Preemptive Effect Research Articles

A novel frame preemption model in TSN networks

This paper identifies a limitation in the frame preemption model in the TSN standard (IEEE 802.1Q-2018), due to which high priority frames can experience significantly long blocking delays, thereby exacerbating their worst-case response times. This limitation can have a considerable impact on the design, analysis and performance of TSN-based systems. To address this limitation, the paper presents a novel and more efficient frame preemption model in the TSN standard that allows over 90% reduction in the maximum blocking delay leading to lower worst-case response times of high priority frames compared to the frame preemption model used in the existing works. The paper also shows that the improvement becomes even more significant in multi-switch TSN networks. In order to evaluate the effects of preemption, the paper performs simulations by enabling and disabling preemptions as well as enabling and disabling the Hold/Release mechanism supported by TSN. Furthermore, the paper performs a comparative evaluation of the two models of frame preemption in TSN using simulations. The evaluation shows that the maximum response times of high priority frames can be significantly reduced with very small impact on the response times of lower priority frames. The paper also shows the improvement in the maximum response times of higher priority frames using an automotive industrial use case that employs a multi-hop TSN network for on-board communication.

Postoperative pain and edema control following different protocols of preemptive analgesia in the surgical removal of impacted third molars: A triple-blind parallel randomized placebo-controlled clinical trial

This randomized controlled clinical trial aimed to evaluate the preemptive effects of acetaminophen, ibuprofen, ketoprofen, nimesulide or dexamethasone on postoperative pain and edema in the surgical removal of impacted third molars.Participants underwent bilateral surgeries at 2 different times and were randomly given the test drug or placebo (split-mouth). Postoperative pain, edema and rescue medication were evaluated at different times. Study power was >80% for the observed effect size in the crossover repeated measures design. Differences between test drug and placebo were the response variable. Generalized Estimation Equation models were adjusted for each outcome.Sample comprised 5 groups (n = 20 each). Ibuprofen and nimesulide showed higher overall effects on pain scores over time, with no differences between them (p = 0.557). Acetaminophen showed significantly lower overall effects in edema control over time, when compared to other test drugs, that showed similar effects. Lower quantity of rescue medication were also observed for ibuprofen and nimesulide, with no differences between them (p = 0.999). Ibuprofen and nimesulide showed beneficial overall preemptive effects. Hence, in the decision-making process for preemptive analgesia in impacted third molar surgeries, ibuprofen and nimesulide should be considered on a case-by-case basis as the drugs of choice.

Intraoperative Ketamine for the Opioid-Naïve Patients: Move Along Folks, Nothing to See Here?

Intraoperative Ketamine for the Opioid-Naïve Patients: Move Along Folks, Nothing to See Here?

Preemptive effect of amantadine as adjuvant in postoperative analgesia of ovaryhisterectomy in dogs

This study aimed to evaluate the preemptive analgesic effect of amantadine on postoperative pain control in female dogs that underwent ovariohysterectomy. Twenty female dog were randomly assigned to two groups of ten. The control group (CONTROL) received oral placebo capsules, while the amantadine (AMANT) group received 5 mg/kg of oral amantadine one hour before sedation. All the animals were premedicated with 3 mg/kg (IM) meperidine, induced with propofol and maintained with isofluorane. The transanesthetic physiological parameters were recorded, and postoperative pain was evaluated every hour after extubation for six hours with the Dynamic Interactive Visual Analog Scale (DIVAS) and mechanical nociceptive threshold (MNT) and when the necessary analgesic rescue was administered (morphine, 0.2 mg/kg (IM)). During the surgical procedure, there was no significant difference in the variables measured between the two groups. Regarding postoperative pain assessment, there was a significant difference in the DIVAS score (p = 0.004) between the groups, in which AMANT required fewer rescues than did CONTROL (p = 0.03). The MNT was significantly higher ​​in AMANT than in CONTROL (p = 0.03). The results suggested that the preoperative administration of amantadine decreased analgesic requirement in female dogs that underwent elective ovariohysterectomy.

