Commments: Preemption of State Law under the Federal Arbitration Act

The Federal Arbitration Act, in contrast to common law, makes arbitration agreements in contracts evidencing a transaction involving commerce valid and enforceable. Recent decisions of the United States Supreme Court mandate that the federal Act be applied in both federal and state courts. In this comment, the author traces the history of the federal Act and addresses the threshold question of what activities satisfy the commerce requirement. The author examines the inconsistencies that arise when the federal Act is applied in state courts and urges Congress to revise the Act in light of these inconsistencies. Finally, potential changes in Maryland commercial arbitration law are explored

Commments: Preemption of State Law under the Federal Arbitration Act

The Federal Arbitration Act, in contrast to common law, makes arbitration agreements in contracts evidencing a transaction involving commerce valid and enforceable. Recent decisions of the United States Supreme Court mandate that the federal Act be applied in both federal and state courts. In this comment, the author traces the history of the federal Act and addresses the threshold question of what activities satisfy the commerce requirement. The author examines the inconsistencies that arise when the federal Act is applied in state courts and urges Congress to revise the Act in light of these inconsistencies. Finally, potential changes in Maryland commercial arbitration law are explored

Kitchen Gardens: From the White House to Your House

This short article discusses how having small “kitchen gardens” can reduce fossil inputs, keep food and energy dollars in local communities, and add resilience for individuals and local economies in the face of economic downturns

PC-CUBE: A Personal Computer Based Hypercube

PC-CUBE is an ensemble of IBM PCs or close compatibles connected in the hypercube topology with ordinary computer cables. Communication occurs at the rate of 115.2 K-band via the RS-232 serial links. Available for PC-CUBE is the Crystalline Operating System III (CrOS III), Mercury Operating System, CUBIX and PLOTIX which are parallel I/O and graphics libraries. A CrOS performance monitor was developed to facilitate the measurement of communication and computation time of a program and their effects on performance. Also available are CXLISP, a parallel version of the XLISP interpreter; GRAFIX, some graphics routines for the EGA and CGA; and a general execution profiler for determining execution time spent by program subroutines. PC-CUBE provides a programming environment similar to all hypercube systems running CrOS III, Mercury and CUBIX. In addition, every node (personal computer) has its own graphics display monitor and storage devices. These allow data to be displayed or stored at every processor, which has much instructional value and enables easier debugging of applications. Some application programs which are taken from the book Solving Problems on Concurrent Processors (Fox 88) were implemented with graphics enhancement on PC-CUBE. The applications range from solving the Mandelbrot set, Laplace equation, wave equation, long range force interaction, to WaTor, an ecological simulation

Comparison of osteoporosis pharmacotherapy fracture rates: Analysis of a marketScan® claims database cohort

Background: Several different classes of medications have been shown to be efficacious at preventing fractures in patients with osteoporosis. No study has compared real world efficacy at preventing fractures between all currently approved medications. Objectives: To directly compare the efficacy of all currently available osteoporosis medications by using a large population claims database. Methods: The Truven Health Analytics MarketScan® database from 2008 - 2012 was used to identify all patients who started a new osteoporosis medication. Patients who experienced a fracture after at least 12 months of treatment were identified and risk factors for fracture for all patients were recorded. Logistic regression was used to account for and quantify the contribution of risk factors, and to make direct comparisons between different osteoporosis medications. Results: A total of 51649 patients were included in the cohort, with an average age of 56 years. The overall incidence rate of fracture was 1.55 per 100 person - years of treatment. Orally administered medications had the lowest fracture rates, led by raloxifene and alendronate (1.24 and 1.54 respectively), while parenterally administered medications including teriparatide and zolerdonic acid had the highest rates (3.90 and 1.98 respectively). No statistically significant differences found between oral or parenterally administered bisphosphonate medications. Conclusions: While patients taking orally administered drugs including bisphosphonates had less frequent incident fracture no statistically significant differences were found between most drugs in head - to - head comparisons, even considering the route of administration of bisphosphonates. These findings support previous evidence that minimal differences in efficacy exist between different osteoporosis medications. This is the first study using a large database to compare all currently available osteoporosis treatments and will hopefully be augmented by further study to provide more evidence to make clinical decisions on osteoporosis medication use. © 2017 American Association of Neuropathologists, Inc

Earth has not anything to show more fair….

