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Background: Colonic diverticulosis, the most common lesion found in routine colonoscopy, affects more than 50% of individuals aged ≥ 60 years. Emerging evidence suggest that dysbiosis of gut microbiota may play an important role in the pathophysiology of diverticular disease. However, specific changes in microbial species and metabolic functions in asymptomatic diverticulosis remain unknown. Methods: In a cohort of US adults undergoing screening colonoscopy, we analyzed the gut microbiota using shotgun metagenomic sequencing. Demographic factors, lifestyle, and medication use were assessed using a baseline questionnaire administered prior to colonoscopy. Taxonomic structures and metabolic pathway abundances were determined using MetaPhlAn3 and HUMAnN3. We used multivariate association with linear models to identify microbial species and metabolic pathways that were significantly different between asymptomatic diverticulosis and controls, while adjusting for confounders selected a priori including age at colonoscopy, sex, body mass index (BMI), and dietary pattern. Results: Among 684 individuals undergoing a screening colonoscopy, 284 (42%) had diverticulosis. Gut microbiome composition explained 1.9% variation in the disease status of asymptomatic diverticulosis. We observed no significant differences in the overall diversity of gut microbiome between asymptomatic diverticulosis and controls. However, microbial species Bifidobacterium pseudocatenulatum and Prevotella copri were significantly enriched in controls (q value = 0.19 and 0.14, respectively), whereas Roseburia intestinalis, Dorea sp. CAG:317, and Clostridium sp. CAG: 299 were more abundant in those with diverticulosis (q values = 0.17, 0.24, and 0.10, respectively). We observed that the relationship between BMI and diverticulosis appeared to be limited to carriers of Bifidobacterium pseudocatenulatum and Roseburia intestinalis (Pinteraction = 0.09). Conclusions: Our study provides the first large-scale evidence supporting taxonomic and functional shifts of the gut microbiome in individuals with asymptomatic diverticulosis. The suggestive interaction between gut microbiota and BMI on prevalent diverticulosis deserves future investigations. [ABSTRACT FROM AUTHOR]

This article considers the context, development, and significance of the Higher Education (Freedom of Speech) Act 2023. The Act was relatively unusual in aiming to increase the normative strength of freedom of speech. The central justification given for the Act was the need to respond to an increasing number of interferences with free speech and academic freedom occurring at universities. The growth of a "cancel culture" was having a "chilling effect" on students, staff, and visiting speakers. The article examines a range of high-profile cases and incidents that have attracted political and media attention. Many of these have concerned contemporary debates related to trans issues and identity politics. The issues discussed in the article are of wider international interest. Similar controversies have been experienced in universities in other states. The article makes comparative reference to developments in the field in the United States, Canada, Australia, and New Zealand. The article examines the perceived issues and evidential bases for the Act, reviews the legal duties, and analyzes the key legal concepts. It considers these in terms of compatibility with the European Convention on Human Rights (1950). It concludes by addressing three thematic issues: (i) a Model Code; (ii) challenging university ideologies; and (iii) securing cultural change. [ABSTRACT FROM AUTHOR]

Background. The 2018 Organ Procurement and Transplantation Network (OPTN) heart allocation policy change prioritizes patients bridged to transplant with mechanical circulatory support (MCS) devices, including extracorporeal membrane oxygenation (ECMO). As a result, the use of ECMO has significantly increased. Methods. We reviewed the OPTN database for adult patients undergoing heart transplant after bridge with ECMO between January 1st 2000 and October 18th 2018. We excluded patients with ≥180 days of ECMO duration, prior transplants, and those using additional MCS devices. Survival and morbidity outcomes of patients with ≥7 days of pre-transplant ECMO were compared to those of patients with <7 days. Results. Of 362 eligible transplant recipients, 163 (45%) utilized <7 days of pre-transplant ECMO and 199 (55%) utilized ≥7 days. Those with ≥7 days were younger (median age: 43 [28–54] vs. 50 [36–57] years, p = 0.006) and more likely to have temporary waitlist inactivity (18% vs. 7%, p = 0.003) with significantly longer duration of ECMO use (median: 14 [9–24] vs. 4 [2–5] days, p < 0.001). Patients with ≥7 days of ECMO had comparable survival to those with <7 days at one year (81.1% vs. 79.4%, p = 0.64) and five years (61.1% vs. 49.3%, p = 0.27). After adjustment for clinically relevant variables, duration of ECMO ≥7 days did not increase mortality at five years (HR = 0.90, p = 0.59). Conclusions. Longer duration of ECMO (≥7 days vs. <7 days) among patients successfully bridged to transplant is not associated with increased mortality or selected adverse outcome, including graft failure or rejection, at up to five years. [ABSTRACT FROM AUTHOR]

