Toward a Theory of Effective Supranational Adjudication

Supranational adjudication in Europe is a remarkable and surprising success. Europe\u27s two supranational courts -- the European Court of Justice (ECJ) and the European Court of Human Rights (ECHR) -- issue dozens of judgments each year with which defending national governments habitually comply in essentially the same manner as they would with domestic court rulings. These experiences stand in striking contrast to those of many international tribunals past and present. Can the European experience of supranational adjudication be transplanted beyond Europe? Professors Helfer and Slaughter argue that the effectiveness of the ECJ and the ECHR is linked to their power to hear claims brought by private parties directly against national governments or against other private parties. Such supranational jurisdiction has allowed the European courts to penetrate the surface of the state, to forge direct relationships not only with individual citizens but also with distinct government institutions such as national courts. Over time, this penetration and the deepening relationships between supranational jurists and domestic legal actors have led to the evolution of a community of law, a web of nominally apolitical relations among subnational and supranational legal actors. The simple provision of supranational jurisdiction, however, is not a guarantee of effective adjudication. Drawing on the observations of scholars, practitioners, and judges, Professors Helfer and Slaughter develop a checklist of factors that enhance the effectiveness of supranational adjudication. They distinguish among those factors that are within the control of member states; those that are within the control of the judges themselves; and those that may be beyond the control of either states or judges. Isolating the factors in this way provides both a rough metric for evaluating the effectiveness of other supranational tribunals and a potential set of prescriptions for judges on those tribunals seeking to enhance their institutions\u27 effectiveness. After developing the checklist, Professors Helfer and Slaughter use it to analyze the United Nations Human Rights Committee (UNHRC). Although the UNHRC was established expressly as a committee of experts rather than a court, analysis of its recent practice reveals that it is becoming increasingly court-like. Moreover, within the constraints imposed by severely limited resources, UNHRC members are independently following many of the checklist prescriptions for increased effectiveness. The next step is for the organization to enter into a sustained dialogue with its European counterparts, harmonizing its decisions with theirs in some areas while consciously preserving its own distinctive jurisprudence in others. Structured and regular interaction between these tribunals would add additional voices to an emerging transjudicial conversation, potentially laying the foundation for a global community of law

High Caveolin-1 Expression in Tumor Stroma Is Associated with a Favourable Outcome in Prostate Cancer Patients Managed by Watchful Waiting.

In the present study we have investigated whether Caveolin-1 expression in non-malignant and malignant prostate tissue is a potential prognostic marker for outcome in prostate cancer patients managed by watchful waiting. Caveolin-1 was measured in prostate tissues obtained through transurethral resection of the prostate from 395 patients diagnosed with prostate cancer. The majority of the patients (n = 298) were followed by watchful waiting after diagnosis. Tissue microarrays constructed from malignant and non-malignant prostate tissue were stained with an antibody against Caveolin-1. The staining pattern was scored and related to clinicopathologic parameters and outcome. Microdissection and qRT-PCR analysis of Cav-1 was done of the prostate stroma from non-malignant tissue and stroma from Gleason 3 and 4 tumors. Cav-1 RNA expression was highest in non-malignant tissue and decreased during cancer progression. High expression of Caveolin-1 in tumor stroma was associated with significantly longer cancer specific survival in prostate cancer patients. This association remained significant when Gleason score and local tumor stage were combined with Caveolin-1 in a Cox regression model. High stromal Caveolin-1 immunoreactivity in prostate tumors is associated with a favourable prognosis in prostate cancer patients managed by watchful waiting. Caveolin-1 could possibly become a useful prognostic marker for prostate cancer patients that are potential candidates for active surveillance

High density of S100A9 positive inflammatory cells in prostate cancer stroma is associated with poor outcome.

To elucidate if the density of inflammatory cells expressing S100A9 in malignant and surrounding non-malignant prostate tissues is a prognostic marker for outcome in prostate cancer patients

Age, Gleason scores, incidence of metastases at diagnosis and tumour Ki67-IR at diagnosis for the cases divided on the basis of tumour pAkt-IR and pEGFR-IR scores.

