Juveniles Make Bad Decisions, but Are Not Adults & Law Continues to Account for This Difference: The Supreme Court’s Decision to Apply Miller v. Alabama Retroactively Will Have a Significant Impact on Many Decades of Reform and Current Debate Around Juvenile Sentencing

In January 2016, the Supreme Court made a monumental decision, reflecting the notion that juveniles are not adults. For years, courts have been grappling with the notion that juveniles are not adults. The Supreme Court has finally published an opinion that will have extreme implications on the juvenile justice system. Part I of this Note will discuss the birth of the juvenile justice system. Part II of this Note will briefly introduce the recent oral argument heard before the Supreme Court regarding whether the Supreme Court will apply Miller v. Alabama retroactively or non-retroactively. Part III will discuss the history of the juvenile justice system and show the progression of Supreme Court decisions regarding juveniles in the penal system. Part IV will discuss how neuroscience throughout the years has incessantly proven that juveniles are inherently different than adults. Part V will discuss and analyze the Miller decision and its effects, and Part VI will discuss the many implications that the recent Supreme Court decision to apply Miller retroactively has on the entire future of the juvenile justice system

Confronto randomizzato tra ablazione circonferenziale delle vene polmonari e terapia antiaritmica in pazienti con fibrillazione atriale parossistica – Studio APAF (Ablation for Paroxysmal Atrial Fibrillation)

Il presente progetto di ricerca focalizza la sua attenzione su due aree di crescente interesse della cardiologia in generale e dell’aritmologia in particolare: la fibrillazione atriale e l’insufficienza cardiaca. Fibrillazione atriale e scompenso cardiaco sono due condizioni cliniche strettamente associate. Il meccanismo fondamentale alla base della loro co-prevalenza è che l’una condizione patologica determina e sostiene il meccanismo eziopatogenetico dell’altra. L’esempio più eclatante di questo rapporto di causalità diretta è rappresentato dalla cosiddetta tachicardiomiopatia, condizione clinica frequente in pazienti con funzione ventricolare normale al momento dell’insorgenza della FA e che successivamente sviluppano una cardiomiopatia dilatativa potenzialmente reversibile mediante efficace trattamento della FA. Un altro dato estremamente interessante rigurada il tasso di mortalità: il rischio di mortalità risulta di due volte più alto nei pazienti con HF che sviluppano successivamente FA e addirittura di tre volte in quelli con FA poi complicata da scompenso cardiaco. La comprensione ed il trattamento della fibrillazione atriale sono in evoluzione come mai prima d’ora grazie alla crescente disponibilità di nuove tecnologie e di nuovi farmaci. Sono pochi i dati attualmente disponibili circa l’evoluzione di malattia dal primo episodio di FA parossistica. In particolare non ci sono studi prospettici ed i soli dati di progressione della fibrillazione atriale disponibili in letteratura derivano da studi retrospettivi, che inoltre non valutano l’influenza della procedura di ablazione transcatetere mediante radiofrequenza (TC-RF) sulla progressione e sulle possibili complicanze della fibrillazione atriale. Il presente progetto di ricerca costituisce uno studio prospettico a lungo termine che ha tra i suoi obiettivi quello di individuare i principali predittori di progressione della FA dal primo episodio parossistico, non dovuto a cause reversibili, in soggetti con e senza comorbilità, indagando anche l’influenza potenziale dell’ablazione transcatetere sulla storia naturale di questa patologia. L’ablazione transcatetere mediante radiofrequenza è attualmente raccomandata in classe I (livello di evidenza A) per il trattamento di pazienti con FA parossistica e atrio sinistro di dimensioni normali o lievemente aumentate; tuttavia mancano dati di out-come a lungo termine per supportare tale raccomandazione ed i soli dati disponibili in letteratura dimostrano la superiorità dell’ablazione TC-RF rispetto alla terapia farmacologica antiaritmica convenzionale nella prevenzione delle recidive aritmiche di FA in un periodo di follow-up di un anno (Pappone e Coll. J Am Coll Cardiol 2006;48:2340-2347). Si tratta, ovviamente, di una finestra temporale piuttosto breve, specialmente se si tiene conto della natura di tale patologia, della sua progressione e delle complicazioni ad essa associate. Abbiamo quindi condotto un studio randomizzato (“Ablation for Paroxysmal Atrial Fibrillation”-APAF TRIAL) per determinare se l’ablazione circonferenziale delle vene polmonari fosse superiore alla terapia antiaritmica nel mantenimento del ritmo sinusale a quattro anni nei pazienti affetti da una lunga storia di FA parossistica. Il presente studio ha il più ampio numero di pazienti arruolati ed il follow-up più lungo tra tutti i trial randomizzati sul trattamento della fibrillazione atriale. In breve, i dati dello studio hanno mostrato come la strategia di impostare una terapia antiaritmica convenzionale e di ricorrere all’ablazione esclusivamente in caso di assenza di risposta alla terapia farmacologica sia assai meno efficace della ablazione mediante CPVA eseguita come approccio iniziale. L’ablazione transcatetere mediante radiofrequenza deve pertanto essere considerata come la strategia terapeutica di prima scelta in pazienti selezionati con fibrillazione atriale parossistica