Background: This study aimed to: (1) Determine the ability to achieve the surgeons' desired cup orientation, without navigation, using contemporary measures with the anterior- (AA) and posterior- approaches (PA); and (2) assess whether surgical approach is associated with cup orientation accuracy, as previously reported, when contemporary measures are used. Methods: A prospective, 2-centre, multi-surgeon study of 400 THAs (200 AA; 200 PA) was performed. Intraoperative radiographs were obtained with the AA. A digital inclinometer and 3-point pelvic support were used with the PA. With the PA, intraoperative cup inclination at impaction was recorded. Radiographic inclination/anteversion (RI/RA) was measured from intraoperative radiographs (AA-only) and from postoperative radiographs for all cases. Optimum inclination/anteversion was defined as 40°/20° (±10°). The difference between intra- and postoperative orientations allowed for determination of the difference in pelvic position at impaction. Results: Optimum RI and RA were achieved in 91.3% (n = 365) and 92% (n = 368) of cases respectively. Optimum cup orientation was detected in 84% of cases (n = 336). There was equivalent ability to achieve cup orientation between approaches (AA: 82.5% vs. PA: 85.5%; p = 0.41). The use of an inclinometer in the PA was associated with a smaller variability of inclination at implantation (10° vs. 14°) and counteracted the greater difference in pelvic position (4.4° vs. 2.1°) seen with the PA. Conclusions: Over 80% of cases can have optimum orientation without navigation, using simple, cheap contemporary measures. Such measures eliminate differences between approaches, related to patient position. Narrower implantation angles will further reduce variability in cup orientation achieved. [ABSTRACT FROM AUTHOR]

Over the last year, the Keeping Well in South East London service have offered Schwartz Rounds to social care staff in response to the significant impact of Covid-19 on staff wellbeing and ongoing post-pandemic pressures (e.g. recruitment and retention). This text shares preliminary evaluation data and key learnings around implementation. [ABSTRACT FROM AUTHOR]

New Zealand is facing a disability housing crisis. There are insufficient homes available in New Zealand that meet the international requirements of an adequate home: physical accessibility, security of tenure, affordability, proximity to services and habitability. In particular, New Zealand struggles with a lack of homes that are physically accessible and affordable. This is a clear breach of the obligation to provide adequate housing for disabled people; a breach that has serious consequences for New Zealand. Economic incentives are a policy tool that works within New Zealand's sociopolitical structures and thus will be easier to implement, both in terms of using existing infrastructure and political will. Comparable international jurisdictions provide a useful model of how these might work in practice in the housing context. This article makes recommendations along two veins: first, to provide long-term solutions that incentivise the private sector to build more physically accessible houses and second, to provide short-term solutions that improve access to retrofitted modifications. [ABSTRACT FROM AUTHOR]

Cybersecurity and encryption are critical in diverse applications from simple emails to high‐priority government secrets. It is best accomplished by an "unbreakable" cipher or one which is only decrypted by those with a matching cipher key to the initial encryption. Recent advances have incorporated quantitative data as an asymmetric encryption key. With this method, the sender and receiver each run the same experiment to encode and decode the message of interest. Experimental asymmetric keys can come from DNA, enzymatic assays, and most recently, electrochemical data. This manuscript summarizes recent advances in cryptography and outlines new electrochemical techniques. [ABSTRACT FROM AUTHOR]