a<p>Kruskal-Wallis test.</p>b<p>The % value refers to the % of cases for the pAkt-IR/pEGFR-IR group in question (i.e. vertical numbers add up to 100%).</p>c<p>ķ² test.</p>d<p>Dunn’s Multiple Comparison Test following significant Kruskal-Wallis test. ^NSNot significant (P>0.05). "pEGFR effect" refers to the comparison between pEGFR-IR <3.2 and ≥3.2 for the given pAkt-IR tranche. For comparisons between pAkt-IR <2.75 and ≥2.75 for pEGFF <3.2 alone, the significance levels for Gleason score, metastases at diagnosis and Ki67-IR (T) were P<0.01^c, NS^c and P<0.05^d, respectively. The corresponding significance levels for pEGFR-IR ≥3.2 alone were P<0.01^c, NS^c and P<0.01^d, respectively.</p

Improving the Specificity of Screening for Lethal Prostate Cancer Using Prostate-specific Antigen and a Panel of Kallikrein Markers: A Nested Case-Control Study.

A disadvantage of prostate-specific antigen (PSA) for the early detection of prostate cancer (PCa) is that many men must be screened, biopsied, and diagnosed to prevent one death

Prognostic significance of tumour and non-malignant pAkt-IR for cases who were followed by expectancy.

<p>Panels A and B are for tumour pAkt-IR (n = 204), C and D for non-malignant pAkt-IR (n = 194). In Panels A and C, Exp(B) (±95% confidence intervals), obtained from Cox proportional-hazards regression analyses are shown for different cut-offs. Exp(B) is defined as the increase in risk for death due to prostate cancer for a score above the cut-off value relative to a score below the cut-off value. When both confidence limits are above unity (filled symbols in the figure), the cut-off value provides significant prognostic information. Values with a significance level 0.052.5), 82 cases (40%) were ≤ the cut-off value and 122 cases (60%) above the cut-off value. In Panels B and D, Kaplan-Meier plots are shown for the cut-offs showing the highest significances. ^†Pca refers to the number of patients who died as a result of their prostate cancer during the follow-up period. The ķ² values are for the log-rank (Mantel-Cox) tests, with the P values shown: ***P<0.001, *P<0.05.</p

Improving the Specificity of Screening for Lethal Prostate Cancer Using Prostate-specific Antigen and a Panel of Kallikrein Markers : a Nested Case-Control Study

Background: A disadvantage of prostate-specific antigen (PSA) for the early detection of prostate cancer (PCa) is that many men must be screened, biopsied, and diagnosed to prevent one death. Objective: To increase the specificity of screening for lethal PCa at an early stage. Design, setting, and participants: We conducted a case-control study nested within a population-based cohort. PSA and three additional kallikreins were measured in cryopreserved blood from a population-based cohort in Vasterbotten, Sweden. Of 40 379 men providing blood at ages 40, 50, and 60 yr from 1986 to 2009, 12 542 men were followed for &gt; 15 yr. From this cohort, the Swedish Cancer Registry identified 1423 incident PCa cases, 235 with distant metastasis. Outcome measurements and statistical analysis: Risk of distant metastasis for different PSA levels and a prespecified statistical model based on the four kallikrein markers. Results and limitations: Mostmetastatic cases occurred in men with PSA in the top quartile at age 50 yr (69%) or 60 yr (74%), whereas 20-yr risk of metastasis for men with PSA below median was low (&lt;= 0.6%). Among men with PSA &gt; 2 ng/ml, a prespecified model based on four kallikrein markers significantly enhanced the prediction of metastasis compared with PSA alone. About half of all men with PSA &gt; 2 ng/ml were defined as low risk by this model and had a &lt;= 1% 15-yr risk of metastasis. Conclusions: Screening at ages 50-60 yr should focus on men with PSA in the top quartile. A marker panel can aid biopsy decision making. Patient summary: For men in their fifties, screening should focus on those in the top 10% to 25% of PSA values because the majority of subsequent cases of distant metastasis are found among these men. Testing of four kallikrein markers in men with an elevated PSA could aid biopsy decision making

Correlation coefficients for pAkt-IR scores with pEGFR-IR, total EGFR-IR and PDFRß-IR scores in the tumour and non-malignant tissue samples.

<p>Abbreviations: T, tumour; N, non-malignant; Nl, non-malignant lumiunal, Nb; non-malignant basal; ep, epithelial; st, stroma. Sp ρ refers to Spearman’s rho value for the non-parametric comparisons.</p

Correlation coefficients for pAkt-IR scores with clinical parameters and with the proliferation marker Ki-67.

<p>Sp ρ refers to Spearman’s rho value for the non-parametric comparisons.</p>a<p>% of core that was tumour associated.</p