Evaluation of Preoperative Administration of Rectal Indomethacin in Reducing the Severity of Ileus after Open Cholecystectomy

Introduction: Ileus or transient intestinal motility disorder is one of the problems after surgery, which poses challenges facing the medical team. Previous studies approved the preemptive effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ileus; however, the majority of them have focused on animal models. This study aimed to investigate the effects of administration of rectal indomethacin in reducing ileus in patients who underwent cholecystectomy. Materials and Methods: This randomized controlled trial included 40 patients with cholelithiasis who were divided into two groups of indomethacin (n=20) and placebo (n=20). The indomethacin group received 100 mg rectal indomethacin before the operation. Cholecystectomy was performed using an open technique. The recovery of bowel functions (i.e. the time of the first flatus passage, return of appetite, and total dosage of opioid analgesic medications) was evaluated in this study. Results: Time of the first ileus passage (P=0.004), return of appetite time (P=0.06), and reduction of opioid usage (65.62±5.5 mg/day versus 93.26±2.56) were significantly shorter in the indomethacin group, compared to the placebo group. Furthermore, none of the patients had any significant indomethacin-related complications. Conclusion: According to the outcomes of this study, it is concluded that preoperative administration of NSAIDS can be helpful in postoperative ileus reduction.

Creative Sovereignties: Should Copyright Apply on Tribal Lands?

The federal Copyright Act grants authors the exclusive right to use their original creative expressions in certain ways. At the same time, the Act pre-empts most equivalent rights to creative expressions established by States. However, the Copyright Act is silent as to its applicability on the lands of Native American Tribes and its preemptive effect on rights sovereign Tribal governments accord to creativity. With Tribes and Tribal members increasingly engaged in the global creative economy and in litigation to defend their intellectual properties, the status of the Copyright Act on Tribal lands has become a critical issue that Congress or the courts must now address. The stakes of applying the Copyright Act on Tribal lands may be quite high for Tribes. Drawing on doctrinal research coupled with community-partnered ethnographic research conducted with the Hopi Tribe, I explain how federal copyright law impacts contemporary tribal sovereignty. Copyright clearly supports certain forms of Tribal creativity intended for off-reservation markets. But for locally circulating creativity — including forms of cultural or ceremonial creativity that help maintain Tribal identity, social relations, and traditional sources of authority — applying Copyright may very well disrupt the exercise of Tribal sovereignty and cause substantial harm to Tribal creative economies. Based on this research, I argue that the Copyright Act should apply on Tribal lands, but only to the extent permitted by each Tribe. Where Tribal intellectual property laws, protocols, or customary laws occupy the same field as the Copyright Act, Tribal entitlements and remedies, not federal ones, should govern creativity occurring on Tribal lands, with federal copyright law providing enforcement of Tribal intellectual property rights beyond a Tribe’s borders. Otherwise, the unilateral imposition of the Copyright Act on tribal creativity, to the exclusion of Tribal laws, impermissibly invades Tribal sovereignty as articulated in both current federal policy and the international norms enshrined in the United Nations Declaration on the Rights of Indigenous Peoples.

Protocolos de medicação pré e pós-operatória para cobertura radicular combinada com enxerto de tecido conjuntivo.

Este estudo avaliou o efeito pré e pós-operatório de dexametasona e ibuprofeno na prevenção de dor / desconforto, edema e interferência na vida diária em pacientes submetidos à cobertura radicular combinada com enxerto de tecido conjuntivo subepitelial (CAF + CTG). Vinte pacientes foram aleatoriamente designados da seguinte forma: Grupo AINE: 400mg de ibuprofeno 60 min preemptivo + 400mg de ibuprofeno no pós-operatório; ou Grupo SAID: 4mg de dexametasona 60 min preemptiva + 4mg de dexametasona pós-operatória. A medicação pós-operatória foi administrada 8 e 16 horas após a cirurgia. Cada paciente recebeu questionários com base em uma escala numérica (escala numérica de 101 pontos [NRS-101]) e questões de múltipla escolha (escala de avaliação verbal de quatro pontos [VRS-4]) sobre dor / desconforto transoperatório, de hora em hora para 8 h após a cirurgia e uma vez por dia durante três dias. Também foi respondida a Escala Visual Analógica (EVA) para edema e interferência na vida diária durante o 1º, 2º, 3º e 7º dia. O grau de ansiedade foi avaliado estatisticamente pelo teste Qui-quadrado. Os testes de Mann-Whitney e Friedman foram usados ​​para os demais questionários. O tempo de cirurgia e o número de comprimidos analgésicos consumidos foram comparados usando o teste t de Student. Pacientes que fizeram uso de dexametasona apresentaram tendência a menos dor quando comparados aos indivíduos que ingeriram ibuprofeno, com diferença significativa observada três horas após o procedimento (p <0,05). O uso de dexametasona também promoveu menos edema até o 2º dia e menor interferência na vida diária no terceiro dia quando comparado ao ibuprofeno (p <0,05).