Background: Restoration of normal hip anatomy and biomechanics is a key surgical goal for success in total hip arthroplasty. The aim of this study was to evaluate the influence, if any, that patient positioning in the supine and lateral decubitus positions has in achieving this goal. Materials and methods: A single center multi-surgeon case-matched series from a tertiary level referral center of patients undergoing primary unilateral THA for osteoarthritis between April 2018 and December 2019 was retrospectively analyzed. Patients (n = 200) were divided into two matched groups: supine (anterior approach, n = 100) and lateral decubitus (direct lateral or posterior/SuperPATH™ approaches, n = 100). Post-operative anteroposterior pelvic radiographs were analyzed using a previously validated software (SurgiMap, Nemaris Inc., USA) for parameters of reconstruction of the hip in the coronal plane; leg length discrepancy, vertical and horizontal displacement of the center of rotation, femoral offset, and total offset. Results: Mean absolute leg length discrepancy in the supine group was 0.6 ± 3.3 mm (95% [CI] − 0.1 to 1.2 mm) versus 2.4 ± 3.8 mm (95% [CI] 1.6 to 3.1) in the lateral decubitus position (p < 0.001). The center of rotation was displaced medially by a mean of 3.2 ± 2.7 mm in the supine group versus 1.3 ± 4.0 mm in the lateral decubitus group (p < 0.001). For a surgical target of reconstructing both leg length and total offset within 5 mm of native anatomy, the supine group was more than twice as likely to achieve these goals with fewer outliers (OR 2.631, 95% [CI] 1.901–3.643) (76% v 30%, p < 0.001). Conclusion: Total hip arthroplasty through the anterior approach in the supine position is more consistent and accurate for the restoration of leg length and total offset. Further study is required to assess how this translates with outcome. Level of evidence: III—retrospective cohort study. [ABSTRACT FROM AUTHOR]

Background: Microscopic colitis (MC) primarily affects older adults; thus, data in younger patients are scarce. Aims: To compare clinical characteristics and treatment response by age at diagnosis. Methods: This retrospective cohort study was performed at Mayo Clinic and Massachusetts General Hospital. Patients were chosen consecutively using established databases. Patients were 'younger' if age at diagnosis was ≤ 50 years and 'older' if age > 50 years. Treatment outcomes were captured for induction (12 ± 4 weeks), based on the total number of daily stools, and defined as remission (complete resolution), response (≥ 50% improvement), non-response (< 50% improvement), and intolerance. Patients were considered 'responders' if they had remission or response and 'non-responders' if they had non-response or intolerance. Results: We included 295 patients (52 younger, 243 older). There were no differences in sex, race, MC subtype, and diarrhea severity between groups (all P > 0.05). Younger patients were more likely to have celiac disease (17.3% vs. 5.8%, P = 0.01), while older patients had higher BMI (mean 25.0 vs. 23.8 kg/m2, P = 0.04) were more likely smokers (53.9% vs. 34.6%, P = 0.01) and use NSAIDs (48.6% vs. 15.4%, P < 0.01) and statins (22.6% vs. 3.8%, P < 0.01). Overall treatment response was highest for budesonide (88.3%) and did not differ when comparing older to younger patients (90.6% vs. 77.8%, P = 0.12) or by MC subtype (LC, 81.5% vs. CC, 92.9%, P = 0.07). Conclusions: There are no significant differences in MC treatment response based on age or disease subtype. These findings support treating patients with MC based on symptom severity rather than age. [ABSTRACT FROM AUTHOR]

