Which One Here Is Not like the Others - No Third-Party Standing for Lawyers to Assert Indigent Criminal Defendants\u27 Right to Counsel on Appeal

In Kowalski v. Tesmer, the Supreme Court held that attorneys lack standing to assert the rights of indigent criminal defendants.1t The Court\u27s application of its prudential rules of standing presents great concern, as it leaves thirty years of precedent in doubt. This Note examines the parameters of the Court\u27s prudential standing requirements and the great shift in thirdparty standing after Kowalski.

Local Man Phones Spiritual Leaders, Ends Up in Federal Prison: Congressional Commerce Power to Curb Discrimination Motivated Violence

In United States v. Corum,12 the Eighth Circuit examined two categories of congressional commerce power used to eradicate religious discrimination.13 The result in this case perpetuates a split among the circuits regarding the extent of congressional authority to regulate non-economic, criminal activity. 14 This Note examines the parameters of the Commerce Clause and the continuing confusion in the Courts of Appeals following the Supreme Court\u27s holdings in United States v. Lopez\u275 and United States v. Morrison.1

Late diagenesis of illite-smectite in the Podhale Basin, southern Poland: Chemistry, morphology, and preferred orientation

Well-characterized samples from the Podhale Basin, southern Poland, formed the basis for exploring and illuminating subtle diagenetic changes to a mudstone toward the upper end of the diagenetic window, prior to metamorphism.Transmission electron microscopy (TEM) performed on dispersed grains and ion-beam thinned preparations, selected area diffraction patterns,and chemistry by TEM-EDS (energy dispersive spectra) augmented mineralogy and fabric data. The deepest samples show no change in their percent illite in illite-smectite (I-S), yet I-S–phase octahedral Fe3+ and Al3+ are statistically different between samples. A decrease in the Fe3+ concentration in the octahedral sheet correlates with an increase in I-S fabric intensity and apparent crystallinity. The D-statistic from the Kolmogorov-Smirnov test on TEM- EDS data describes statistical differences in the I-S chemistry. Previous work on these samples showed a significant increase in the preferred orientation of the I-S phase across the smectite to illite transition and a significant slowdown in the rate of development of preferred orientation beyond the termination of smectite illitization. Lattice fringe images describe an I-S morphology that coalesces into larger and tighter packets with increasing burial temperature and a decrease in I-S packet contact angle, yet some evidence for smectite collapse structures is retained. The deepest sample shows the thickest, most coherent I-S packets. We propose that the deepest samples in the Podhale Basin describe the precursor stage in phyllosilicate fabric preferred orientation increase from diagenesis into metamorphism, where continued evolution of crystallite packets and associated crystallinity create higher I-S fabric intensities as the structural formulae of I-S approach an end-member composition

Ferumoxytol-enhanced MRI in patients with prior cardiac transplantation.

Objectives: Ultra-small superparamagnetic particles of iron oxide (USPIO)-enhanced MRI can detect cellular inflammation within tissues and may help non-invasively identify cardiac transplant rejection. Here, we aimed to determine the normal reference values for USPIO-enhanced MRI in patients with a prior cardiac transplant and examine whether USPIO-enhanced MRI could detect myocardial inflammation in patients with transplant rejection. Methods: Ten volunteers and 11 patients with cardiac transplant underwent T2, T2* and late gadolinium enhancement 1.5T MRI, with further T2* imaging at 24 hours after USPIO (ferumoxytol, 4 mg/kg) infusion, at baseline and 3 months. Results: Ten patients with clinically stable cardiac transplantation were retained for analysis. Myocardial T2 values were higher in patients with cardiac transplant versus healthy volunteers (53.8±5.2 vs 48.6±1.9 ms, respectively; p=0.003). There were no differences in the magnitude of USPIO-induced change in R2* in patients with transplantation (change in R2*, 26.6±7.3 vs 22.0±10.4 s-1 in healthy volunteers; p=0.28). After 3 months, patients with transplantation (n=5) had unaltered T2 values (52.7±2.8 vs 52.12±3.4 ms; p=0.80) and changes in R2* following USPIO (29.42±8.14 vs 25.8±7.8 s-1; p=0.43). Conclusion: Stable patients with cardiac transplantation have increased myocardial T2 values, consistent with resting myocardial oedema or fibrosis. In contrast, USPIO-enhanced MRI is normal and stable over time suggesting the absence of chronic macrophage-driven cellular inflammation. It remains to be determined whether USPIO-enhanced MRI may be able to identify acute cardiac transplant rejection. Trial registration number: NCT02319278349 (https://clinicaltrials.gov/ct2/show/NCT02319278) Registered 03.12.2014 EUDraCT 2013-002336-24