The effects of nap duration on sleep inertia and physical performance

PURPOSE: To assess the effects of 15 and 30-min naps on 3-km time trial performance and peak muscle strength. METHODS: Six recreationally trained college-aged participants visited the lab on 4 separate occasions. During each visit, participants completed a peak strength test, and a 3-km time trial following the nap condition. For the muscle strength test, peak isokinetic leg extension strength was assessed. The 3-km time trial was computer simulated time of completion and average power output was recorded. Nap conditions were: no-nap, 15-minute nap, and 30-minute nap. One-Way (nap condition) and Repeated Measures ANOVA’s (time x nap condition) were used to statistically analyze the data, with the level of significance set at pRESULTS: Neither the 15 or 30-minute nap had an impact on 3-km time trial finishing time or average power output when compared to the no nap condition. Though it did not reach statistical significance, peak strength tended to be impaired by the 30-min nap when compared to the 15-min nap (p=.075). CONCLUSION: A 15- or 30-minute nap has no effect on 3-km time trial finishing time, average power output, or peak strength performance, suggesting that napping prior to competition will not improve performance. Data should be gathered on a larger sample size and with naps of longer duration to definitively conclude that napping has no impact on performance

The Question of Comparison

Comparison is a key component of legal reasoning. We move merrily from like to like within the doctrine of precedent. We invoke comparison whenever we distinguish or apply a case. This Article begins by elucidating how comparison is present in law. The Article shows how law cannot function without comparison, and how the legal world skips over the central role comparison plays in these matters. The Article explores the literature on legal comparison and draws on insights from philosophy, comparative law, and anthropology to better understand comparison in practice. This Article argues that while we are entangled in the questions of sameness and difference, of finding the function and tying together, we are still not asking the question of comparison. What is function and how is it related to comparison? Inspired by James Tully’s writings, the Article explores the aspectival views of the legal world suggested by the different games of comparison. The Article draws on Stephen Mulhall’s work on Wittgenstein’s seeing as, aspect dawning, and aspect blindness to further ask about our relationship to comparison. The Article shows how mainstream comparisons are ontic comparisons that think togetherness through the comparatist. The comparatist steers the belonging together and (un)makes the meaning of all things in mainstream comparison. The argument builds on earlier work by Igor Stramignoni, showing how the Western legal tradition is within a kind of Heideggerian calculative thinking. The Article explores the possibility of other kinds of comparison through Stramignoni’s poetic comparisons. This Article calls on us to slow down our comparisons and begin to question comparison itself

Prediction Models for Cardiac Risk Classification with Nuclear Cardiology Techniques

Regression modeling strategies are increasingly used for the management of subjects with cardiovascular diseases as well as for decision-making of subjects without known disease but who are at risk of disease in the short- or long-term or during life span. Accurate individual risk assessment, taking in account clinical, laboratory, and imaging data is useful for choosing among prevention strategies and/or treatments. The value of nuclear cardiology techniques for risk stratification has been well documented. Many models have been proposed and are available for diagnostic and prognostic purposes and several statistical techniques are available for risk stratification. However, current approaches for prognostic modeling are not perfect and present limitations. This review analyzes some specific aspects related to prediction model development and validation

Mar-Co: a new dependence structure to model match outcomes in football

The approaches commonly used to model the number of goals in a football match are characterised by strong assumptions about the dependence between the number of goals scored by the two competing teams and about their marginal distribution. In this work, we argue that the assumptions traditionally made are not always based on solid arguments and sometimes they can be hardly justified. In light of this, we propose a modification of the Dixon and Coles (1997) model by relaxing the assumption of Poisson-distributed marginal variables and by introducing an innovative dependence structure. Specifically, we define the joint distribution of the number of goals scored during a match by means of thoroughly chosen marginal (Mar-) and conditional distributions (-Co). The resulting Mar-Co model is able to balance flexibility and conceptual simplicity. A real data application involving five European leagues suggests that the introduction of the novel dependence structure allows to capture and interpret fundamental league-specific dynamics. In terms of betting performance, the newly introduced Mar-Co model does not perform worse than the Dixon and Coles one in a traditional framework (i.e. 1-X-2 bet) and it outperforms the competing model when a more comprehensive dependence structure is needed (i.e. Under/Over 2.5 bet)