Spinopelvic mobility affects outcome after THA. Whether the sacro‐femoral‐pubic (SFP) angle, measured on AP radiographs, can be reliably used to estimate pelvic tilt (PT) in hip osteoarthritis patients is unknown. This study aimed to (1) validate the use of the SFP angle in the calculation of PT from AP radiographs, and (2) identify individual patient factors affecting the estimation of PT. A cohort of 100 patients awaiting THA for end‐stage hip osteoarthritis was prospectively studied. AP and lateral radiographs, taken in the standing and relaxed‐seated positions were evaluated for spinopelvic measurements (SFP, PT, and pelvic incidence [PI]). To validate the SFP angle, estimated PT values using the formula [PT = 75°‐SFP] were compared to the true, measured values from the lateral radiographs. Despite good agreement for the estimated and true PT (16.2 ± 5.9° vs. 15.5 ± 8.6°; p =.315), a significantly poorer agreement could be found between the two methods at high or low values of PT. Patient‐specific PI correlated with the difference between the two measurement methods (Pearson's r = −0.644; p <.001). However, the change in SFP angle equaled approximately the change in pelvic tilt (∆PT = 2°−∆SFP; Pearson's r = −0.934; p <.001). Absolute values for the sagittal PT should not be estimated from AP pelvic radiographs in patients awaiting total hip arthroplasty. However, the relative change in PT between different positions equals approximately the change in SFP angle. This may allow functional cup orientation after THA to be determined between different postures from an AP radiograph of the pelvis. The SFP angle has moderate accuracy in determining a patient's pelvic tilt; however, it can accurately determine a patient's change in pelvic tilt in different positions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has shown itself to be an unprecedented challenge for vaccines which are widely recognized as the most important tool to exit this pandemic. We have witnessed vaccine scientists, developers, manufacturers, and stakeholders deliver several vaccines in just about a year. This is an unprecedented achievement in an environment that was not ready to manage such a global public health crisis. Indeed, the pandemic has highlighted some hurdles that need to be addressed in the system in order to streamline the regulatory processes and be in a situation where life-saving pharmaceutical solutions such as vaccines can be delivered quickly and equitably to people across the globe. More precisely, trade-offs had to be made between the need for regulatory flexibility in the requirements for manufacturing and controls to enable rapid availability of large volumes of vaccines vs the increased stringency and the lack of harmonization in the regulatory environment for vaccines globally. It is also characterized by a high heterogeneity in terms of review and approval processes, limiting equitable and timely access. We review and highlight the challenges relating to several topics, including process validation, comparability, stability, post-approval-changes, release testing, packaging, genetically modified organisms and variants. We see four areas for accelerating access to vaccines which provide solutions for the regulatory concerns, (1) science- and risk-based approaches, (2) global regulatory harmonization, (3) use of reliance, work-sharing, and recognition processes and (4) digitalization. These solutions are not new and have been previously highlighted. In recent months, we have seen some progress at the health authority level, but still much needs to be done. It is now time to reflect on the first lessons learnt from a devastating pandemic to ultimately ensure quick and wide access to medicines and vaccines for the citizens and patients. [ABSTRACT FROM AUTHOR]

Vaccine discovery and vaccination against preventable diseases are one of most important achievements of the human race. While medical, scientific & technological advancements have kept in pace and found their way into treatment options for a vast majority of diseases, vaccines as a prevention tool in the public health realm are found languishing in the gap between such innovations and their easy availability/accessibility to vulnerable populations. This paradox has been best highlighted during the unprecedented crisis of the COVID-19 pandemic. As part of a two series publication on the vaccine industry's view on how to accelerate the availability of vaccines worldwide, this paper offers a deep dive into detailed proposals to enable this objective. These first-of-its-kind technical proposals gleaned from challenges and learnings from the COVID-19 pandemic are applicable to vaccines that are already on the market for routine pathogens as well as for production of new(er) vaccines for emerging pathogens with a public health threat potential. The technical proposals offer feasible and sustainable solutions in pivotal areas such as process validation, comparability, stability, post-approval changes, release testing, packaging, genetically modified organisms and variants, which are linked to manufacturing and quality control of vaccines. Ultimately these proposals aim to ease high regulatory complexity and heterogeneity surrounding the manufacturing & distribution of vaccines, by advocating the use of (1) Science and Risk based approaches, (2) global regulatory harmonization, (3) use of reliance, work-sharing, and recognition processes and (4) digitalization. Capitalizing & collaborating on such new-world advancements into the science of vaccines will eventually benefit the world by turning vaccines into vaccination, ensuring the health of everyone. [ABSTRACT FROM AUTHOR]

The introduction of magnetic moments to topological materials provides rich opportunities for studying the interplay among magnetism, electron correlation, and topological orders, which can give rise to exotic magnetoelectric effects and allow one to manipulate the topological band structure via spintronic approaches. Here, we report current-induced switching in a thin film of ferromagnetic Weyl semimetal Co2MnGa with perpendicular magnetic anisotropy, via the spin–orbit torque from a neighboring heavy metal Pt. The reversal of the large anomalous Hall signal indicates an effective electrical control of the Berry curvatures associated with the Weyl nodes in the topological band structure. The efficiency of the spin–orbit torque switching is calibrated to be comparable to that in conventional ferromagnets. Given the compatibility of Co2MnGa films with various spintronic devices and techniques, our work represents an essential step toward memory and computing devices built by topological ferromagnetic materials. [ABSTRACT FROM AUTHOR]

