Effectiveness of State and Federal Government Agreements with Major Credit Card and Shipping Companies to Block Illegal Internet Cigarette Sales

Most Internet vendors offer tax-free cigarettes making them cheaper than those sold at stores. This undermines the impact that higher prices have upon reducing consumption. Most Internet tobacco sales have violated taxation and youth access laws, which led to landmark voluntary agreements in 2005 with the major credit card companies and major private shippers to ban payment transactions and shipments for all Internet cigarette sales

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Morphology of the jaw system in trichiurids: trade-offs between mouth closing and biting performance

In this study, we focus on two piscivore species of cutlassfishes (Trichiuridae) that show some degree of differences in morphology of the jaw system: Aphanopus carbo and Trichiurus lepturus. As studies dealing with myological features of A. carbo and T. lepturus are presently lacking, we first provide a detailed description of the head musculature of A. carbo and T. lepturus. Secondly, we focus on the mechanics of the mouth closing system of these trichiurids by using biomechanical modelling. More specifically, models allows us to: (1) describe the differences between how the lower jaw lever system works during mouth closure and during generating static bite force; (2) evaluate the effects of morphological change on the performance of both functions; (3) determine whether the configuration of each component of the lower jaw lever system is a compromise between both functions, or whether there is a partition of function (optimization for either hard biting or fast jaw closing) between the different parts of the jaw closing musculature; and (4) discuss the dynamical implications of having elongate jaws for capturing prey