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This article tracks a speech the author gave inMay 2023 at the 38th Annual ICC SIA QMUL Joint Symposium of Arbitrators, which focused on ideas to improve the international arbitration process. Arbitrators frequently complain about written submissions. Their most common complaint is that they are too long. They frequently have a hard time motivating to read them when they come in, if at all. While there is little prospect of written submissions becoming materially shorter, artificial intelligence (AI) may soon revolutionize the speed with which parties can produce them, resulting in proceedings becoming frontloaded. It may also help arbitrators isolate the material legal and factual issues and expedite the preparation of awards. AI is not a substitute for human expertise and judgment, but rather a tool that promises to augment human abilities and allow legal teams and arbitrators to work more efficiently and effectively. If you have yet to familiarize yourself with ChatGPT and the like, you would be well advised to do so sooner rather than later.

Although written before the COVID-19 pandemic, Amy Seimetz’s She Dies Tomorrowis widely regarded as speaking to collective social anxiety. In the film, Amy is convinced that she will die the next day. She tells her friend, Jane, who becomes convinced that she too will die. Everyone that Jane tells catches the conviction and it spreads like a virus. This article offers an alternative reading, analysing the film as a meditation on (horror) cinema as a vehicle for affective bodily contagion. Filmic images and sounds are intangible and do not physically touch viewers yet can nevertheless carry affect that makes bodies respond to and sometimes replicate what is shown on screen. Similarly, in She Dies Tomorrow, an intangible idea causes affective response and mimesis, as well as audio-visual hallucinations. The article explores how contagious anxiety might be spread through cinematic objects, drawing from affect, phenomenology and object-oriented ontology (OOO). Finally, it explores the film’s engagement with both Derrida’s spectrality of cinema and the nature of the horror genre.

Background Postoperative glycemic control improves cardiac surgery outcomes but insulin protocols are limited by complexity and inflexibility. We sought to evaluate the effect of implementing an electronic glycemic management system (eGMS) in conjunction with a cardiac surgery endocrinology consult service on glycemic control and outcomes after cardiac surgery.Methods All patients with a calculated preoperative risk of mortality who underwent cardiac surgery before and after implementation of an eGMS and an endocrinology consult service were identified. Glycemic control and surgical outcomes were compared using univariate analysis, and multivariate regression was used to model the risk-adjusted effects of the interventions on glycemic control, surgical outcomes, and resource utilization. The health care–related value added by the interventions was calculated by dividing risk-adjusted outcomes by total hospital costs.Results A total of 2612 patients were identified, with 1263 patients in the preimplementation cohort and 1349 in the postimplementation cohort. Multivariate regression demonstrated fewer postoperative hyperglycemic events (odds ratio [OR] 0.8, 95% CI, 0.65-0.99) after protocol implementation without an increase in hypoglycemic events (OR 0.96, 95% CI, 0.71-1.3). Average day-weighted mean glucose decreased from 144 to 138 mg/dL (P< .001). The improved glycemic control correlated with a risk-adjusted decrease in composite morbidity or mortality (OR 0.61, 95% CI, 0.47-0.79). Although hospital costs increased after implementation, the protocol increased health care–related value by 38%.Conclusion Implementation of a protocol consisting of an eGMS paired with a cardiac surgery–specific endocrinology consult service was associated with improved glycemic control and reduced morbidity. Despite higher costs health care–related value increased as a result of eGMS implementation.