Background: Cardiac sarcoidosis is an increasingly common indication for a heart transplant, but there is a paucity of knowledge with regard to long‐term outcomes following transplant. Methods: We utilized the Organ Procurement and Transplantation Network database to retrospectively analyze adult patients undergoing first‐time, single‐organ heart transplant between January 1999 and March 2020. Results: Of the 41,447 patients that underwent heart transplant during the study period, 289 (0.7%) were transplanted for a primary diagnosis of restrictive cardiomyopathy due to cardiac sarcoidosis (RCM‐Sarcoidosis). RCM‐Sarcoidosis was associated with 33% reduced risk of mortality over 10 years compared to non‐RCM indications in a multivariable Cox proportional hazards model (p =.03). Ten‐year survival functions were improved among RCM‐Sarcoidosis compared to this reference group (73.4% [64.2%–80.6%] vs. 59.5% [58.8%–60.1%], p =.002). Among patients transplanted after 1999 who had at least 10 years of follow‐up (n = 19,489), median survival of RCM‐Sarcoidosis patients was 11.9 [8.3–14.6] years while that of non‐RCM patients was 9.9 [4.0–13.1] years. RCM‐Sarcoidosis was not associated with an increased risk of secondary outcomes such as graft failure, rejection, or infection. The incidence of retransplant was comparable between RCM‐Sarcoidosis and non‐RCM patients (1.38% vs. 1.50%, p =.93). Conclusions: These data suggest that long‐term outcomes following transplant for cardiac sarcoidosis are favorable compared to heart transplant for other indications. [ABSTRACT FROM AUTHOR]

Background: The incidence of systemic amyloidosis is rising, and there is a concomitant rise in heart transplant for an indication of cardiac amyloidosis. Methods: We utilized the Organ Procurement and Transplantation Network (OPTN) database to retrospectively assess survival and outcomes in adult patients undergoing heart transplant for cardiac amyloidosis from 1999 to 2019. We also compared survival among four distinct time periods: 1999–2001, 2002–2008, 2008–2015, 2016–2019. Results: Of 41,103 patients, 425 (1.03%) were transplanted for an indication of restrictive cardiomyopathy due to cardiac amyloidosis (RCM‐Amyloidosis). The percent of all transplants occurring for RCM‐Amyloidosis increased from 0.25% in the 1999–2001 era to 1.74% in the 2015–2019 era (p <.001). Across eras, Kaplan–Meier survival functions were comparable between RCM‐Amyloidosis and non‐RCM patients at 1 year (88% vs. 89%, p =.56) and at 5 years (72% vs. 77%, p =.092), but worse for RCM‐Amyloidosis patients at 10 years (44% vs. 59%, p =.002). With adjustment for other clinical variables in multivariable Cox regression model, RCM‐Amyloidosis was not associated with increased risk of death at 1 year (hazard ratio [HR] = 1.11, p =.56) or at 5 years (HR = 1.20, p =.18), but it was associated with increased risk of death at 10 years (HR = 1.35, p =.01). Cardiac amyloidosis was not associated with any morbidity outcomes following transplant, including graft failure, acute rejection, or hospitalization for infection or rejection. Conclusions: Our data suggest a trend of improving survival among RCM‐Amyloidosis patients compared with non‐RCM patients across transplant eras, with current similarities in 1‐ and 5‐year survival but a persistent, increased risk of mortality at 10 years. [ABSTRACT FROM AUTHOR]

This paper reflects on our decades‐long cultural training experiences, offering details on training efforts we made and considers in hindsight interventions we wish we had been able to implement. The paper describes what we think could be necessary for organizational training/consultation to facilitate the transformation of organizations in the direction of social justice and the delivery of efficient and effective services to a community. We reflect on organizational training to promote cultural competence and social justice. We encourage readers to take the broadest possible perspective on the larger systems issues that tend to undermine such efforts, so they can better achieve their goals for organizational change. [ABSTRACT FROM AUTHOR]

Prospective memory difficulties are commonly reported in people with dementia. The evidence supporting the use of prospective memory devices among the dementia population remains limited. MindMate is a recently developed smart device application that aims to support individuals with a diagnosis of dementia, improving self-management skills and quality of life. This study investigated the effectiveness and usability of the reminder tool on the MindMate application as a memory aid. Three participants with a diagnosis of Alzheimer's disease were recruited to this multiple baseline single-case experimental design study. Partners of the participants recorded their performance on everyday tasks on weekly monitoring forms during a baseline phase (between five and seven weeks) and during the intervention phase (five weeks) whilst using MindMate. Two participants successfully used the app throughout the intervention weeks and gave positive usability ratings. Tau-U analysis showed a significant increase in memory performance between baseline and intervention phase (Tau-U = 1, 0.94, p < .01). A third participant withdrew from the intervention phase following difficulties turning off the reminders and frustrations with the reminder alert sound. For two of the three participants, use of MindMate was feasible and effective in supporting remembering of everyday tasks compared to practice as usual. [ABSTRACT FROM AUTHOR]