Preoperative Implementation of Transverse Thoracic Muscle Plane Block and Rectus Sheath Block Combination for Pediatric Cardiac Surgery

Systemic intravenous administration of opioids is the main treatment strategy for intraoperative and postoperative pain management in patients undergoing cardiac surgery with sternotomy. However, using lower doses of opioids may achieve the well-established benefits of the fast-track approach, with minimal opioid-related side effects. Postoperative pain is coupled with a long stay in the intensive care unit. Although neuraxial anesthesia has some benefits, its use remains controversial due to the potential development of epidural hematoma after anticoagulation for cardiopulmonary bypass and coagulopathy after cardiac surgery. Therefore, there is a need for other effective postoperative analgesic strategies, such as peripheral nerve blocks other than neuraxial anesthesia, for cardiac surgery with sternotomy. The effects of real-time ultrasound-guided transverse thoracic muscle plane (TTP) block on postoperative pain after sternotomy have been reported; however, the pain and discomfort in the epigastric area caused by chest drainage tubes placed through the rectus abdominis muscle also are major postoperative problems after cardiac surgery. Herein, the authors report on a preoperative combination of TTP block and rectus sheath block (RSB) for postoperative pain management after cardiac surgery with sternotomy that addresses pain in both the chest and epigastric areas. Considering previous studies, it is presumed that preemptive analgesic effects can be expected via a combination of the TTP block and RSB, and indeed, the preemptive effect was observed in the present study's patients. In this article, the procedure and tips for combining the TTP block and RSB are introduced.

The preemptive effect of tramadol and metamizole on the intensity of postoperative pain.

Aim To demonstrate the analgesic effect of preemptively administered tramadol and metamizole on the postoperative pain severity, after an elective operative hysterectomy with adnexectomy. Methods There were three groups with 30 patients in each group. Patients included in the study were between 45 to 67 years old. They were all in the ASA group II. Randomization was performed in random order according to the regular elective operating program. Patients in Group I received i. m. tramadol 1mg/kg, and in Group II 30mg/kg of metamizole, five minutes before anaesthesia induction. Patients did not receive preemptive analgesia in Group III (control). All patients underwent the same induction anaesthesiology procedure with propofol, fentanyl, tracrium, supplemented with O2, N2O, and sevoflurane at an appropriate dose until MAC 1 was reached. Surgeries lasted for 80-120 minutes. Every patient performed a resting pain assessment 30 minutes after an extubation by Numerical Pain Scale (NPS). Results We found out that tramadol had a better effect in preemptive analgesia and that the average pain score for Group I was 6.10 (p=0.043). In Group II, it was 7.93 (p=0.022). There is significant difference in pain intensity between patients in the control group, (pain intensity was 9.16), and those who received tramadol and metamizole. There was no significant difference in the intensity of pain when using these two analgesics (p=0.733). Conclusion The effect of preemptively administered tramadol prior to the introduction of general anaesthesia in postoperative pain is significantly more favourable than the effect of metamizole.

Comparison of Preemptive Effect of Dexamethasone and Methylprednisolone After Third Molar Surgery: A Split-Mouth Randomized Triple-Blind Clinical Trial.

