The Role and Responsibility of Defense Counsel

How does a defense attorney\u27s role change when defending a high-profile client? Beyond traditional legal defense, must a modern defense attorney seek to protect a client\u27s public image? When speaking with the media, what rules, if any, should constrain a defense attorney\u27s behavior? Does media coverage affect the fairness of a trial? These are some of the questions dealt with in Panel #4: The Role Of Defense Counsel, moderated by Robert Mosteller, and featuring Laurie Levenson, Michael Tigar and Harold Haddon. Laurie Levenson begins the discussion by outlining some of the rules governing attorney behavior in the media, with special emphasis on the ABA Model Rules of Professional Conduct. Next, Michael Tigar discusses how the press has traditionally served as a watchdog against government misconduct in high-profile cases, and how media coverage of cases from his own career has helped his clients. Lastly, Harold Haddon provides a word of caution about the dangers attorneys face in using the media in high-profile cases and discusses how media coverage can hurt defendants by leading to premature public judgment. Questions/themes/discussion topics ABA Model Rule of Professional Conduct 3.6: Trial Publicity Attorney conduct not prohibited by ABA MRPC 3.6 Media gag orders Allowing video cameras in the courtroom Proposed rules to govern legal commentators unconnected to a proceeding Historic instances of media coverage acting as a judicial watchdog Examples of media coverage aiding defendants in high-profile cases The effect of defense attorney\u27 statements on the public perception of defendants The difficulty of changing public perception of a defendant\u27s guilt or innocenc

Serum Penicillin G Levels Are Lower Than Expected in Adults within Two Weeks of Administration of 1.2 Million Units

When introduced in the 1950s, benzathine penicillin G (BPG) was shown to be effective in eradicating group A beta-hemolytic streptococcus (GAS) for at least 3 weeks after administration. Several studies since the 1990s suggest that at 3–4 weeks serum penicillin G levels are less than adequate (below MIC90 of 0.016 µg/ml). We studied these levels for 4 weeks after the recommended dose of BPG in military recruits, for whom it is used as prophylaxis against GAS. The 329 subjects (mean age 20 years) each received 1.2 million units BPG IM and gave sera 1 day post injection and twice more at staggered time points over 4 weeks. Serum penicillin G levels were measured by liquid chromatography/tandem mass spectometry. The half-life of serum penicillin G was 4.1 days. By day 11, mean levels were <0.02 µg/ml, and by day 15<0.01 µg/ml. Levels in more than 50% of the subjects were below 0.02 µg/ml on day 9, and <.01 µg/ml on day 16. There was no demonstrable effect of subject body-surface area nor of the four different lots of BPG used. These data indicate that in healthy young adults serum penicillin G levels become less than protective <2½ weeks after injection of 1.2 million units of BPG. The findings require serious consideration in future medical and public health recommendations for treatment and prophylaxis of GAS upper respiratory tract infections

A robust measure of correlation between two genes on a microarray

<p>Abstract</p> <p>Background</p> <p>The underlying goal of microarray experiments is to identify gene expression patterns across different experimental conditions. Genes that are contained in a particular pathway or that respond similarly to experimental conditions could be co-expressed and show similar patterns of expression on a microarray. Using any of a variety of clustering methods or gene network analyses we can partition genes of interest into groups, clusters, or modules based on measures of similarity. Typically, Pearson correlation is used to measure distance (or similarity) before implementing a clustering algorithm. Pearson correlation is quite susceptible to outliers, however, an unfortunate characteristic when dealing with microarray data (well known to be typically quite noisy.)</p> <p>Results</p> <p>We propose a resistant similarity metric based on Tukey's biweight estimate of multivariate scale and location. The resistant metric is simply the correlation obtained from a resistant covariance matrix of scale. We give results which demonstrate that our correlation metric is much more resistant than the Pearson correlation while being more efficient than other nonparametric measures of correlation (e.g., Spearman correlation.) Additionally, our method gives a systematic gene flagging procedure which is useful when dealing with large amounts of noisy data.</p> <p>Conclusion</p> <p>When dealing with microarray data, which are known to be quite noisy, robust methods should be used. Specifically, robust distances, including the biweight correlation, should be used in clustering and gene network analysis.</p