Background: Previous studies of the relationship between dietary factors and risk of diverticulosis have yielded inconsistent results. We therefore sought to investigate the association between consumption of fruit and vegetables and prevalent diverticulosis.Methods: Our study population included participants in the Gastrointestinal Disease and Endoscopy Registry (GIDER), a colonoscopy-based longitudinal cohort at the Massachusetts General Hospital, who provided comprehensive information on dietary intake and lifestyle factors using validated questionnaires prior to colonoscopy. Information on presence and location of diverticula was obtained from the endoscopist at the end of each procedure. We used Poisson regression modeling to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs).Results: Among 549 participants with a mean age of 61 years enrolled in GIDER, we confirmed diverticulosis in 245 (44.6%). The prevalence of diverticulosis appeared to decrease with higher consumption of fruit and vegetables (Ptrend = 0.007 for fruit and 0.008 for vegetables, respectively). Compared to participants with less than five servings of vegetables per week, the multivariable-adjusted PRs of diverticulosis were 0.84 (95% CI, 0.60-1.17) with five to seven servings per week and 0.62 (95% CI, 0.44-0.89) with greater than one serving per day. Similarly, compared to participants with less than five servings per week of fruit, the multivariable-adjusted PR of diverticulosis was 0.60 (95% CI, 0.41-0.87) with greater than one serving per day. These associations were not modified by age, BMI, smoking, or red meat intake (All Pinteraction > 0.055).Conclusion: In a colonoscopy-based longitudinal cohort study, we show that higher consumption of fruit and vegetables is associated with lower risk of prevalent diverticulosis. [ABSTRACT FROM AUTHOR]

This article attempts to develop the undue burden balancing and the virtually per se discrimination tests of the modern Dormant Commerce Clause starting with the 1945 case of Southern Pacific v. Arizona1 and moving to Tennessee Wine & Spirits Retailers Ass'n v. Thomas,2 a case decided by the United States Supreme Court in June of 2019. The Commerce Clause, Article I, Section 8, Clause 3 gives Congress the power "To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes."3 Our most famous Chief Justice of the United States Supreme Court, John Marshall, defined Congress's commerce power "among the several states" to be plenary and complete, setting the stage for Congress to use this power over interstate commerce as the basis for much of Congress' power to pass legislation. Out of this immense federal power, Chief Justice Marshall deduced that since Congress had plenary power over interstate commerce, the states had none. Only Congress could regulate interstate commerce. Marshall called the implied limitations of the Commerce Clause "dormant" leading to what we now call the Dormant Commerce Clause. There are two main aspects to the modern Dormant Commerce Clause. First, states may pass evenhanded laws that impact interstate commerce, but even evenhanded laws may not impose undue burdens on interstate commerce. Second, states may not discriminate against interstate commerce by treating commerce from other states differently than in-state commerce simply because it is out of state. Under the undue burdens test, the Court will consider a number of factors, but primarily the Court will undertake a factual evaluation of the importance of the state interest in passing the law that impacted interstate commerce versus a practical consideration of the harm to interstate commerce. Under the discrimination rule, the Court will almost certainly find the discriminatory state law to violate the Dormant Commerce Clause, but the Court uses an almost tortuous series of approaches to reach what is close to a foregone conclusion. This tortious approach has led some to say that it is impossible to know which of the two tests to apply. This article attempts to identify the key factors involved in the Court's undue burdens balancing approach and to closely explore the Court's attempt to define discrimination and to determine when a state might be allowed to discriminate against interstate commerce. The hope is that at the very least students, lawyers, and lower courts might have some guidance in applying the two tests and in knowing the difference between the two. [ABSTRACT FROM AUTHOR]

