A defining feature of the drug treatment court movement is the judicial adoption of the disease model for explaining drug using behavior; an interpretive paradigm that historically has not played a ...defining role in the adjudication of drug offenders. In drug treatment courts, however, the disease model finds a very central place in the adjudicative process, and profoundly shapes the way judges view and treat defendants. This article examines the application of the disease model to drug and non-drug-related crimes in the context of drug treatment courts, and considers the significance of these developments as it concerns the meaning of criminal justice.
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DOBA, FSPLJ, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
ATOMIC DOCTORS: Conscience and Complicity at the Dawn of the Nuclear Age by James L. Nolan Jr. Cambridge, MA: The Belknap Press of Harvard University Press, 2020. 294 pages, plus index. Hardcover; ...$29.95. ISBN: 9780674248632. *This book ends with a tragic photograph. The reader will see a young boy carrying a sleeping infant on his back. However, the infant is not asleep but instead is dead as his brother waits his turn to have his brother's body thrown into a giant pyre at Nagasaki in the days following the atomic bomb blast. This picture is symbolic of the tragedy of war and provides a provocative statement regarding the involvement of US physicians in the development of the atomic weapons program toward the end of World War II. The author, James L. Nolan Jr., PhD (Professor of Sociology, Williams College), provides an excellent historical vignette of this period through a written biography of his grandfather, James F. Nolan, MD. *Dr. Nolan, as well as Louis Hempelmann, MD and Stafford Warren, MD, were intricately involved with the Trinity testing in New Mexico as well as with the development of the atomic bomb as part of the Manhattan Project. Dr. Nolan met and collaborated with such famous people associated with the Manhattan Project, including J. Robert Oppenheimer, Edward Teller, and General Leslie Groves. The entire group of physicians oversaw determining radiation risks during atomic bomb development and testing. This placed them in a difficult situation which "linked the arts of healing and war in ways that had little precedent" (p. 166) especially regarding the Hippocratic Oath.1 *Dr. Nolan was involved with setting up the hospital at Los Alamos as well as providing medical care for the Los Alamos staff and families. However, the job of these clinicians also had other aspects. Radiation exposure to workers was observed and recorded at Los Alamos leading to some of the initial descriptions of radiation poisoning. Additionally, the physicians were involved in determining radiation hazards associated with Los Alamos and in the setting of Trinity with most of their findings either being ignored or hidden from the public, sometimes with the complicity of these individuals. It is fascinating to consider that Dr. Nolan was one of the military personnel chosen to accompany Little Boy (the bomb that exploded over Hiroshima) to the Pacific Front at Tinian Island on the famous and later tragic USS Indianapolis. I cannot imagine, in our present time, that a physician would be charged with transporting and reporting the safety of a technologically advanced weapons system. *The book contains many fascinating stories, including how military physicians as well as other personnel were told to assert there was no significant radiation after the bombing in Japan (despite obvious radiation injury being noted in thousands of individuals), how the military allowed reporters at the Trinity test site after the bomb test with no protection except for "protective" booties, how US military physicians were told to not treat Japanese civilians after the bombing in order to circumvent moral responsibility of the bombing (this was ignored), how the inhabitants of the Bikini Atoll and Enewetak Atoll were forced to abandon their ancestral homes so that further atomic bomb testing could occur (with subsequent deleterious effects in their sociologic and health outcomes), and how patients in the United States (many who were already terminally ill) were secretly injected with plutonium to determine the effects of radiation injury. *Besides being a biography and history of a physician and his colleagues, this book also goes in some philosophical directions, including considering what is the goal of technology. Oppenheimer himself stated that "It's amazing ... how the technology tools trap one" (p. 33). The "trap" leads to a myriad of issues. Dr. Nolan believed radiation should be considered under the paradigm of an "instrumentalist view of technology" in which new technology could be used for the advancement or decline of our species. In his case, he began experimenting with radiation to treat gynecologic cancer in his patients. The book then explores "technological determinism," both optimistic and pessimistic, which is still an issue permeating our culture today. The author states that humans appear to always choose technologic advances even before fully knowing downstream economic, political, or cultural effects. Such examples cited by the author include the internet, social media, and genetic engineering. *A Christian will find this book unsettling when one considers what one prioritizes in his (her) faith. For example, one of the physicists who worked at Los Alamos was a Quaker. The Trinity test was named after the Christian Trinity (based on a John Donne sonnet). These facts are sobering when the author provides reports of "downwinders" who suffered catastrophic disease after the Trinity test as well as going into detail about the thousands of Japanese who suffered radiation poisoning after the nuclear bombing. In addition, the bombing of Nagasaki was close to the Christian part of the city resulting in the killing of most of the Christians living there. Indeed, the pursuit of science is a fascinating human endeavor, but the point of science is to objectively determine facts. Science does not necessarily provide subjectivity by itself which allows it to be influenced by meaning, moral values, and responsibility.2 In the moral arena, people with religious beliefs, including Christians, are required to influence the idea of technologic determinism in a positive direction. I highly recommend this book not only to learn about an interesting part of world history but also to appreciate the tragedy of the human condition in the setting of war. *Notes *1Michael North, translator, "Greek Medicine," History of Medicine Division, National Library of Medicine, National Institutes of Health, last updated February 7, 2012, https://www.nlm.nih.gov/hmd/greek/greek_oath.html. *2Mehdi Golshani, "Science Needs a Comprehensive Worldview," Theology and Science 18, no. 3 (2020): 438-47. *Reviewed by John F. Pohl, MD, Professor of Pediatrics, Department of Pediatrics, University of Utah, Salt Lake City, UT 84113.
Abstract only Objective Critical limb ischemia (CLI) is a challenging clinical entity complicated by chronic microvascular disease. Stromal vascular fraction (SVF), a heterogeneous population of ...cells derived from adipose tissue, has garnered interest as a means of an autologous cell-based approach to vasculogenesis in these patients. The SVF concentration needed to achieve this goal is still unknown. Our goal was to determine if SVF vasculogenesis exhibits a dose-response using in vitro and murine in vivo models. Methods SVF was isolated from adult male Sprague Dawley transgenic-GFP+ Rat epididymal fat pads and serially diluted using SVF growth media and then added to a respectively labeled matrigel-coated plates. Wells were then labeled with Griffonia simplicifolia-1 (GS-1) rhodamine lectin. Phase and fluorescent microscopy images of each well were then taken. The same SVF concentrations were suspended in collagen gels and subcutaneously implanted into the flanks of 6 Rag-1 deficient mice and imaged with confocal microscopy 2 weeks later to determine if a dose-response could be seen in-vivo. Tubule length was calculated using Metamorph software. Results Vasculogenic networks showed monolayering at concentrations of 5.0 x 10 5 and 1.0 x 10 6 cells/mL, where as the intermediate dose exhibited greater complexity to its network. Total tubule length, measured in μm, peaked with the 2.50 x 10 5 cells/mL concentration. Tubule length increased significantly up to this peak, and then gradually decreased at higher concentrations. GS-1 staining was positive when viewing the tubules under fluorescence microscopy. Preliminary results from the in-vivo model showed increasing vasculogenesis up to a maximal tubule length for the 1 x 10 6 cells/mL concentration. Conclusion SVF vasculogenesis exhibits a dose-response. Tubule formation is of endothelial phenotype and tubule length is directly proportional to cell concentration up to a peak concentration of 2.5 x 10 5 cells/mL. Preliminary in-vivo data also suggests that a dose-reponse exists. We are encouraged by these results that suggest that cell based therapy may be tailored for appropriate dosing in CLI patients.
