Health Claims Arbitration in Maryland: The Experiment Has Failed

The authors note that Maryland\u27s system for health claims arbitration has failed to reduce the number of malpractice suits, the size of damages awards, or the delay in resolving these claims. After reviewing the current system, its strengths and weaknesses, and various proposals to remedy its problems by amending the current legislation, the authors advance their own suggestions for amending Maryland\u27s health claims arbitration legislation

Exocyst mutants suppress pollen tube growth and cell wall structural defects of hydroxyproline O‐arabinosyltransferase mutants

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/1/tpj14808-sup-0003-FigS3.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/9/tpj14808.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/8/tpj14808-sup-0001-FigS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/7/tpj14808-sup-0004-FigS4.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/6/tpj14808-sup-0005-FigS5.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/5/tpj14808-sup-0007-FigS7.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/4/tpj14808-sup-0006-FigS6.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/3/tpj14808-sup-0002-FigS2.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156472/2/tpj14808_am.pd

Variety of transversus thoracis muscle in relation to the internal thoracic artery: an autopsy study of 120 subjects

<p>Abstract</p> <p>Background</p> <p>The transversus thoracis muscle is a thin muscular layer on the inner surface of the anterior thoracic wall that is always in concern during harvesting of the internal thoracic artery. Because the muscle is poorly described in the surgical literature, the aim of the present study is to examine in details its variations.</p> <p>Methods</p> <p>The data was obtained at standard autopsies of 120 Caucasian subjects (Bulgarians) of both sexes (97 males and 23 females), ranging in age from 18 to 91 years (mean age 52.8 ± 17.8 years). The transversus thoracis morphology was thoroughly examined on the inner surface of the chest plates collected after routine incisions.</p> <p>Results</p> <p>An overall examination revealed that in majority of cases the transversus thoracis slips formed a complete muscular layer (left - 75.8%, right - 83.3%) or some of the slips (left - 22.5%, right - 15%) or all of them (left - 1.7%, right - 1.7%) were quite separated. Rarely (left - 3.3%, right - 5.8%), some fibrous slips of the transversus thoracis were noted. In 55.8% of the cases there was left/right muscle symmetry; 44.2% of the muscles were asymmetrical. Most commonly, the highest muscle attachment was to the second (left - 53.3%, right - 37.5%) or third rib (left - 29.2%, right - 46.7%). The sixth rib was the most common lowest attachment (left - 94.2%, right - 89.2%). Most frequently, the muscle was composed of four (left - 31.7%, right - 44.2%) or fifth slips (left - 53.3%, right - 40.8%).</p> <p>Conclusions</p> <p>This study provides detailed basic information on the variety of the transversus thoracic muscle. It also defines the range of the clearly visible, uncovered by the muscle part of the internal thoracic artery and the completeness of the muscular layer over it. The knowledge of these peculiar muscle-arterial relations would definitely be beneficial to cardiac surgeon in performing fast and safe arterial harvesting.</p

Stomatal development: focusing on the grasses

The development and patterning of stomata in the plant epidermis has emerged as an ideal system for studying fundamental plant developmental processes. Over the past twenty years most studies of stomata have used the model dicotyledonous plant Arabidopsis thaliana. However, cultivated monocotyledonous grass (or Gramineae) varieties provide the majority of human nutrition, and future research into grass stomata could be of critical importance for improving food security. Recent studies using Brachypodium distachyon, Hordeum vulgare (barley) and Oryza sativa (rice) have led to the identification of the core transcriptional regulators essential for stomatal initiation and progression in grasses, and begun to unravel the role of secretory signaling peptides in controlling stomatal developmental. This review revisits how stomatal developmental unfolds in grasses, and identifies key ontogenetic steps for which knowledge of the underpinning molecular mechanisms remains outstanding

Molecular control of stomatal development

Plants have evolved developmental plasticity which allows the up- or down-regulation of photosynthetic and water loss capacities as new leaves emerge. This developmental plasticity enables plants to maximise fitness and to survive under differing environments. Stomata play a pivotal role in this adaptive process. These microscopic pores in the epidermis of leaves control gas exchange between the plant and its surrounding environment. Stomatal development involves regulated cell fate decisions that ensure optimal stomatal density and spacing, enabling efficient gas exchange. The cellular patterning process is regulated by a complex signalling pathway involving extracellular ligand-receptor interactions, which, in turn, modulate the activity of three master transcription factors essential for the formation of stomata. Here, we review the current understanding of the biochemical interactions between the epidermal patterning factor ligands and the ERECTA family of leucine-rich repeat receptor kinases. We discuss how this leads to activation of a kinase cascade, regulation of the bHLH transcription factor SPEECHLESS and its relatives, and ultimately alters stomatal production

Septal aperture of the humerus: Aetiology and frequency rates in two European populations.