The Bolivian water wars in 2000 over Bechtel contracts to privatize its water supply in the city of Cochabamba spurred the Episcopal Conference of Bolivia to respond with two important Catholic Social Thought theological applications to the questions of water as a human right and environmental stewardship. The sacramental character of water as well the importance of water for life itself are applied in a unique way in these statements that argues water can never be allowed to be a commodity with theological arguments. Bolivia's new constitution and mother earth laws seek to further apply the principle of water as a human right to the collective rights the country's indigenous peoples to own their ancestral land and even grant juridical personality to nature itself. The connection of its indigenous people to mother earth, Pachamama, in harmony with its ecosystems, has a sacred dimension that is behind Bolivia's new constitution, where these ideals have been enshrined and ultimately a vision for society at odds with neoliberalism that has both benefits and dangers for modern Bolivia. [ABSTRACT FROM AUTHOR]

The Nuclear Suppliers Group should play a vital role in preventing the spread of sensitive nuclear technologies, and its members, including the United States, should welcome international participation in their facilities. [ABSTRACT FROM AUTHOR]

The Bolivian water wars in 2000 over Bechtel contracts to privatize its water supply in the city of Cochabamba spurred the Episcopal Conference of Bolivia to respond with two important Catholic Social Thought theological applications to the questions of water as a human right and environmental stewardship. The sacramental character of water as well the importance of water for life itself are applied in a unique way in these statements that argues water can never be allowed to be a commodity with theological arguments. Bolivia's new constitution and mother earth laws seek to further apply the principle of water as a human right to the collective rights the country's indigenous peoples to own their ancestral land and even grant juridical personality to nature itself. The connection of its indigenous people to mother earth, Pachamama, in harmony with its ecosystems, has a sacred dimension that is behind Bolivia's new constitution, where these ideals have been enshrined and ultimately a vision for society at odds with neoliberalism that has both benefits and dangers for modern Bolivia. [ABSTRACT FROM AUTHOR]

Background: The term osteochondral lesion (OCL) refers to a defect involving the chondral surface and or subchondral bone. These lesions are associated with ankle injuries with bony and soft tissue and cause pain, decreased range of motion, swelling and impact adversely on quality of life. To date the standard treatment has been isolated microfracture (BMS). The aim of this study was to compare the outcomes of BMS alone to BMS augmented with bone marrow aspirate concentrate (BMAC) in the treatment of ankle OCLs.Methods: This study was a prospective cohort study carried out from 2010-2015 in a single surgeon's practice. Patients from 2010-2012 were treated with microfracture alone while patients from 2013-2015 were treated with micro fracture augmented with bone marrow aspirate concentrate and fibrin glue. Self-reported patient outcome measures were measured. Complications, revision rates, and visual analogue pain scores were compared.Results: 101 patients were included in the study. 52 patients were in the microfracture group while 49 patients were in the microfracture/BMAC group. The minimum follow-up for both groups was 36 months. Both groups had a statistically significant improvement in pain scores, quality of life scores, participation in sport and activities of daily living. The revision rate was 28.8% in the microfracture group versus 12.2% in the microfracture/BMAC group, which was statistically significant, p=0.0145. The majority of the lesions were less than 1.5cm2 in diameter in both cohorts.Conclusions: Microfracture and bone marrow aspirate concentrate appears to be a safe and effective treatment option for osteochondral lesions of the talus. The addition of bone marrow aspirate concentrate does not result in any increase in ankle or donor site morbidity. It is a well-tolerated therapy which decreases revision rates for treatment of the osteochondral lesions when compared to microfracture alone.Level Of Evidence: Level III. [ABSTRACT FROM AUTHOR]

The article explore Justice, Clarence Thomas's dissenting views on the Commerce Clause of the U.S. Constitution. It delves into Justice Thomas's criticisms of two aspects of the Commerce Clause. It is further reported that the Justice, Clarence Thomas criticizes the broad interpretation of Congress's power to regulate interstate commerce.

The article discusses the origin of the Dormant Commerce Clause, also called the Negative Commerce Clause in the U.S. Topics discussed include Chief Justice John Marshall's opinion about the right of the Congress to regulate interstate commerce in the case Gibbons v. Ogden, how Marshall gave the Dormant Commerce Clause its name in the case Willson v. Black-Bird Creek, and the evolution of the modern version of the doctrine.