Osteocrin, a novel bone-specific secreted protein that modulates the osteoblast phenotype

Although a number of secreted factors have been demonstrated to be bone regulators, none of these are unique to bone. Using a viral- based signal- trap strategy we have identified a novel gene we have termed " osteocrin." A 1280- bp mRNA encodes osteocrin producing a mature protein of 103 amino acids with a molecular mass of 11.4 kDa. Osteocrin shows no homology with any known gene except for two conserved sequence motifs reminiscent of dibasic cleavage sites found in peptide hormone precursors. Immunofluorescence and Western blot analysis confirmed the secretory nature of osteocrin. Two protein species were identified in the medium of cells overexpressing osteocrin, a full- length 11.4 kDa species and a processed similar to 5 kDa species. Mutation of the (KKKR79)-K-76 dibasic cleavage site abolished the appearance of this smaller osteocrin fragment. By in situ hybridization in mouse embryos, osteocrin was expressed specifically in Cbfa- 1- positive, osteocalcin- negative osteoblasts. Immunohistochemistry on adult mouse bone showed osteocrin localization in osteoblasts and young osteocytes. By Northern blot analysis, osteocrin expression was only detected in bone, expression peaking just after birth and decreasing markedly with age. In primary osteoblastic cell cultures osteocrin expression coincided with matrix formation then decreased in very mature cultures. Treatment of cultures with 1,25- dihydroxyvitamin D-3 resulted in a rapid dose- dependent down- regulation of osteocrin expression, suggesting direct regulation. Chronic treatment of primary cultures with osteocrin- conditioned media inhibited mineralization and reduced osteocalcin and alkaline phosphatase expression. These results suggest that osteocrin represents a novel, unique vitamin D- regulated bone- specific protein that appears to act as a soluble osteoblast regulator

Altered aortic 3D hemodynamics and geometry in pediatric Marfan syndrome patients

BACKGROUND: Blood flow dynamics make it possible to better understand the development of aortopathy and cardiovascular events in patients with Marfan syndrome (MFS). Aortic 3D blood flow characteristics were investigated in relation to aortic geometry in children and adolescents with MFS. METHODS: Twenty-five MFS patients (age 15.6 ± 4.0 years; 11 females) and 21 healthy controls (age 16.0 ± 2.6 years; 12 females) underwent magnetic resonance angiography and 4D flow CMR for assessment of thoracic aortic size and 3D blood flow velocities. Data analysis included calculation of aortic diameter and BSA-indexed aortic dimensions (Z-score) along the thoracic aorta, 3D mean systolic wall shear stress (WSS(mean)) in ten aortic segments and assessment of aortic blood flow patterns. RESULTS: Aortic root (root), ascending (AAo) and descending (DAo) aortic size was significantly larger in MFS patients than healthy controls (Root Z-score: 3.56 ± 1.45 vs 0.49 ± 0.78, p < 0.001; AAo Z-score 0.21 ± 0.95 vs −0.54 ± 0.64, p = 0.004; proximal DAo Z-score 2.02 ± 1.60 vs 0.56 ± 0.66, p < 0.001). A regional variation in prevalence and severity of flow patterns (vortex and helix flow patterns) was observed, with the aortic root and the proximal DAo (pDAo) being more frequently affected in MFS. MFS patients had significantly reduced WSS(mean) in the proximal AAo (pAAo) outer segment (0.65 ± 0.12 vs. 0.73 ± 0.14 Pa, p = 0.029) and pDAo inner segment (0.74 ± 0.17 vs. 0.87 ± 0.21 Pa, p = 0.021), as well as higher WSS(mean) in the inner segment of the distal AAo (0.94 ± 0.14 vs. 0.84 ± 0.15 Pa, p = 0.036) compared to healthy subjects. An inverse relationship existed between pDAo WSS(mean) and both pDAo diameter (R = −0.53, p < 0.001) and % diameter change along the pDAo segment (R = −0.64, p < 0.001). CONCLUSIONS: MFS children and young adults have altered aortic flow patterns and differences in aortic WSS that were most pronounced in the pAAo and pDAo, segments where aortic dissection or rupture often originate. The presence of vortex flow patterns and abnormal WSS correlated with regional size of the pDAo and are potentially valuable additional markers of disease severity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12968-017-0345-7) contains supplementary material, which is available to authorized users