The study aimed to compare the efficacy of methylprednisolone and dexamethasone injected into masseter muscle preoperatively in surgical extraction of lower third molars. This study was carried out on 20 patients who reported to the department of Oral and Maxillofacial surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital Bangalore, requiring surgical removal of bilateral mandibular third molars. The efficacy of corticosteroid was evaluated based on its ability to reduce pain, swelling and trismus following the surgical extraction of impacted lower third molars. There was no statistical difference between the two steroids with both of them achieving equal level of pain control. There was a statistically significant difference on the second postoperative day with dexamethasone showing clinically superior result. The difference in oral aperture was found to be statistically significant with dexamethasone showing a decreased reduction in postoperative mouth opening on both second and seventh day. This study conclusively proves that patient comfort levels are far better with the use of dexamethasone.

Equity First: Conceptualizing a Normative Framework to Assess the Role of Preemption in Public Health.

Policy Points Preemption is a legal doctrine whereby a higher level of government may limit or even eliminate the power of a lower level of government to regulate a certain issue. Some state legislatures are using preemption with increasing regularity to thwart local policies that have the potential to reduce health inequities.Despite recent trends, preemption is not inherently adversarial to public health, equity, or good governance but rather reflects its wielder's goals and values. Existing frameworks for assessing preemption fail to reconcile its potential to both advance and hinder health equity.An equity‐first preemption framework can facilitate case‐by‐case assessments of whether preemption is likely to worsen inequities or whether it is an appropriate response to address existing inequities. Robust empirical evidence is needed to develop and operationalize such a framework. ContextDue to the inequitable distribution of various social determinants of health, disparities in health and well‐being are tied to where an individual lives. In the United States, a zip code often better predicts a person's health than their genetic code. As communities seek to redress these inequities, many find that, due to state preemption, their zip code also dictates their ability to pursue more equitable laws through local government action. Preemption is a legal doctrine whereby a higher level of government may limit or even eliminate the power of a lower level of government to regulate a certain issue.MethodsWe conducted a literature review to survey existing scholarship about the effects of preemption on public health and health equity using online databases such as PubMed, WestLaw, and Google Scholar. We also cohosted a series of cross‐sector, interdisciplinary research convenings with preemption, public health, and equity experts. Based on our findings, this article reviews the role of law and policy in the genesis of health inequities and highlights how preemption has both created and alleviated such inequities. We demonstrate how a normative framework rooted in redressing health inequities can advance a more just approach to preemption and outline a research agenda to support future action.FindingsLaw and policy have been central to creating health inequities, and while those same tools can promote health equity, some state legislatures are using preemption with increasing regularity to thwart local policies that may improve health and equity. Nevertheless, preemption is not inherently adversarial to public health, equity, or good governance. Preemptive federal civil rights laws, for example, have countered government‐sanctioned discrimination. However, existing frameworks for assessing preemption fail to reconcile its potential to both advance and hinder health equity.ConclusionsShortcomings in existing preemption frameworks demonstrate the need for new approaches to elevate equity as a central consideration in assessing preemption. We propose the development of an equity‐first preemption framework to establish evidence‐based criteria for assessing when preemption will enhance or inhibit equity and a research agenda for developing the evidence necessary to inform and operationalize the framework. An equity‐first reconceptualization of preemption can help ensure that local governments remain places of innovation while allowing states and the federal government to block local actions that are likely to create or perpetuate inequities.

Suppression of Dynamical Network Biomarker Signals at the Predisease State (Mibyou) before Metabolic Syndrome in Mice by a Traditional Japanese Medicine (Kampo Formula) Bofutsushosan.

