Is Congress\u27 Latest Effort to De-Juice Professional Sports Unconstitutional?

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Effects of dietary L -arginine on structure and function of flow-restricted vein grafts

AbstractPurpose: Experiments were designed to determine effects of dietary supplementation with L -arginine on structure and function of flow-restricted vein grafts. Methods: Saphenous veins were placed as bilateral interposition grafts in femoral arteries of two groups of adult male mongrel dogs; one group was maintained on a normal diet (control), the other group supplemented with L -arginine (200 mg/kg per day) beginning 1 week before surgery. In each dog, flow was reduced by 50% in one graft by placing an adjustable clamp on the artery distal to the distal anastomosis. Plasma amino acids and oxidized products of nitric oxide (NOx ) were measured before and after L -arginine feeding. At postoperative week 4, grafts were removed and prepared for organ chamber studies to determine functions of the endothelium or smooth muscle and for histology. Results: Plasma L -arginine increased within 3 hours after feeding and increased from 141 ± 8 nmol/mL to 169 ± 11 nmol/mL (n = 6) after 5 weeks of supplementation. Plasma ornithine and citrulline paralleled arginine, whereas circulating NOx was unchanged. Maximal contractions to 60 mmol/L KCl were reduced in grafts from L -arginine–fed dogs. Endothelium-dependent relaxations to the calcium ionophore A23187 and relaxations of the smooth muscle NO were reduced in grafts from L -arginine–fed dogs. Neointimal hyperplasia was increased in grafts with reduced flow and not affected by arginine feeding. Conclusions: Dietary supplementation with L -arginine did not increase plasma NO in dogs with peripheral vein grafts or increase endothelium-dependent relaxations in control or flow-restricted grafts. Therefore, dietary supplementation with L -arginine may not improve long-term functions of flow-restricted peripheral bypass grafts. (J Vasc Surg 2001;33:829-39.

Embedding Recovery to Transform Inpatient Mental Health Care: The 333 Model

Objective: The 333 model is a radical redesign of acute mental health care. Time-limited inpatient pathways for assessment (≤3 days), treatment (≤3 weeks), and recovery (≤3 months) replaced traditional geographical-sector wards. By making beds available, 333 aspired to improve access, deliver early treatment, and shorten hospital stays—generating savings through reductions in beds and out-of-area placements (OAPs). This article compares the model’s performance against national benchmarking and internal targets. Methods: The complement of general adult beds (2011–2016) was mapped out. Patient flow data (April 2015–March 2017) were extracted from the National Health Service data warehouse and compared with 2016 NHS benchmarking and 333 targets. Results: Between 2012 and 2016, beds were reduced by 44% compared with 17% nationally. OAPs due to bed unavailability became extremely rare. More than 74% (N=2,679) of patients who were admitted to the assessment unit between 2015 and 2017 were discharged back to the community, minimizing fragmentation of care. Median length of stay was one-sixth as long as the national rate, but readmission rates were higher than the national mean because of the model’s innovative approach to managing treatment of patients with personality disorders. Bed occupancy was below the national average, with beds available every night for 2 years. Conclusions: With its recovery-focused approach, 333 has reduced length of stay and ensured that a stay on any ward is meaningful and adds value. The article demonstrates that bed and OAP reduction and the delivery of safe care can be achieved simultaneously

Along-Strike Differences in the Southern Alps of New Zealand: Consequences of Inherited Variation in Rheology

Long- and short-term strain variations along the Australian-Pacific plate boundary through the South Island of New Zealand, including a 300% increase in orogen width, coexistence of oblique thrusting on orthogonal structures, and variability in the locus of orogenic gold deposits, coincide with rheologically relevant geological variation. Our model investigates the consequences of thin, strong lower crust in the north and thick, weak lower crust in the south. Solution of the full 3-D mechanical equations reproduces the larger wavelength strain patterns of the orogen. A 3-D perturbation-based analytical solution leads to the identification of the sensitivity of displacement type to minor stress changes. Transition from boundary-normal thrusting to boundary-parallel thrusting occurs at the transition from strong to weak lower crust and is related to an increase in either tau(yz) (shear stress in the yz plane) or the ratio of the coordinate normal stresses, (sigma(yy)/sigma(xx)), where x and y are in the horizontal and z is vertical. Both mechanisms are compatible with the geologically dependent rheological variation employed in our model. Citation: Upton, P., P. O. Koons, D. Craw, C. M. Henderson, and R. Enlow (2009), Along-strike differences in the Southern Alps of New Zealand: Consequences of inherited variation in rheology, Tectonics, 28, TC2007, doi:10.1029/2008TC002353

Uptake of hepatitis C specialist services and treatment following diagnosis by dried blood spot in Scotland

Background: Dried blood spot (DBS) testing for hepatitis C (HCV) was introduced to Scotland in 2009. This minimally invasive specimen provides an alternative to venipuncture and can overcome barriers to testing in people who inject drugs (PWID). Objectives: The objective of this study was to determine rates and predictors of: exposure to HCV, attendance at specialist clinics and anti-viral treatment initiation among the DBS tested population in Scotland. Study design: DBS testing records were deterministically linked to the Scottish HCV Clinical database prior to logistic regression analysis. Results: In the first two years of usage in Scotland, 1322 individuals were tested by DBS of which 476 were found to have an active HCV infection. Linkage analysis showed that 32% had attended a specialist clinic within 12 months of their specimen collection date and 18% had begun anti-viral therapy within 18 months of their specimen collection date. A significantly reduced likelihood of attendance at a specialist clinic was evident amongst younger individuals (<35 years), those of unknown ethnic origin and those not reporting injecting drug use as a risk factor. Conclusion: We conclude that DBS testing in non-clinical settings has the potential to increase diagnosis and, with sufficient support, treatment of HCV infection among PWID

Late Quaternary slip rates across the central Tien Shan, Kyrgyzstan, central Asia

Slip rates across active faults and folds show that late Quaternary faulting is distributed across the central Tien Shan, not concentrated at its margins. Nearly every intermontane basin contains Neogene and Quaternary syntectonic strata deformed by Holocene north‐south shortening on thrust or reverse faults. In a region that spans two thirds of the north‐south width of the central Tien Shan, slip rates on eight faults in five basins range from ∼0.1 to ∼3 mm/yr. Fault slip rates are derived from faulted and folded river terraces and from trenches. Radiocarbon, optically stimulated luminescence, and thermoluminescence ages limit ages of terraces and aid in their regional correlation. Monte Carlo simulations that sample from normally distributed and discrete probability distributions for each variable in the slip rate calculations generate most likely slip rate values and 95% confidence limits. Faults in basins appear to merge at relatively shallow depths with crustal‐scale ramps that underlie mountain ranges composed of pre‐Cenozoic rocks. The sum and overall pattern of late Quaternary rates of shortening are similar to current rates of north‐south shortening measured using Global Positioning System geodesy. This similarity suggests that deformation is concentrated along major fault zones near range‐basin margins. Such faults, separated by rigid blocks, accommodate most of the shortening in the upper crust