Exercise is essential in regulating energy metabolism and whole-body insulin sensitivity. To explore the exercise signaling network, we undertook a global analysis of protein phosphorylation in human ...skeletal muscle biopsies from untrained healthy males before and after a single high-intensity exercise bout, revealing 1,004 unique exercise-regulated phosphosites on 562 proteins. These included substrates of known exercise-regulated kinases (AMPK, PKA, CaMK, MAPK, mTOR), yet the majority of kinases and substrate phosphosites have not previously been implicated in exercise signaling. Given the importance of AMPK in exercise-regulated metabolism, we performed a targeted in vitro AMPK screen and employed machine learning to predict exercise-regulated AMPK substrates. We validated eight predicted AMPK substrates, including AKAP1, using targeted phosphoproteomics. Functional characterization revealed an undescribed role for AMPK-dependent phosphorylation of AKAP1 in mitochondrial respiration. These data expose the unexplored complexity of acute exercise signaling and provide insights into the role of AMPK in mitochondrial biochemistry.
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•Identification of the human muscle acute exercise signaling repertoire•Integrated AMPK substrate prediction in human muscle and cells•Targeted validation of exercise-regulated AMPK substrates•AKAP1 phosphorylation by AMPK that regulates mitochondrial respiration
Combining phosphoproteomics, biochemical, and bioinformatics approaches, Hoffman et al. perform a global analysis of exercise signaling in human skeletal muscle and reveal an interconnected network of kinases and AMPK substrates in response to exercise. Among these, AKAP1 is shown to regulate mitochondrial respiration via AMPK-dependent phosphorylation.
Therapeutic adjudication Nolan, James L
Society (New Brunswick),
1/2002, Letnik:
39, Številka:
2
Journal Article
Recenzirano
The redefined role of the drug court judge is examined, focusing on the therapeutically oriented actions, words and judicial disposition of drug court judges. This legal innovation represents an ...important departure from America's common law tradition, a change that is commensurate with broader changes taking place in the American judiciary.
When Alexis de Tocqueville and Gustave de Beaumont came to the United States in 1831, their ostensible reason for making the trip was to observe America's new prisons, which were regarded at the time ...as among the very best in the world.1 We know from Tocqueville's famous work, Democracy in America,2 that he was interested in much more than America's prisons. However, Tocqueville and Beaumont were faithful to their commission from the French government to carefully look at America's prison system. One example of their diligence in this regard is the fact that Tocqueville individually interviewed 63 prisoners at the Cherry Hill prison in Philadelphia and, upon their return to France, Beaumont and Tocqueville submitted a detailed and substantive report on the American penitentiary system, which included their views on the applicability of the American model to the French system. The young French commissioners were largely impressed with what they observed in the US penitentiaries. However, they did not see the American model as easily transferable to France. They recognised that France had a very different political system and a very different culture. Therefore, they did not suppose that 'France could suddenly undertake a general revolution in its prison system', but they did think that 'one may reasonably ask for step-by-step reforms in our prison system.'
When Alexis de Tocqueville and Gustave de Beaumont came to the United States in 1831, their ostensible reason for making the trip was to observe America's new prisons, which were regarded at the time ...as among the very best in the world.1 We know from Tocqueville's famous work, Democracy in America,2 that he was interested in much more than America's prisons. However, Tocqueville and Beaumont were faithful to their commission from the French government to carefully look at America's prison system. One example of their diligence in this regard is the fact that Tocqueville individually interviewed 63 prisoners at the Cherry Hill prison in Philadelphia and, upon their return to France, Beaumont and Tocqueville submitted a detailed and substantive report on the American penitentiary system, which included their views on the applicability of the American model to the French system. The young French commissioners were largely impressed with what they observed in the US penitentiaries. However, they did not see the American model as easily transferable to France. They recognised that France had a very different political system and a very different culture. Therefore, they did not suppose that 'France could suddenly undertake a general revolution in its prison system', but they did think that 'one may reasonably ask for step-by-step reforms in our prison system.'
When Alexis de Tocqueville and Gustave de Beaumont came to the United States in 1831, their ostensible reason for making the trip was to observe America's new prisons, which were regarded at the time ...as among the very best in the world.1 We know from Tocqueville's famous work, Democracy in America,2 that he was interested in much more than America's prisons. However, Tocqueville and Beaumont were faithful to their commission from the French government to carefully look at America's prison system. One example of their diligence in this regard is the fact that Tocqueville individually interviewed 63 prisoners at the Cherry Hill prison in Philadelphia and, upon their return to France, Beaumont and Tocqueville submitted a detailed and substantive report on the American penitentiary system, which included their views on the applicability of the American model to the French system. The young French commissioners were largely impressed with what they observed in the US penitentiaries. However, they did not see the American model as easily transferable to France. They recognised that France had a very different political system and a very different culture. Therefore, they did not suppose that 'France could suddenly undertake a general revolution in its prison system', but they did think that 'one may reasonably ask for step-by-step reforms in our prison system.'
