Proof and Progress: Coping with the Law of Evidence in a Technological Age

This article outlines those rules of evidence that are most likely to be called upon to fit new technologies. It identifies some of the challenges that are presented, and identifies modest techniques or suggestions for coping. Those suggestions include taking the kind of relaxed view as to when expert evidence is being offered illustrated by the Ontario Court of Appeal in R. v. Hamilton; taking a functional approach to judicial notice; ensuring that authentication and the “best evidence” rule for electronic records are not applied in a highly technical fashion; understanding the law of hearsay and remaining familiar with key hearsay exceptions; applying the law of privilege in ways that reflect the new realities that compromise privacy; understanding the limits of character evidence and the opportunities for the exclusionary discretion; and recognizing the utility in the technological presentation of evidence

When Open Courts Meet Closed Government

The law largely controls the degree to which the open court principle is respected. “Legal culture,” however, has as much to do with the fortunes of the “open court principle” as does the law. The law often provides only standards — not clear answers. The extent to which the open court principle is respected the refore comes down to attitude or the commitment to it among justice system participants. We are fortunate that this is a country with a long and demonstrated commitment to the open court principle. The terrorist attacks of 2001 have ushered in a heightened sense of purpose and secrecy on the part of government and the intelligence and law enforcement communities, all in the interests of that profoundly powerful goal of “national security.” National security is being invoked, however, with increasing frequency. The attitude that gives priority to national security concerns challenges the open court principle in criminal cases. While it is to be expected, it is worrisome because it is precisely in times of national insecurity that the open court principle takes on special urgency. After all, one of the roles of the open court principle is to ensure that individuals brought before the courts for prosecution are being treated fairly. The other role of the open court principle is to secure democracy, yet, as has also been observed, “the powers necessary to defeat terrorism and suppress insurrection [including state control on the flow of information] are the very ones needed to enforce a tyranny.” Unless those responsible for the administration of the open court principle – the executive, government officials, line peace officers and of course courts — turn their mind to the issue and reaffirm their commitment to leave our courts as open as they can be in this age of insecurity, our freedom and democracy will be diminished more than it need be. Society will suffer for it, and so too will some individuals

Leukocyte adhesion deficiency disorder in an infant.

Leukocyte adhesion defect (LAD) is an inherited disorder of phagocytic function. The three different alpha-chains of the leukocyte integrin family (CD 11a, 11b, 11c) are all dependent on the common beta chain (CD18) for proper insertion into the cell membrane. Deficiency of CD 18 thus causes an inability to express any of these proteins and results in the syndrome of LAD type 1. Clinical features include delayed separation of the umbilical cord, persistent leukocytosis and recurrent infection. A case of severe LAD occurred in a 1 month-old infant. The immunological pattern of the baby showed pathological values of CD11b and CD18 (1.3% and 0.2% respectively) when compared with normal values (50-70%) and lack of random (1.0 nm vs normal of 10±5) and casein-induced (22.0 nm vs normal of 60-120nm) chemotaxis. The baby is now waiting for bone marrow transplantation. Although LAD is a rare form of congenital immune deficiency this disease should be considered when delayed wound healing and recurrent bacterial skin infections are present in a newborn

P2613Initial combination therapy with ambrisentan and tadalafil for pulmonary arterial hypertension: clinical effect and haemodynamic changes. A multicenter retrospective analysis

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Right-to-left shunt with hypoxemia in pulmonary hypertension

<p>Abstract</p> <p>Background</p> <p>Hypoxemia is common in pulmonary hypertension (PH) and may be partly related to ventilation/perfusion mismatch, low diffusion capacity, low cardiac output, and/or right-to-left (RL) shunting.</p> <p>Methods</p> <p>To determine whether true RL shunting causing hypoxemia is caused by intracardiac shunting, as classically considered, a retrospective single center study was conducted in consecutive patients with precapillary PH, with hypoxemia at rest (PaO₂< 10 kPa), shunt fraction (Qs/Qt) greater than 5%, elevated alveolar-arterial difference of PO₂(AaPO₂), and with transthoracic contrast echocardiography performed within 3 months.</p> <p>Results</p> <p>Among 263 patients with precapillary PH, 34 patients were included: pulmonary arterial hypertension, 21%; PH associated with lung disease, 47% (chronic obstructive pulmonary disease, 23%; interstitial lung disease, 9%; other, 15%); chronic thromboembolic PH, 26%; miscellaneous causes, 6%. Mean pulmonary artery pressure, cardiac index, and pulmonary vascular resistance were 45.8 ± 10.8 mmHg, 2.2 ± 0.6 L/min/m², and 469 ± 275 dyn.s.cm^-5, respectively. PaO₂in room air was 6.8 ± 1.3 kPa. Qs/Qt was 10.2 ± 4.2%. AaPO₂under 100% oxygen was 32.5 ± 12.4 kPa. Positive contrast was present at transthoracic contrast echocardiography in 6/34 (18%) of patients, including only 4/34 (12%) with intracardiac RL shunting. Qs/Qt did not correlate with hemodynamic parameters. Patients' characteristics did not differ according to the result of contrast echocardiography.</p> <p>Conclusion</p> <p>When present in patients with precapillary PH, RL shunting is usually not related to reopening of patent <it>foramen ovale</it>, whatever the etiology of PH.</p

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase

Proof and Progress: Coping with the Law of Evidence in a Technological Age

This article outlines those rules of evidence that are most likely to be called upon to fit new technologies. It identifies some of the challenges that are presented, and identifies modest techniques or suggestions for coping. Those suggestions include taking the kind of relaxed view as to when expert evidence is being offered illustrated by the Ontario Court of Appeal in R. v. Hamilton; taking a functional approach to judicial notice; ensuring that authentication and the “best evidence” rule for electronic records are not applied in a highly technical fashion; understanding the law of hearsay and remaining familiar with key hearsay exceptions; applying the law of privilege in ways that reflect the new realities that compromise privacy; understanding the limits of character evidence and the opportunities for the exclusionary discretion; and recognizing the utility in the technological presentation of evidence