA and its inhibition by GKT137831/Setanaxib protected spinal MN from SMA-induced degeneration. These improvements were associated with a significant increase in lifespan and motor behaviour of the mice. At the molecular level, GKT137831 activated the pro-survival AKT/CREB signaling pathway, leading to an increase in SMN expression in SMA MNs. Most importantly, we found that the per os administration of GKT137831 acted synergistically with a FDA-validated SMN-upregulating treatment.ConclusionThe pharmacological inhibition of NOX4 by GKT137831/Setanaxib is neuroprotector and could represent a complementary therapeutic strategy to fight against SMA

Cursive Eye-Writing With Smooth-Pursuit Eye-Movement Is Possible in Subjects With Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder causing a progressive motor weakness of all voluntary muscles, whose progression challenges communication modalities such as handwriting or speech. The current study investigated whether ALS subjects can use Eye-On-Line (EOL), a novel eye-operated communication device allowing, after training, to voluntarily control smooth-pursuit eye-movements (SPEM) so as to eye-write in cursive. To that aim, ALS participants (n = 12) with preserved eye-movements but impaired handwriting were trained during six on-site visits. The primary outcome of the study was the recognition of eye-written digits (0–9) from ALS and healthy control subjects by naïve “readers.” Changes in oculomotor performance and the safety of EOL were also evaluated. At the end of the program, 69.4% of the eye-written digits from 11 ALS subjects were recognized by naïve readers, similar to the 67.3% found for eye-written digits from controls participants, with however, large inter-individual differences in both groups of “writers.” Training with EOL was associated with a transient fatigue leading one ALS subject to drop out the study at the fifth visit. Otherwise, itching eyes was the most common adverse event (3 subjects). This study shows that, despite the impact of ALS on the motor system, most ALS participants could improve their mastering of eye-movements, so as to produce recognizable eye-written digits, although the eye-traces sometimes needed smoothing to ease digit legibility from both ALS subjects and control participants. The capability to endogenously and voluntarily generate eye-traces using EOL brings a novel way to communicate for disabled individuals, allowing creative personal and emotional expression

Muscle cells of sporadic amyotrophic lateral sclerosis patients secrete neurotoxic vesicles

Background: The cause of the motor neuron (MN) death that drives terminal pathology in amyotrophic lateral sclerosis (ALS) remains unknown, and it is thought that the cellular environment of the MN may play a key role in MN survival. Several lines of evidence implicate vesicles in ALS, including that extracellular vesicles may carry toxic elements from astrocytes towards MNs, and that pathological proteins have been identified in circulating extracellular vesicles of sporadic ALS patients. Because MN degeneration at the neuromuscular junction is a feature of ALS, and muscle is a vesicle-secretory tissue, we hypothesized that muscle vesicles may be involved in ALS pathology. Methods: Sporadic ALS patients were confirmed to be ALS according to El Escorial criteria and were genotyped to test for classic gene mutations associated with ALS, and physical function was assessed using the ALSFRS-R score. Muscle biopsies of either mildly affected deltoids of ALS patients (n = 27) or deltoids of aged-matched healthy subjects (n = 30) were used for extraction of muscle stem cells, to perform immunohistology, or for electron microscopy. Muscle stem cells were characterized by immunostaining, RT-qPCR, and transcriptomic analysis. Secreted muscle vesicles were characterized by proteomic analysis, Western blot, NanoSight, and electron microscopy. The effects of muscle vesicles isolated from the culture medium of ALS and healthy myotubes were tested on healthy human-derived iPSC MNs and on healthy human myotubes, with untreated cells used as controls. Results: An accumulation of multivesicular bodies was observed in muscle biopsies of sporadic ALS patients by immunostaining and electron microscopy. Study of muscle biopsies and biopsy-derived denervation-naïve differentiated muscle stem cells (myotubes) revealed a consistent disease signature in ALS myotubes, including intracellular accumulation of exosome-like vesicles and disruption of RNA-processing. Compared with vesicles from healthy control myotubes, when administered to healthy MNs the vesicles of ALS myotubes induced shortened, less branched neurites, cell death, and disrupted localization of RNA and RNA-processing proteins. The RNA-processing protein FUS and a majority of its binding partners were present in ALS muscle vesicles, and toxicity was dependent on the expression level of FUS in recipient cells. Toxicity to recipient MNs was abolished by anti-CD63 immuno-blocking of vesicle uptake. Conclusions: ALS muscle vesicles are shown to be toxic to MNs, which establishes the skeletal muscle as a potential source of vesicle-mediated toxicity in ALS