Roux-en-Y Gastric Bypass (RYGB) is well known to ameliorate type 2 diabetes mellitus (T2DM), and recent work suggests that the preoperative DiaREM model predicts successful remission up to 1 year post-RYGB. However, no data exist for long-term validity. Therefore, we sought to determine the utility of this score on long-term RYGB effectiveness for T2DM resolution at 2 and 10 years, respectively. T2DM patients (Age: 48, BMI: 49, HbA1C: 8.1) undergoing RYGB at the University of Virginia between 2004–2006 (n= 42) and 2012–2014 (n= 59) were evaluated prospectively to assess preoperative DiaREM score, defined from insulin use, age, HbA1C, and type of antidiabetic medication. T2DM partial remission status was based on the American Diabetes Association guidelines (HbA1C< 6.5 % and fasting glycemia <125 mg/dL, and no anti-diabetic medications). Chi-square test was used to compare patient’s T2DM status to their DiaREM probability of remission. Among RYGB patients with 2-year postoperative data, 2 were lost (n= 1 no follow-up and n= 1 died) resulting in 57 patients for analysis. For the 10-year postoperative data, 11 were lost (n= 6 no follow-up and n= 5 died), thereby resulting in only 31 patients for analysis. Patients were distributed by DiaREM score to correlate with the predicted probability of remission as follows: 0–2 (Predicted 94 %, 2-year 100 % p= 0.61, 10-year 100 % p= 0.72), 3–7 (Predicted 76 %, 2-year 94 % p= 0.08, 10-year 83 % p= 0.57), 8–12 (Predicted 36 %, 2-year 47 % p= 0.38, 10-year 43 % p= 0.72), 13–17 (Predicted 22 %, 2-year 20 % p= 0.92, 10-year 33 % p= 0.64), and 18–22 (Predicted 9 %, 2-year 15 % p= 0.40, 10-year 14 % p= 0.64). Preoperative DiaREM scores are a good tool for predicting both short- and long-term T2DM remissions following RYGB. This study highlights the need to identify strategies that improve T2DM remission in those at highest risk.

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AbstractThis study investigated women’s lived experience of becoming less obsessed with their bodily appearance. Written narrative accounts were collected from seven women co-participants and a phenomenological analysis of these descriptive protocols was then performed in order to reveal the prereflective structure of the focal phenomenon, seven essential constituents of which emerged. A major goal of this research was to contribute to the undernourished area of phenomenological research regarding the experience of body image.

The article offers step-by-step instructions for instrumentalists in adjusting the English horn which include differentiation between the terms key and vent, the effect of adjustment screws on the height of a key or keys, and the use of ungummed cigarette paper for testing the seal of pads.

Several genes expressed in the initial segment of the epididymis depend on factors from the testis that reach the epididymis via the luminal system. These include gamma-glutamyl transpeptidase mRNA IV (Ggt_pr4), steroid 5 alpha reductase (Srd5a1), glutathione peroxidase 5 (Gpx5), and cystatin-related epididymal spermatogenic (Cst8) genes. Promoter analyses indicated that these genes contain several ETS DNA-binding sites. Members of the polyomavirus enhancer activator 3 (ETV4) family bind to ETS sites on the promoter of target genes to regulate transcription. In this study, the role of ETV4 family members (ETV4, ETV5, ETV1) in the transcription of initial segment specific genes was evaluated. All three ETV4 family mRNAs are expressed in the principal cells of the initial segment and depend upon the presence of testicular luminal fluid factors. ETV4 protein was localized to principal cell nuclei and displayed the highest expression in the most proximal region of the initial segment. In addition, ETV4 protein levels were diminished after loss of testicular luminal fluid factors. A dominant-negative construct of ETV5 was in vivo electroporated into the initial segment to determine if ETV4 family members can regulate the transcription of testicular luminal fluid factor-regulated genes. Quantitative PCR indicated that 1 day postelectroporation, all three ETV4 family member mRNAs were significantly decreased. In addition, Ggt_pr4, Srd5a1, and Gpx5mRNA levels were also significantly decreased. The data suggest that ETV4 family members regulate their own expression, and that they regulate transcription of a subset of genes that are dependent upon testicular luminal fluid factors.