Abstract Objective: To determine whether tight control of blood pressure with either a β blocker or an angiotensin converting enzyme inhibitor has a specific advantage or disadvantage in preventing ...the macrovascular and microvascular complications of type 2 diabetes. Design: Randomised controlled trial comparing an angiotensin converting enzyme inhibitor (captopril) with a β blocker (atenolol) in patients with type 2 diabetes aiming at a blood pressure of <150/<85 mm Hg. Setting: 20 hospital based clinics in England, Scotland, and Northern Ireland. Subjects: 1148 hypertensive patients with type 2 diabetes (mean age 56 years, mean blood pressure 160/94 mm Hg). Of the 758 patients allocated to tight control of blood pressure, 400 were allocated to captopril and 358 to atenolol. 390 patients were allocated to less tight control of blood pressure. Main outcome measures: Predefined clinical end points, fatal and non-fatal, related to diabetes, death related to diabetes, and all cause mortality. Surrogate measures of microvascular and macrovascular disease included urinary albumin excretion and retinopathy assessed by retinal photography. Results: Captopril and atenolol were equally effective in reducing blood pressure to a mean of 144/83 mm Hg and 143/81 mm Hg respectively, with a similar proportion of patients (27% and 31%) requiring three or more antihypertensive treatments. More patients in the captopril group than the atenolol group took the allocated treatment: at their last clinic visit, 78% of those allocated captopril and 65% of those allocated atenolol were taking the drug (P<0.0001). Captopril and atenolol were equally effective in reducing the risk of macrovascular end points. Similar proportions of patients in the two groups showed deterioration in retinopathy by two grades after nine years (31% in the captopril group and 37% in the atenolol group) and developed clinical grade albuminuria ≥300 mg/l (5% and 9%). The proportion of patients with hypoglycaemic attacks was not different between groups, but mean weight gain in the atenolol group was greater (3.4 kg v 1.6 kg). Conclusion: Blood pressure lowering with captopril or atenolol was similarly effective in reducing the incidence of diabetic complications. This study provided no evidence that either drug has any specific beneficial or deleterious effect, suggesting that blood pressure reduction in itself may be more important than the treatment used.
Background aims Peripheral blood progenitor cell (PBPC) products are often transported at high cell concentrations (>200 × 109 /L) over long distances, requiring >36 h transport time. Methods Fresh ...PBPC samples from 12 healthy donors were studied with various viability assays regarding the effects of temperature, cell concentration and duration of storage. Results Trypan blue exclusion was far less sensitive to cell damage than two-color fluorescence for CD34 and 7-AAD, and colony-forming unit–granulocyte-macrophage (CFU-GM) assays; the latter assay proved the most sensitive. All products stored at 4°C maintained their viability for up to 4 days. Thus, at 96 h, recovery of viable CD34+ cells was still 82%, and of CFU-GM 57%, even at concentrations of 200 × 109 /L. Higher storage temperatures rapidly decreased the viability, with extensive variation between donors. At room temperature 80% of viable CD34+ cells and >90% of CFU-GM were lost after 48 h of storage at 200 × 109 /L. Lower cell concentrations allowed storage at higher temperatures: at 17°C a concentration of 50 × 109 /L resulted in only 5% loss of viable CD34+ cells after 48 h, while the loss was >30% at 200 × 109 /L. Conclusions PBPC products should be transported at 4°C. Dilution of the product may partly compensate for slightly higher temperatures. Trypan blue exclusion should be abandoned as a method for assessing viability after prolonged transportation. Proliferative assays should be used to validate transportation conditions.
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