Genetic deletion in uncoupling protein 3 augments 18F-fluorodeoxyglucose cardiac uptake in the ischemic heart

BACKGROUND: We investigated the effects of uncoupling protein 3 (UCP3) genetic deletion on 18F-fluorodeoxyglucose (FDG) cardiac uptake by positron emission tomography (PET)/computed tomography (CT) dedicated animal system after permanent coronary artery ligation. METHODS: Cardiac 18F-FDG PET/CT was performed in UCP3 knockout (UCP3-/-) and wild-type (WT) mice one week after induction of myocardial infarction or sham procedure. RESULTS: In sham-operated mice no difference in left ventricular (LV) volume was detectable between WT and UCP3-/-. After myocardial infarction, LV volume was higher in both WT and UCP3-/- compared to sham animals, with a significant interaction (p < 0.05) between genotype and myocardial infarction. In sham-operated animals no difference in FDG standardized uptake value (SUV) was detectable between WT (1.8 ± 0.6) and UCP3-/- (1.8 ± 0.6). After myocardial infarction SUV was significantly higher in remote areas than in infarcted territories in both UCP3-/- and WT mice (both p < 0.01). Moreover, in remote areas, SUV was significantly higher (p < 0.001) in UCP3-/- as compared to WT, while in the infarcted territory SUV was comparable (p = 0.29). A significant relationship (r = 0.68, p < 0.001) between LV volume and SUV was found. CONCLUSIONS: In a mice model of permanent coronary occlusion, UCP3 deficiency results in a metabolic shift that favored glycolytic metabolism and increased FDG uptake in remote areas

Assessment of poststress left ventricular ejection fraction by gated SPECT: comparison with equilibrium radionuclide angiocardiography

PURPOSE: We compared left ventricular (LV) ejection fraction obtained by gated SPECT with that obtained by equilibrium radionuclide angiocardiography in a large cohort of patients. METHODS: Within 1 week, 514 subjects with suspected or known coronary artery disease underwent same-day stress-rest (99m)Tc-sestamibi gated SPECT and radionuclide angiocardiography. For both studies, data were acquired 30 min after completion of exercise and after 3 h rest. RESULTS: In the overall study population, a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.82, p<0.0001) and after stress (r=0.83, p<0.0001). In Bland-Altman analysis, the mean differences in ejection fraction (radionuclide angiocardiography minus gated SPECT) were -0.6% at rest and 1.7% after stress. In subjects with normal perfusion (n=362), a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.72, p<0.0001) and after stress (r=0.70, p<0.0001) and the mean differences in ejection fraction were -0.9% at rest and 1.4% after stress. Also in patients with abnormal perfusion (n=152), a good correlation between the two techniques was observed both at rest (r=0.89, p<0.0001) and after stress (r=0.90, p<0.0001) and the mean differences in ejection fraction were 0.1% at rest and 2.5% after stress. CONCLUSION: In a large study population, a good agreement was observed in the evaluation of LV ejection fraction between gated SPECT and radionuclide angiocardiography. However, in patients with perfusion abnormalities, a slight underestimation in poststress LV ejection fraction was observed using gated SPECT as compared to equilibrium radionuclide angiocardiography

Nuclear cardiac imaging between implementation and globalization: The key role of integration

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The question of comparison

Comparison is a key component of legal reasoning. We move merrily from like-to-like within the doctrine of precedent. We invoke comparison whenever we distinguish or apply a case. This article begins by exposing how comparison is present in law. The article shows how law cannot function without comparison and how the legal world skips over the central stake comparison has in these matters. The paper explores the literature on legal comparisons and brings insights from philosophy, comparative law, and anthropology to better understand comparison in practice. This paper argues that while we are entangled in the questions of sameness and difference, of finding the function and tying together - we are still not asking comparison. What is function and how is it related to comparison? Inspired by James Tully’s writings, the paper explores the aspectival views of the legal world offered through the different games of comparison. The paper draws from Stephen Mulhall’s work on Wittgenstein’s seeing-as, aspect-dawning, and aspect-blindness to further ask about our relationship to comparison. The paper shows how mainstream comparisons are ontic comparisons that think togetherness through the comparatist. The comparatist steers the belonging-together and (un)makes the meaning of all things in mainstream comparison. The argument builds on earlier work by Igor Stramignoni showing how the Western legal tradition is within a kind of Heideggerian calculative thinking. The paper explores the possibility of other kinds of comparison through Stramignoni’s poetic comparisons. This paper is calling on us to slow down our comparisons and begin to question comparison itself