The Future of American Sentencing: A National Roundtable on Blakely

In the wake of the dramatic Supreme Court decision in Blakely v. Washington, Stanford Law School convened an assembly of the most eminent academic and professional sentencing experts in the country to jointly assess the meaning of the decision and its implications for federal and state sentencing reform. The event took place on October 8 and 9, just a few months after Blakely came down and the very week that the Supreme Court heard the arguments in United States v. Booker and United States v. Fanfan, the cases that will test Blakely\u27s application to the Federal Sentencing Guidelines. Thus the Roundtable offered these experts an intellectual breathing space at a crucial point in American criminal law. The event was built around six sessions, with shifting panels of participants doing brief presentations on the subject of the session, and with others then joining in the discussion. We are pleased that FSR is able to publish this version of the proceedings of the event-a condensed and edited transcript of the sessions

Species composition and habitat preferences of the nearshore fish fauna of Bonne Bay, Newfoundland

Determining biodiversity baseline is the first step toward establishing species monitoring and conservation programs. In this study we report on a 10-year survey of the fish fauna of Bonne Bay, a fjord surrounded by the Gros Morne National Park on the west coast of Newfoundland, Canada. The objectives of our study were: 1) to determine the fish fauna of Bonne Bay using standardized sampling methods; 2) to gather information on the habitats of fishes of conservation concern; and 3) to provide baseline information on Bonne Bay as a potential candidate for a National Marine Conservation Area (NMCA). Methods A survey of the fish fauna of the inner Bonne Bay was conducted each summer from 2002 to 2011 at multiple sites representing a range of fish habitats within the fjord. Sampling gears included two types of beach seine, gillnets with various mesh sizes and a bottom trawl. Species composition was statistically compared across sites within the fjord. Results We collected and identified 29 fish species from 17 families. Fish assemblages comprised anadromous, estuarine, and marine fish species, including a late-maturing type of winter skate (Leucoraja ocellata) that is rarely found in the adjacent waters of the northern Gulf of St. Lawrence. Similarity in species composition across sites reflected salinity, substrate composition, and presence of eelgrass (Zostera marina), but not the geographic distance between sites. Conclusions Bonne Bay’s adjacency to a United Nations Educational, Scientific, and Cultural Organization (UNESCO) World Heritage Site, its diverse fish fauna that includes several species of conservation concern, its potential for education and enjoyment, and its stewardship by local people are suggestive of the future candidacy as a NMCA. The data presented here will help managers assess the potential of Bonne Bay as a National Marine Conservation Area

Behavior-based diabetes management: Impact on care, hospitalizations, and costs

OBJECTIVES: To (1) examine the impact of the Diabetes Care Rewards (DCR) program on adherence to care standards and (2) evaluate the economic impact of adherence to care standards. STUDY DESIGN: A retrospective observational cohort study design with propensity matching. Additional covariates adjustment was used to minimize residual imbalance. METHODS: Utilization and cost data were compared between individuals enrolled vs individuals eligible for but not enrolled in the DCR program using a standard mean difference. Individuals were employees or their dependents from self-insured companies throughout the United States. Outcomes included adherence to the care standards, service utilization, and costs. RESULTS: A total of 3318 propensity-matched participants were included. Primary analysis revealed that enrolled members increased adherence to semiannual glycated hemoglobin, annual lipid, and annual urine albumincreatinine ratio testing. Additionally, enrolled members experienced less utilization of high-acuity services and increased rates of physician visits. In a secondary analysis, the enrolled group was associated with greater pharmaceutical costs but lower medical costs. CONCLUSIONS: A behavioral science- and incentive-based diabetes management program was associated with greater rates of adherence to recommended diabetes monitoring care standards, increased routine clinic visits, decreased hospital admissions, and decreased inpatient days. Anticipated increases in pharmaceutical expenditures were offset by overall lower medical expenditures. Results indicate the economic benefits of adherence to evidencebased standards for diabetes care

Iron deficiency linked to altered bile acid metabolism promotes Helicobacter pylori-induced inflammation-driven gastric carcinogenesis.

Gastric carcinogenesis is mediated by complex interactions among Helicobacter pylori, host, and environmental factors. Here, we demonstrate that H. pylori augmented gastric injury in INS-GAS mice under iron-deficient conditions. Mechanistically, these phenotypes were not driven by alterations in the gastric microbiota; however, discovery-based and targeted metabolomics revealed that bile acids were significantly altered in H. pylori-infected mice with iron deficiency, with significant upregulation of deoxycholic acid (DCA), a carcinogenic bile acid. The severity of gastric injury was further augmented when H. pylori-infected mice were treated with DCA, and, in vitro, DCA increased translocation of the H. pylori oncoprotein CagA into host cells. Conversely, bile acid sequestration attenuated H. pylori-induced injury under conditions of iron deficiency. To translate these findings to human populations, we evaluated the association between bile acid sequestrant use and gastric cancer risk in a large human cohort. Among 416,885 individuals, a significant dose-dependent reduction in risk was associated with cumulative bile acid sequestrant use. Further, expression of the bile acid receptor transmembrane G protein-coupled bile acid receptor 5 (TGR5) paralleled the severity of carcinogenic lesions in humans. These data demonstrate that increased H. pylori-induced injury within the context of iron deficiency is tightly linked to altered bile acid metabolism, which may promote gastric carcinogenesis