Robust Modal Filtering and Control of the X-56A Model with Simulated Fiber Optic Sensor Failures

The X-56A aircraft is a remotely-piloted aircraft with flutter modes intentionally designed into the flight envelope. The X-56A program must demonstrate flight control while suppressing all unstable modes. A previous X-56A model study demonstrated a distributed-sensing-based active shape and active flutter suppression controller. The controller relies on an estimator which is sensitive to bias. This estimator is improved herein, and a real-time robust estimator is derived and demonstrated on 1530 fiber optic sensors. It is shown in simulation that the estimator can simultaneously reject 230 worst-case fiber optic sensor failures automatically. These sensor failures include locations with high leverage (or importance). To reduce the impact of leverage outliers, concentration based on a Mahalanobis trim criterion is introduced. A redescending M-estimator with Tukey bisquare weights is used to improve location and dispersion estimates within each concentration step in the presence of asymmetry (or leverage). A dynamic simulation is used to compare the concentrated robust estimator to a state-of-the-art real-time robust multivariate estimator. The estimators support a previously-derived mu-optimal shape controller. It is found that during the failure scenario, the concentrated modal estimator keeps the system stable

Bayesian Mode Regression

This article has been made available through the Brunel Open Access Publishing Fund.Like mean, quantile and variance, mode is also an important measure of central tendency of a distribution. Many practical questions, particularly in the analysis of big data, such as \Which element (gene or le or signal) is the most typical one among all elements in a network?" are directly related to mode. Mode regression, which provides a convenient summary of how the regressors a ect the conditional mode, is totally di erent from other models based on conditional mean or conditional quantile or conditional variance. Some inference methods for mode regression exist but none of them is from the Bayesian perspective. This paper introduces Bayesian mode regression by exploring three different approaches, including their theoretic properties. The proposed approacher are illustrated using simulated datasets and a real data set

Antiretroviral Therapy, Renal Function among HIV-Infected Tanzanian, Adults, HIV/AIDS, .

Data regarding the outcomes of HIV-infected adults with baseline renal dysfunction who start antiretroviral therapy are conflicting. We followed up a previously-published cohort of HIV-infected adult outpatients in northwest Tanzania who had high prevalence of renal dysfunction at the time of starting antiretroviral therapy (between November 2009 and February 2010). Patients had serum creatinine, proteinuria, microalbuminuria, and CD4(+) T-cell count measured at the time of antiretroviral therapy initiation and at follow-up. We used the adjusted Cockroft-Gault equation to calculate estimated glomerular filtration rates (eGFRs). In this cohort of 171 adults who had taken antiretroviral therapy for a median of two years, the prevalence of renal dysfunction (eGFR <90 mL/min/1.73 m(2)) decreased from 131/171 (76.6%) at the time of ART initiation to 50/171 (29.2%) at the time of follow-up (p<0.001). Moderate dysfunction (eGFR<60 mL/min/1.73 m(2)) decreased from 21.1% at antiretroviral therapy initiation to 1.1% at follow-up (p<0.001), as did the prevalence of microalbuminuria (72% to 44%, p<0.001). Use of tenofovir was not associated with renal dysfunction at follow-up. Mild and moderate renal dysfunction were common in this cohort of HIV-infected adults initiating antiretroviral therapy, and both significantly improved after a median follow-up time of 2 years. Our work supports the renal safety of antiretroviral therapy in African adults with mild-moderate renal dysfunction, suggesting that these regimens do not lead to renal damage in the majority of patients and that they may even improve renal function in patients with mild to moderate renal dysfunction