Due to the increasing incidence of metabolic syndrome, the development of new therapeutic strategies is urgently required. One promising approach is to focus on the predisease state (so-called Mibyou in traditional Japanese medicine) before metabolic syndrome as a preemptive medical target. We recently succeeded in detecting a predisease state before metabolic syndrome using a mathematical theory called the dynamical network biomarker (DNB) theory. The detected predisease state was characterized by 147 DNB genes among a total of 24,217 genes in TSOD (Tsumura-Suzuki Obese Diabetes) mice, a well-accepted model of metabolic syndrome, at 5 weeks of age. The timing of the predisease state was much earlier than the onset of metabolic syndrome in TSOD mice reported to be at approximately 8–12 weeks of age. In the present study, we investigated whether the predisease state in TSOD mice can be inhibited by the oral administration of a Kampo formula, bofutsushosan (BTS), which is usually used to treat obese patients with metabolic syndrome in Japan, from 3 to 7 weeks of age. We found the comprehensive suppression of the early warning signals of the DNB genes by BTS at 5 weeks of age and later. Specifically, the standard deviations of 134 genes among the 147 DNB genes decreased at 5 weeks of age as compared to the nontreatment control group, and 80 of them showed more than 50% reduction. In addition, at 7 weeks of age, the body weight and blood glucose level were significantly lower in the BTS-treated group than in the nontreatment control group. The results of our study suggest a novel mechanism of BTS; it suppressed fluctuations of the DNB genes at the predisease state before metabolic syndrome and thus prevented the subsequent transition to metabolic syndrome. In conclusion, this study demonstrated the preventive and preemptive effects of a Kampo formula on Mibyou before metabolic syndrome for the first time based on scientific evaluation.

Pre-emptive Analgesia Effect in Different Psycho-emotional Status Patients During Lower Third Molar Surgical Extractions

Pre-emptive Analgesia Effect in Different Psycho-emotional Status Patients During Lower Third Molar Surgical Extractions

The Constitutionality of State and Local 'Norm Sustaining' Actions on Global Climate Change Actions: The Foreign Affairs Federalism Grey Zone

States and cities have long been leaders on global climate change by participating in international meetings, forming cross-border alliances, entering into bilateral memoranda of understanding, and even harmonizing their regulatory systems, as in the case of the California-Quebec emissions trading program. Such subnational efforts have taken on a new importance in the wake of President Trump’s withdrawal of the United States from the Paris Agreement on climate change. Although states and cities cannot be parties to this international agreement, they can contribute to its success by engaging in what I describe as “norm sustaining” activities. However, how can such norm sustaining activities survive constitutional scrutiny when the Supreme Court has often said the nation should speak with “one voice” on foreign affairs? The analysis of several different cross-border climate agreements between subnational actors raises some concern, especially for California’s linked cap-and-trade program with Quebec, which the Trump administration has challenged in court. Under the Compact Clause, the presumed constitutionality of existing agreements between states and foreign governments largely turns on the assumption that the interstate doctrine applies. Under the Supremacy Clause, the Supreme Court’s expansive reading of executive power could be interpreted to give preemptive effect to President Trump’s repudiation of the Paris Agreement. If California’s emissions trading program is perceived as a tax under the dormant Foreign Commerce Clause, then the requirement that the nation speak with one voice on international commerce could be violated. However, two trends—one legal and one factual—suggest otherwise. First, the legal and historical justifications for foreign affairs exceptionalism may make less sense in today’s society than at our nation’s founding. Recent cases suggest that the Supreme Court may be more likely to treat foreign affairs like domestic matters, at least where national security is not at issue. Second, when one considers the other ways in which state and local governments have engaged in the grey zone of foreign affairs law—such as by conducting trade and investment missions, entering into agreements to facilitate cross-border legal processes, and engaging in human rights treaty processes —subnational climate actions do not seem so extraordinary. Even the agreement creating the California-Quebec emissions trading program is similar to other cross-border activities, such as an agreement between New York and Quebec on driver’s licenses and an agreement between states and provinces on the Great Lakes. Through a unique analysis that situates subnational climate change agreements within a broader legal and factual context, this Article argues that cross-border climate action by states and cities is well-positioned to survive constitutional scrutiny.

Preemptive Effect of Two Different (Intracuff and Intravenous) Routes of Dexamethasone Administration on Postoperative Sore Throat and Cough