Analysis of the septal aperture was conducted on two documented European populations. Collections from the National Museum of Natural History Lisbon, Portugal and University of Athens, Greece were used for the study. Both collections are modern and documented for sex and age. The Portuguese sample comprises 297 individuals (149 males and 148 females) between the ages of 18 and 88. A septal aperture was observed in 50 individuals resulting in a frequency of 16.83%. The Greek sample comprises 117 individuals (68 males and 49 females) between the ages of 20 and 65. Twenty-five septal apertures were observed, giving a frequency of 21.37%. Both populations had high frequencies which exceeded those observed in European countries in previous studies. Sex analysis shows that both samples confirm that septal apertures are more common in females. The Portuguese sample also supports that septal apertures are more common in the left humerus, however the Greek sample had a higher frequency of bilateral cases. Measurements of the Portuguese sample were taken to determine whether robusticity correlates with presence of septal apertures. These measurements concluded that there was no difference in robusticity with presence or absence of a septal aperture, challenging previous studies

Constructing a climate change logic: An institutional perspective on the "tragedy of the commons"

Despite increasing interest in transnational fields, transnational commons have received little attention. In contrast to economic models of commons, which argue that commons occur naturally and are prone to collective inaction and tragedy, we introduce a social constructionist account of commons. Specifically, we show that actor-level frame changes can eventually lead to the emergence of an overarching, hybrid "commons logic" at the field level. These frame shifts enable actors with different logics to reach a working consensus and avoid "tragedies of the commons." Using a longitudinal analysis of key actors' logics and frames, we tracked the evolution of the global climate change field over 40 years. We bracketed time periods demarcated by key field-configuring events, documented the different frame shifts in each time period, and identified five mechanisms (collective theorizing, issue linkage, active learning, legitimacy seeking, and catalytic amplification) that underpin how and why actors changed their frames at various points in time-enabling them to move toward greater consensus around a transnational commons logic. In conclusion, the emergence of a commons logic in a transnational field is a nonlinear process and involves satisfying three conditions: (1) key actors view their fates as being interconnected with respect to a problem issue, (2) these actors perceive their own behavior as contributing to the problem, and (3) they take collective action to address the problem. Our findings provide insights for multinational companies, nation-states, nongovernmental organizations, and other stakeholders in both conventional and unconventional commons

Histologic analysis of temporomandibular joint adaptation to protrusive function in young adult rhesus monkeys (Macaca mulatta)

It is generally believed that the adult temporomandibular joint is incapable of a significant adaptive response to forces produced by functional jaw orthopedics. To evaluate this view, twelve young adult female rhesus monkeys were fitted with functional protrusive appliances for periods ranging from 2 to 24 weeks. Histologic analysis of the temporomandibular joint demonstrated that six of the experimental animals exhibited a tissue response that was qualitatively similar to that noted in juvenile animals. However, the response in young adults was greatly reduced in magnitude from that seen in juveniles and was not related to duration of treatment. It must also be noted that three adult animals developed cross-bites in response to appliance placement, and three animals who functioned anteriorly exhibited little or no detectable condylar response. This study indicates that while some adaptive capability may still be present in the temporomandibular joints of young adults, the potential magnitude of the joint response is limited and highly variable in occurrence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23852/1/0000091.pd

Chewing Through the Miocene: An Examination of the Feeding Musculature in the Ground Sloth Hapalops from South America (Mammalia: Pilosa)

Hapalops, a smaller-sized and early sloth of the Megatheroidea, appeared in the middle Miocene Santa Cruz formation of Argentina. This genus is part of the group from which later, larger megatheroids arose, i.e., Nothrotheriops and Megatherium. Many cranial characters support this idea; however Hapalops is not merely a smaller antecedent of the later forms. Specifically, Hapalops retains short anterior caniniform teeth, and a temporomandibular joint elevated above the cheek tooth row; a combination distinct among sloths. An elevated temporomandibular joint occurs in Bradypus, a tree sloth with anterior chisel-shaped teeth instead of caniniforms, and the tree sloth Choloepus, which is aligned with the megalonychids, has anterior caniniforms. Hapalops has an elongated zygomatic ascending process that is reminiscent of that in Bradypus; however, the Bradypus skull is extremely foreshortened while that of Hapalops is elongated, as in nothrotheres, but not deepened as in megatheres. Previous work identified many sloth cranial character complexes, and functional limitations on skull feature combinations. The unique Hapalops character patterns indicate a selective feeder with a mediolaterally oriented grinding stroke during mastication

Embryology and bony malformations of the craniovertebral junction

BACKGROUND: The embryology of the bony craniovertebral junction (CVJ) is reviewed with the purpose of explaining the genesis and unusual configurations of the numerous congenital malformations in this region. Functionally, the bony CVJ can be divided into a central pillar consisting of the basiocciput and dental pivot and a two-tiered ring revolving round the central pivot, comprising the foramen magnum rim and occipital condyles above and the atlantal ring below. Embryologically, the central pillar and the surrounding rings descend from different primordia, and accordingly, developmental anomalies at the CVJ can also be segregated into those affecting the central pillar and those affecting the surrounding rings, respectively. DISCUSSION: A logical classification of this seemingly unwieldy group of malformations is thus possible based on their ontogenetic lineage, morbid anatomy, and clinical relevance. Representative examples of the main constituents of this classification scheme are given, and their surgical treatments are selectively discussed