The challenges faced in the design, conduct and analysis of surgical randomised controlled trials

Randomised evaluations of surgical interventions are rare; some interventions have been widely adopted without rigorous evaluation. Unlike other medical areas, the randomised controlled trial (RCT) design has not become the default study design for the evaluation of surgical interventions. Surgical trials are difficult to successfully undertake and pose particular practical and methodological challenges. However, RCTs have played a role in the assessment of surgical innovations and there is scope and need for greater use. This article will consider the design, conduct and analysis of an RCT of a surgical intervention. The issues will be reviewed under three headings: the timing of the evaluation, defining the research question and trial design issues. Recommendations on the conduct of future surgical RCTs are made. Collaboration between research and surgical communities is needed to address the distinct issues raised by the assessmentof surgical interventions and enable the conduct of appropriate and well-designed trials.The Health Services Research Unit is funded by the Scottish Government Health DirectoratesPeer reviewedPublisher PD

Does attendance at a specialist antenatal clinic improve clinical outcomes in women with Class III obesity compared to standard care? a retrospective case-note analysis

OBJECTIVES: To determine whether attendance at a specialised multidisciplinary antenatal clinic for women with class III obesity (BMI >40 kg/m2) is associated with improved clinical outcomes compared with standard antenatal care. DESIGN: Retrospective cohort study using routinely collected data from electronic patient record. SETTING: Community and hospital based antenatal care. PARTICIPANTS: Women with a singleton pregnancy with class III obesity booked for antenatal care and delivered in one of two hospitals in NHS Lothian, Scotland, UK between 2008 and 2014. Maternal and offspring outcomes were compared in women who attended a specialised obesity clinic (n=511) compared with standard antenatal care (n=502). MAIN OUTCOME MEASURES: Included stillbirth, low birth weight, gestational diabetes, induction of labour and caesarean section. RESULTS: Compared with standard care, women receiving specialist care were less likely to have a stillbirth (OR 0.12, 95% CI 0.06 to 0.97) and a low birthweight baby (OR 0.57, 95% CI 0.33 to 0.99) and more likely to be screened for (100% vs 73.6%; p<0.001) and diagnosed with (26.0% vs 12.5%; p<0.001) gestational diabetes, to require induction of labour (38.4% vs 29.9%; p=0.009), an elective (20.3% vs 17.7%; p<0.001) and emergency (23.9% vs 20.3%; p<0.001) caesarean section and attend antenatal triage one or more times during pregnancy (77.7% vs 53.1%; p<0.001). Women attending the specialist clinic had a higher BMI (44.5 kg/m2 (4.3) vs 43.2 kg/m2 (3.1); p<0.001) and were more likely to be nulliparous (46.0% vs 24.9%; p<0.001). There were no other differences in maternal demographic or maternal and offspring outcomes between groups. CONCLUSIONS: Attendance at a specialised antenatal clinic for obesity is associated with reduced rates of stillbirth and low birth weight and improved detection of gestational diabetes. The improvement in clinical outcomes is associated with an increase in healthcare attendance to obstetric triage and clinical interventions including induction of labour and caesarean section

Conformation and dynamics of human urotensin II and urotensin related peptide in aqueous solution

Conformation and dynamics of the vasoconstrictive peptides human urotensin II (UII) and urotensin related peptide (URP) have been investigated by both unrestrained and enhanced-sampling molecular-dynamics (MD) simulations and NMR spectroscopy. These peptides are natural ligands of the G-protein coupled urotensin II receptor (UTR) and have been linked to mammalian pathophysiology. UII and URP cannot be characterized by a single structure but exist as an equilibrium of two main classes of ring conformations, <i>open</i> and <i>folded</i>, with rapidly interchanging subtypes. The <i>open</i> states are characterized by turns of various types centered at K⁸Y⁹ or F⁶W⁷ predominantly with no or only sparsely populated transannular hydrogen bonds. The <i>folded</i> conformations show multiple turns stabilized by highly populated transannular hydrogen bonds comprising centers F⁶W⁷K⁸ or W⁷K⁸Y⁹. Some of these conformations have not been characterized previously. The equilibrium populations that are experimentally difficult to access were estimated by replica-exchange MD simulations and validated by comparison of experimental NMR data with chemical shifts calculated with density-functional theory. UII exhibits approximately 72% <i>open</i>:28% <i>folded</i> conformations in aqueous solution. URP shows very similar ring conformations as UII but differs in an <i>open:folded</i> equilibrium shifted further toward <i>open</i> conformations (86:14) possibly arising from the absence of folded N-terminal tail-ring interaction. The results suggest that the different biological effects of UII and URP are not caused by differences in ring conformations but rather by different interactions with UTR