Introduction: The most common complications following anesthesia intubation include postoperative sore throat, post-extubation cough, and hoarse voice. Currently, the use of preoperative Dexamethasone has been effective in controlling these complications. Therefore, the present study aimed to compare the preemptive effect of intracuff and intravenous routes of Dexamethasone administration for postoperative sore throat and cough. Materials and Methods: In the present clinical trial, 96 patients who underwent general anesthesia intubation were randomly assigned to three groups. The first group received 4 mg intracuff Dexamethasone, the second group received 4 mg intravenous Dexamethasone, and the third group was administered a placebo. Cough frequency and severity of a sore throat after extubation were investigated in the three groups. Results: Any significant difference was not observed among the three groups regarding hemodynamic variables (P>0.01); however, the incidence of cough was significantly lower in all the three groups (P<0.01). Also, the average severity of a sore throat in PAR and 1 h after surgery in the three groups was significantly lower (P<0.05). Moreover, no difference was detected in the groups regarding the severity of a sore throat within 24 h post-surgery (P>0.01). Conclusion: The use of two methods of intravenous and intracuff Dexamethasone administration before surgery reduced the incidence of postoperative cough and the severity of sore throat in patients.

Is ERISA Preemption Superfluous in the New Age of Health Care Reform

In June 2010, the Department of Justice (DOJ) submitted a brief to the United States Supreme Court opposing the grant of certiorari in litigation over the legality of San Francisco’s recent health reform law. The claim in the case was that ERISA, which had long preempted a variety of state health reform efforts, also preempted the San Francisco reform. The DOJ, however, recommended against Supreme Court review in large part because of the new federal health care reform law, the Affordable Care Act (“ACA”), had recently been enacted, and even the government was unprepared to predict with confidence its effect on previously settled areas of law like the one at issue in San Francisco. Because the federal reform was so new, the DOJ argued, it was premature for the Court to hear the case. But the ACA is no longer so new, and though Supreme Court review of the question arising from the San Francisco reform may not have been advisable, it is critical to obtain more clarity now about the ACA’s interaction with other major laws. In particular, one of the principal sources of uncertainty is the ACA’s relationship to ERISA. ERISA preempts any state laws that “relate to” employer-provided health benefits. Although the ACA is a federal law and thus not preempted by ERISA itself, the states must implement much of it. Yet despite ERISA’s reputation as a state reform-killer, Congress did not address whether it would have any preemptive effect once the ACA rolled out. Can the states implement reforms mandated with the ACA without running afoul of ERISA? What about ERISA’s effects on states’ non-ACA reforms going forward? And then there is the middle ground: state reform plans that receive waivers through the ACA. These have recently received much publicity, but will state reforms that get an ACA waiver be able to avoid ERISA preemption?

The New York Convention and the American Federal System

Virtually all American states have statutes that make arbitration agreements and awards enforceable and that set out procedures for their enforcement in state courts. A number of states, including California, Texas, and Florida, have enacted international arbitration statutes to supplement their domestic arbitration laws.2 But this extensive body of state arbitration law has had only a “marginal impact” on American arbitration practice – particularly international arbitration practice because the Federal Arbitration Act (FAA) preempts conflicting state arbitration laws, even in state court. Although we know that the FAA preempts state law, the scope of that preemptive effect is not clear. Indeed, a pair of United States Supreme Court cases have suggested a possible broader role for state law in arbitration matters. In Hall Street Associates, LLC v. Mattel Inc., the Court indicated in dicta that parties might be able to contract for expanded review under state law although the FAA does not permit them to do so.5 And in Stolt-Nielsen S.A. v. AnimalFeeds International Corp., the Court suggested that the arbitrators might not have exceeded their powers in construing an arbitration clause to permit class arbitration if they had relied on a state default rule permitting class arbitration. Whether state law can play a broader role in international arbitration matters in the United States depends on the extent to which the New York Convention and Chapter Two of the FAA (which implements the Convention) preempt state arbitration law. This article undertakes a preliminary analysis of that broad topic by examining several legal questions central to determining the preemptive effect of the New York Convention: (1) What effect, if any, does the federal-state clause (Article XI) have on U.S. obligations under the Convention? (2) To what extent does Chapter Two of the FAA apply in state court? and (3) Is the New York Convention self-executing? Part II briefly sets out background information on the New York Convention and its implementation in the U.S. Part III describes three models of how an arbitration convention might be implemented: the “exclusive spheres” model, the “federal preemption” model, and the “access” model. Part IV analyzes the legal questions identified above and considers their implications for the models. Part V discusses the extent to which parties can contract out of the FAA and into state arbitration law. Finally, Part VI identifies some possible implications of this analysis and concludes.