Polychlorinated naphthalenes (PCNs) are legacy contaminants, produced primarily as flame retardants and dielectrics until phased-out in Europe and North America in the 1970s. Spatial and temporal trends (1979–2013) of PCN concentrations were studied in whole fish and herring gull eggs throughout the Great Lakes and St. Lawrence River, whereas sediments were analyzed for 2011–2013 only. For both fish and gull eggs, concentrations of PCNs were highest in western Lake Erie (7660 & 3020 pg/g ww respectively), and declined downstream to St. Lawrence River (range: 34–2370 pg/g ww). For sediments, concentrations were highest in suspended sediments from the Detroit River (264,000 pg/g), and were lower in surficial sediments downstream to the St. Lawrence River (range = 440–19,300 pg/g). PCNs declined at all sites from ~1980 to 1995, but in Lake Erie concentrations of PCNs increased in gulls fish from 1995 until 2005. The resurgence in PCNs in biota corresponded to the timing of remedial dredging of sediment highly contaminated with PCNs in the Detroit River, whose effects appear to manifest themselves downstream to Lake Ontario. Congener profiles of PCNs differed between Lake Erie and Lake Ontario until post-dredging, where PCN profiles of fish in both lakes became increasingly more similar. PCNs in gull eggs were mostly hepta-PCNs, whereas fish had higher concentrations of lower chlorinated PCNs. Patterns of PCNs in gulls and fish appear to be influenced by differences in not only routes of exposure and differential metabolic ability, but also resuspension of PCN contaminated sediments. [ABSTRACT FROM AUTHOR]

The article discusess the mechanism of calmodulin inactivation of the calcium-selective TRP channel TRPV6. It mentions about role played by calcium in numerous physiological processes; calmodulin mediated calcium ions induced inactivation is an ion channel regulatory mechanism that protects cells against the toxic effects of calcium ions overload; and use of cryo-electron microscopy for capturing the epithelial calcium channel TRPV6.

In northwestern British Columbia, the Permian Nahlin ophiolite in the northern Cache Creek terrane comprises spinel harzburgite tectonite with minor lherzolite, lower crustal mafic and ultramafic cumulates, gabbroic rocks including dikes intruding mantle harzburgite, and basaltic volcanic and volcaniclastic rocks. New lithogeochemical data from the Menatatuline Range area confirm that plutonic and volcanic rocks of the ophiolite are tholeiitic and arc related, while only a minor component of volcanic rocks are alkaline intraplate basalts. Tholeiitic basalts of the Nahlin ophiolite represent the products of 2%-20% fractional melting, and their complementary residue may be peridotite from the ophiolite mantle section. Correlative tholeiitic volcanic sections can be found elsewhere in the northern Cache Creek terrane, and they may be linked to a regionally extensive (∼200 km) intraoceanic arc. The arc tholeiite geochemistry of the plutonic and volcanic rocks, and the highly depleted nature of the mantle residues, imply that the Nahlin ophiolite formed in a supra-subduction zone environment. The Nahlin ophiolite therefore occupied the upper plate during intraoceanic collision prior to emplacement of the Cache Creek terrane. The volumetrically minor ocean island basalt type volcanic rocks in the northern Cache Creek terrane are associated with carbonate successions bearing Tethyan fauna. These sequences are likely fragments of oceanic plateaux and their carbonate atolls sliced off of the subducting plate and are unrelated to the Nahlin ophiolite-arc system. [ABSTRACT FROM AUTHOR]

Bovine tuberculosis is an infectious disease of global significance that remains endemic in many countries. Mycobacterium bovis infection in cattle is characterized by a cell-mediated immune response (CMI) that precedes humoral responses, however the timing and trajectories of CMI and antibody responses determined by newer generation assays remain undefined. Here we used defined-antigen interferon-gamma release assays (IGRA) and an eleven-antigen multiplex ELISA (Enferplex TB test) alongside traditional tuberculin-based IGRA and IDEXX M. bovis antibody tests to assess immune trajectories following experimental M. bovis infection of cattle. The results show CMI responses developed as early as two-weeks post-infection, with all infected cattle testing positive three weeks post-infection. Interestingly, 6 of 8 infected animals were serologically positive with the Enferplex TB assay as early as 4 weeks post-infection. As expected, application of the tuberculin skin test enhanced subsequent serological reactivity. Infrequent M. bovis faecal shedding was observed but was uncorrelated with observed immune trajectories. Together, the results show that early antibody responses to M. bovis infection are detectable in some individuals and highlight an urgent need to identify biomarkers that better predict infection outcomes, particularly for application in low-and-middle income countries where test-and-slaughter based control methods are largely unfeasible. [ABSTRACT FROM AUTHOR]