Editoria

Troubles mentaux graves et abus de substances : composantes efficaces de progammes de traitements intégrés à l’intention des personnes présentant une comorbidité

Les approches traditionnelles de soins pour patients souffrant de problèmes de comorbidité qui étaient fondées sur des traitements séquentiels ou en parallèle ont échoué dans les cas de santé mentale et d'abus de substance, ce qui a conduit au développement de programmes de traitements intégrés. Dans cet article, les auteurs définissent les traitements intégrés destinés aux patients ayant ce double diagnostic et identifient les composantes clés des programmes intégrés efficaces, y compris la pratique outreach, l'approche holistique, le partage de la prise de décision, la réduction des méfaits, l'engagement à long terme et le traitement par étapes (basé sur l'approche motivationnelle). Le concept d'étapes de traitement est décrit afin d'illustrer les différents stades de motivation vécus par les personnes à mesure qu'elles se rétablissent de leur dépendance aux substances : l'engagement, la persuasion, le traitement actif et la prévention des rechutes. Les étapes de traitement servent à guider les cliniciens dans l'identification d'objectifs de traitement appropriés à l'état de motivation des patients, et à choisir des interventions fondées sur ces objectifs. En reconnaissant le stade de traitement de chaque personne, les cliniciens peuvent optimiser les résultats en choisissant des interventions qui sont appropriées à l'état de motivation de la personne ou à l'étape de traitement et ainsi minimiser les abandons. Ces programmes intégrés diffèrent dans les services spécifiques qu'ils dispensent. Toutefois, ils partagent des éléments communs dans leur philosophie et leurs valeurs. Des recherches documentent les effets bénéfiques de ces programmes qui s'avèrent de bon augure pour le pronostic à long terme des personnes présentant une comorbidité.Integrated treatment for severe mental illness and substance abuse: Effective components of programs for persons with co-occurring disorders Traditional approaches to treating clients with co-occurring disorders based sequential or parallel mental health and substance abuse treatments have failed, leading to the development of integrated treatment programs. In this article we define integrated treatment for clients with co-occurring disorders, and identify the core components of effective integrated programs, including: assertive outreach, comprehensiveness, shared decision-making, harm-reduction, long-term commitment, and stage-wise (motivation-based) treatment. The concept of stages of treatment is described to illustrate the different motivational states through which clients progress as they recover from substance abuse: engagement, persuasion, active treatment, and relapse prevention. The stages of treatment have clinical utility for guiding clinicians in identifying appropriate treatment goals matched to clients' motivational states, and selecting interventions based on these goals. By recognizing each client's current stage of treatment, clinicians can optimize outcomes by selecting interventions that are appropriate to the client's current motivational state or stage of treatment, and minimize clients dropping out from treatment. Effective integrated treatment programs for clients with co-occurring disorders differ in the specific services they provide, but share common elements in their philosophy and values. Research documents the beneficial effects of these programs, which bodes well for the long-term prognosis of clients with co-occurring disorders.Turbios mentales graves y abusos de sustancias: componentes eficaces de programas de tratamiento integrados para personas presentando una comorbosidad Las aproximaciones tradicionales de cuidos de patientes sufriendo de problemas de comorbosidad fundados sobre tratamientos secuenciales o en paralelo han fracasado en el caso de salud mental y abuso de sustancias, lo que ha conducido al desarrollo de programas de tratamientos integrados. En este artículo los autores definen los tratamientos integrados destinados a patientes con este doble diagnóstico y identifican los componentes claves de programas integrados eficaces, incluyendo la practíca outreach, el aproximación holistica, el reparto de la toma de decisión, la reducción del perjuicio, compromiso a largo plazo y el tratamiento por etapas (basado sobre una aproximación motivacional). El concepto de etapas del tratamiento esta descrito para ilustrar las fases de motivación vividas por las personas al mismo tiempo que se reestablecen de su dependencia de substancia: el empeño, la persuasion, el tratamiento activo y la prevención de recaídas. Las etapas de tratamiento sirven a orientar los clínicos en la identificación de objectivo de tratamiento apropriados al estado de tratamiento de los patientes y a escoger intervenciones fundadas sobre estos objectivos. Reconociendo el estado de tratamiento de cada persona los clínicos puedent optimisar los resultados y escoger intervenciones apropriadas al estado de motivación de la persona o a la etapa de tratamiento y asi minimisar los abandonos. Estos programas integrados diferen en los servicios especificos que dispensan. Sin embargo comparten elementos comunes en su filosofía y sus valores. Investigaciones documenten efectos benificos de estos programas cuales se revelan de buen agüero para el prognostico al largo plazo de personas presentan una comorbosidad

Non-Equilibrium Electrons and the Sunyaev-Zel'dovich Effect of Galaxy Clusters

We present high-resolution cosmological hydrodynamic simulations of three galaxy clusters employing a two-temperature model for the intracluster medium. We show that electron temperatures in cluster outskirts are significantly lower than the mean gas temperature, because Coulomb collisions are insufficient to keep electrons and ions in thermal equilibrium. This deviation is larger in more massive and less relaxed systems, ranging from 5% in relaxed clusters to 30% for clusters undergoing major mergers. The presence of non-equilibrium electrons leads to significant suppression of the SZE signal at large cluster-centric radius. The suppression of the electron pressure also leads to an underestimate of the hydrostatic mass. Merger-driven, internal shocks may also generate significant populations of non-equilibrium electrons in the cluster core, leading to a 5% bias on the integrated SZ mass proxy during cluster mergers.Comment: 5 pages, 4 figures, Accepted for publication in ApJ