The Preemptive Effect of Pregabalin Single Dose on Opioid Consumption after surgery of Mandible Fracture: The Double-Blinded Clinical Trial

Background: Currently, the administration of non-opioid analgesics as a preemptive treatment has been approved by the surgeons of jaw due to lack of side effects of opioids in jaw surgery. However, which medicine as a pre-medication has a good result, is a controversy. Therefore, the aim of this study was to investigate the effect of preemptive therapy by pre-gabalin single dose on opioid consumption rate after surgery on mandibular fractures. Methods: This double-blind clinical trial was conducted in Tabriz Imam Hospital in 2012 on 60 patients who were undergoing mandibular fracture surgery. Patients were classified as intervention and control groups and the intervention group consumed one pregabalin capsule 300 milligrams with 50 ml of water half an hour before surgery. The amount of opioid use in the first eight hours after surgery was measured and recorded in both groups. Results: Opioid use in both groups was decreased with time- spending. There was also a significant relationship between opioid use in both intervention and control groups (P <0.001). Conclusion: Pregabalin premedication could have analgesic effects in lower jaw fracture surgery and decrease opioid use after surgery.

Limiting the Property Clause

The Supreme Court has repeatedly held that the Property Clause of the Constitution grants Congress the power to regulate the public lands “without limitation.” This Article argues that the Court’s interpretation of the Property Clause is inconsistent with constitutional history, antithetical to structure principles of federalism, and undesirable from the standpoint of environmental law. Relying on new historical evidence, this Article contends that, when the country originally debated the meaning of the Property Clause, the leading statesmen of the early Republic rejected a broad interpretation of federal power. In sum, they believed that, while Congress should have a police power over the territories, it should have no more regulatory authority over federal land within a state by virtue of the Property Clause than a private landowner. Under this approach, federal legislation under the Property Clause would have no preemptive effect on state law. This Article further argues that, if the Court’s recent efforts to revive federalism are to be meaningful, it should return to the original understanding of the Property Clause. Congress’s unlimited legislative power over federal lands enables it overrule state policy on many of the core issues of state concern that justify the existence of federalism, including environmental law. This Article also advances the counterintuitive argument that reinvigorating federalism in this context would structurally favor more robust environmental regulation. While the federal government would retain the power to limit the use of its lands as a proprietor, the states would have the power to go beyond federal policy and prevent environmentally destructive activities as sovereign regulators. However, because the state’s regulatory power would not include the power to override federal property rights, the states would not have the power to authorize any land use that would conflict with federal rules. Unlike the current system of federal supremacy, a limited reading of the Property Clause would thus structurally favor conservation over development.

Artificial Shortage in Agricultural Supply Chains

Problem Definition: Price surge of essential commodities despite inventory availability, due to artificial shortage, presents a serious threat to food security in many countries. To protect consumers' welfare, governments intervene reactively with either (i) Cash Subsidy, to increase consumers' purchasing power by directly transferring cash, or (ii) Supply Allocation, to increase product availability by importing the commodity from foreign markets and selling it at subsidized rates. Academic/Practical Relevance: This paper develops a new behavioral game-theoretic model to examine the supply chain and market dynamics that engender artificial shortage, as well as to analyze the effectiveness of various government interventions in improving consumer welfare. Methodology: We analyze a three-stage dynamic game between the government and the trader. We fully characterize the market equilibrium and the resulting consumer welfare under the base scenario of no government intervention, as well as under each of the interventions being studied. Results: The analysis demonstrates the disparate effects of different interventions on artificial shortage; while supply allocation schemes often mitigate shortage, cash subsidy can inadvertently aggravate shortage in the market. Further, empirical analysis with actual data on onion prices in India shows that the proposed model explains the data well and provides specific estimates on the implied artificial shortage. A counterfactual analysis quantifies the potential impacts of government interventions on market outcomes. Managerial Implications: The analysis shows that reactive government interventions with supply allocation schemes can have a preemptive effect to reduce the trader's incentive to create artificial shortage. While cash subsidy schemes have recently gained wide popularity in many countries, we caution governments to carefully consider the strategic response of different stakeholders in the supply chain when implementing cash subsidy schemes.