Ischemia-reperfusion (IR) of the testis results in germ cell-specific apoptosis and can lead to aspermatogenesis. Germ cell-specific apoptosis after IR of the testis has been shown to be correlated with and dependent on neutrophil recruitment to the testis after IR. Studies that used E-selectin-deficient mice have demonstrated that E-selectin expression is critical for neutrophil recruitment to subtunical venules in the testis after IR and for the resultant germ cell-specific apoptosis. The present study investigates the in vivo signaling pathway that exists after IR that leads to neutrophil recruitment in the murine testis. Mice were subjected to a 2-h period of testicular ischemia followed by reperfusion. Results demonstrate that the proinflammatory cytokines, tumor necrosis factor α (TNFα) and interleukin 1β (IL-1β), are stimulated after IR as is the phosphorylation of c-jun N-terminal kinase (JNK). The downstream transcription factors of JNK, ATF-2 and c-jun are also phosphorylated at specific times after IR of the testis. Activation of the JNK stress-related kinase pathway is correlated with an increase in E-selectin expression and neutrophil recruitment to the testis after IR. Intratesticular injection of IL-1β also caused JNK phosphorylation and neutrophil recruitment to the testis. These results suggest that testicular IR injury stimulates IL-1β expression, which leads to activation of the JNK signaling pathway and ultimately E-selectin expression and neutrophil recruitment to the testis. This provides the first evidence of a cytokine/stress-related kinase signaling pathway to E-selectin expression in vivo.

Studies from our laboratory support a model in which growth factors produced in the testis reach the epididymis via the luminal system and play an important role in maintaining the function of epithelial cells, particularly in the initial segment. Previous work showed that γ-glutamyl transpeptidase (GGT) mRNA IV, which is highly expressed in the rat initial segment, may be under the control of luminal fibroblast growth factor 2 (FGF-2) from the testis. The current studies were undertaken to identify which fibroblast growth factor receptors (FGFRs) are present in the principal cells of the rat initial segment and to identify other potential ligands for these receptors in rat rete testis fluid (RTF). Immunoblot analysis revealed that FGFRs 1–4 were present, and reverse transcription polymerase chain reaction (RT-PCR) analysis confirmed that both the IIIb and IIIc splice variants of FGFRs 1–3 were expressed. However, RT-PCR using RNA isolated from principal cells collected by laser capture microdissection revealed only FGFR-1 IIIc. Additional PCR analysis established that both the α and β forms of FGFR-1 IIIc were expressed in principal cells. Both FGF-4 and FGF-8 were present in rat RTF, as determined by immunoblotting. Thus, FGF-2, -4, and -8, found in RTF, may act upon FGFR-1 IIIc in the principal cells of the initial segment to regulate GGT mRNA IV expression.

Focuses on the use of Interactive Metronome, a computer-based training program for disabled persons in the U.S. Importance of timing in the human development; Influence of timing on the ability of the person to plan and sequence actions; Impact of timing on the areas of learning. INSET: The History of IM..

The article discusses visual issues caused by mild traumatic brain injury (mTBI) and why optometrists should seek mTBI patients. Blurred vision, convergence insufficiency and double vision are some issues involved in mTBI which Mike Peters, an Optometry doctor and sports vision specialist said optometrists have command and expertise in. Reasons why mTBI patients should be pursued include mTBI as a serious health problem, to improve practice revenue and, personal and professional fulfillment.

The article offers pointers on how to attract and retain ocular allergy patients. The author reports that more than 20% of Americans are afflicted with ocular allergies. Furthermore, he cites the report by the U.S. Third National Health and Nutrition Examination Survey (NHANES III) which showed that 40% of U.S. adults reported the incidence of watery and itchy eyes throughout one year. These figures, he claims, should not be taken for granted. He also suggests the need to educate current and potential patients.

The article offers advice for optometrists on office design. Barbara Wright Design notes that poor design choices can be detrimental to staff productivity. Some offices fail because the practitioner's initial design did not accommodate for technological innovations, such as new diagnostic equipment or computers. A cluttered and disorganized-looking office can translate to patients that the residing optometrist is a cluttered and disorganized practitioner.

The article presents five ergonomic tips that may help alleviate the strain of practicing optometry. Optometrists should use a height-adjustable stool and/or table to enable them to firmly plant their feet on the ground. Avoid sitting side-saddle when facing the patient. Optometrists should have right- and left-handed examination rooms.

The article presents ways on how to make the practice of an optometrist profitable. An optometrist should determine what types of services to offer in order to attract patients in an area. Checking other practices can give ideas on how to pull patients away from the competition. The author says that marketing externally is also important. This can be done through direct mail, advertisements or e-mail.