Between the Hash Marks: The Absolute Power the NFL’s Collective Bargaining Agreement Grants Its Commissioner

The National Football League has recently faced an onslaught of public criticism stemming from its handling of disciplinary matters over the last few years. This note engages in a comparative analysis of the disciplinary processes of the four major professional sports leagues, the National Football League (NFL), National Basketball Association (NBA), Major League Baseball (MLB), and National Hockey League (NHL), to determine why Commissioner Goodell’s disciplinary decisions have received such public criticism and have been challenged by the National Football League Players Association. While examining the cases of Tom Brady and Adrian Peterson, this note will address the question of whether Commissioner Goodell is acting outside the scope of his authority ordained by the NFL’s collective bargaining agreement (CBA), or if the language of the CBA, that grants Goodell such authority, is the source of the NFL’s flawed disciplinary process. In attempting to determine the source of the NFL’s flawed disciplinary process, Part I provides a brief history of the development of the four major leagues’ CBAs. Part II discusses the NFL CBA specifically, and the particular provisions that have caused issues in recent years. Part III examines how the NBA, MLB, and NHL, have deployed their CBAs in comparison to that of the NFL. Part IV proposes a change to the disciplinary process that limits the Commissioner’s power as the League’s sole disciplinarian when dealing with on-field player conduct or conduct deemed detrimental to the game of football. Such limits will provide players with a higher level of fundamental fairness in the appeals process

Identification and validation of N-acetyltransferase 2 as an insulin sensitivity gene

Journal ArticleDecreased insulin sensitivity, also referred to as insulin resistance (IR), is a fundamental abnormality in patients with type 2 diabetes and a risk factor for cardiovascular disease. While IR predisposition is heritable, the genetic basis remains largely unknown. The GENEticS of Insulin Sensitivity consortium conducted a genome-wide association study (GWAS) for direct measures of insulin sensitivity, such as euglycemic clamp or insulin suppression test, in 2,764 European individuals, with replication in an additional 2,860 individuals. The presence of a nonsynonymous variant of N-acetyltransferase 2 (NAT2) [rs1208 (803A>G, K268R)] was strongly associated with decreased insulin sensitivity that was independent of BMI. The rs1208 "A" allele was nominally associated with IR-related traits, including increased fasting glucose, hemoglobin A1C, total and LDL cholesterol, triglycerides, and coronary artery disease. NAT2 acetylates arylamine and hydrazine drugs and carcinogens, but predicted acetylator NAT2 phenotypes were not associated with insulin sensitivity. In a murine adipocyte cell line, silencing of NAT2 ortholog Nat1 decreased insulin-mediated glucose uptake, increased basal and isoproterenol- stimulated lipolysis, and decreased adipocyte differentiation, while Nat1 overexpression produced opposite effects. Nat1-deficient mice had elevations in fasting blood glucose, insulin, and triglycerides and decreased insulin sensitivity, as measured by glucose and insulin tolerance tests, with intermediate effects in Nat1 heterozygote mice. Our results support a role for NAT2 in insulin sensitivity

In Support of a Patient-Driven Initiative and Petition to Lower the High Price of Cancer Drugs

Comment in Lowering the High Cost of Cancer Drugs--III. [Mayo Clin Proc. 2016] Lowering the High Cost of Cancer Drugs--I. [Mayo Clin Proc. 2016] Lowering the High Cost of Cancer Drugs--IV. [Mayo Clin Proc. 2016] In Reply--Lowering the High Cost of Cancer Drugs. [Mayo Clin Proc. 2016] US oncologists call for government regulation to curb drug price rises. [BMJ. 2015

Between the Hash Marks: The Absolute Power the NFL’s Collective Bargaining Agreement Grants Its Commissioner

The National Football League has recently faced an onslaught of public criticism stemming from its handling of disciplinary matters over the last few years. This note engages in a comparative analysis of the disciplinary processes of the four major professional sports leagues, the National Football League (NFL), National Basketball Association (NBA), Major League Baseball (MLB), and National Hockey League (NHL), to determine why Commissioner Goodell’s disciplinary decisions have received such public criticism and have been challenged by the National Football League Players Association. While examining the cases of Tom Brady and Adrian Peterson, this note will address the question of whether Commissioner Goodell is acting outside the scope of his authority ordained by the NFL’s collective bargaining agreement (CBA), or if the language of the CBA, that grants Goodell such authority, is the source of the NFL’s flawed disciplinary process. In attempting to determine the source of the NFL’s flawed disciplinary process, Part I provides a brief history of the development of the four major leagues’ CBAs. Part II discusses the NFL CBA specifically, and the particular provisions that have caused issues in recent years. Part III examines how the NBA, MLB, and NHL, have deployed their CBAs in comparison to that of the NFL. Part IV proposes a change to the disciplinary process that limits the Commissioner’s power as the League’s sole disciplinarian when dealing with on-field player conduct or conduct deemed detrimental to the game of football. Such limits will provide players with a higher level of fundamental fairness in the appeals process

Cisplatin-associated neuropathy characteristics compared to those associated with other neurotoxic chemotherapy agents (Alliance A151724)

Purpose: The current project was developed to obtain natural history information regarding cisplatin-induced peripheral neuropathy in males with testicular/germ cell cancers and to compare such neuropathy data with similarly obtained data in patients receiving other chemotherapy drugs in similarly conducted clinical trials. Methods: Patients without baseline neuropathy symptoms, who were initiating cisplatin-based chemotherapy, completed the EORTC CIPN 20 patient-reported instrument to evaluate chemotherapy-induced peripheral neuropathy (CIPN). Results were compared with EORTC CIPN 20 data obtained from independent study sets regarding patients receiving (1) paclitaxel, (2) combined paclitaxel and carboplatin, (3) oxaliplatin, or (4) a combination of doxorubicin and cyclophosphamide (AC). The last study set of patients on AC was selected to evaluate the use of EORTC CIPN 20 data in patients receiving chemotherapy not known to cause CIPN. Results: Cisplatin-induced neuropathy was more similar to neuropathy in patients receiving oxaliplatin than in those receiving paclitaxel. The cisplatin and oxaliplatin groups exhibited the coasting phenomenon and more prominent upper extremity symptoms than lower extremity symptoms during chemotherapy administration weeks. In contrast, paclitaxel-treated patients did not, on average, exhibit the coasting phenomenon; additionally, lower extremity symptoms were more prominent during the weeks when paclitaxel was administered. Cisplatin-induced neuropathy was less severe than was seen in patients in the other two groups, potentially because the cisplatin-receiving patients were younger. Patients receiving AC did not report substantial EORTC CIPN 20 changes. Conclusion: Understanding neuropathy similarities and differences with various chemotherapy agents may help elucidate CIPN processes and facilitate means to prevent and/or treat established CIPN