RECENT DEVELOPMENTS IN MEDICINE AND THE LAW Smith, Mark T.; Derevlany, Louise A.; Steen, Jonathan O.
Tort trial & insurance practice law journal,
09/2011, Letnik:
47, Številka:
1
Journal Article
The doctor was not a psychiatrist but engaged the patient in talk therapy and allegedly exploited the "eroticized transference" syndrome of his patient. 12 The jury awarded $334,000 in compensatory ...damages and $166,000 in punitive damages and assigned plaintiff 25 percent fault. 13 In affirming the judgment, the court stated the evidence of a sexual relationship between the mental health provider and his patient supported the finding of medical malpractice, which was very likely to harm the patient due to the dependence of the patient on the provider. 14 A sexual relationship between a mental health provider and patient is a departure from the standard of care, whether it is characterized as part of the treatment or independent of it, and remains a departure even after the treatment has ended. 15 The dissent argued that the judgment should be reversed because the evidence failed to demonstrate medical malpractice. 16 Plaintiff testified that she knew the relationship was not part of her treatment, and was in fact "extraneous to treatment," and that the relationship was consensual. 17 According to the dissent, a doctor's conduct is malpractice " 'only when it constitutes medical treatment or bears a substantial relationship to the rendition of medical treatment.
Over the past decade, single‐use tangential flow filtration (TFF) technologies have emerged to reduce system preparation time, promote fast and flexible product change over, and ultimately shorten ...process development and manufacturing time/cost. In this study, the performance of a recently developed Pellicon® single‐use TFF capsule was compared against traditional Pellicon® cassettes by assessing TFF process performance (such as flux, residuals clearance, and yield) and post‐purification product attributes (such as concentration and mass‐weighted average molecular weight). Good scaling was shown by comparing process performance and product attributes across different scales and formats. Additionally, similar TFF process performance and post‐purification product attributes were observed for the single‐use capsule compared to the reusable TFF cassettes. The capsule requires a smaller flush than the cassette, and it is easier to use since it does not require a compression holder or pre‐sanitization. The results provide insight into the application of the single‐use TFF capsule and scalability of TFF processes for the purification of conjugate vaccines.
RECENT DEVELOPMENTS IN MEDICINE AND THE LAW Gogoel, Mary K.; Miller, Juliane C.; Rovelli, Lynn ...
Tort trial & insurance practice law journal,
09/2012, Letnik:
48, Številka:
1
Journal Article
The physician recommended either an injection or a procedure to terminate the pregnancy.3 After receiving the injection, plaintiff discovered that she had been having a normal uterine pregnancy.4 The ...patient sued her obstetrician for medical malpractice and lack of informed consent, claiming that he had not informed her she may have had a normal pregnancy and he did not give her any alternatives to terminating the pregnancy.5 At trial, the court did not allow the informed consent claim to go to the jury, finding that plaintiff was asserting a claim for deviating from the standard of care in making the diagnosis, not a claim for informed consent.6 The appellate court reversed, stating that the informed consent doctrine applies whenever a patient is "deprived of the opportunity to reasonably determine for herself whether she wishes to accept the risks of a proposed or alternate treatment. 17° The trial court granted defendants' motion, ruling that the Ohio statute was retroactively applicable to the physician's 2001 statement, and further ruling that the statement was inadmissible under the statute.171 On appeal, the Ohio Court of Appeals reversed this ruling, finding that the statute was not retroactively applicable, and that absent this statutory provision, the physician's statement was admissible under Ohio's Rules of Evidence as a party admission.172 D. Conclusion The uniformity of the majority of state statutes and the scarcity of developments in the past year indicate general agreement that expressions of sympathy by health care providers in a medical situation are inadmissible as evidence of an admission of liability or admission against interest.
RECENT DEVELOPMENTS IN MEDICINE AND THE LAW Derevlany, Louise A.; Marulanda, Maria; Colucci, Paul J. ...
Tort trial & insurance practice law journal,
01/2010, Letnik:
45, Številka:
2
Journal Article
... the authorization specifically permitted the "right to discuss the care and treatment of plaintiff"19 The court noted that HIPAA is more stringent than Georgia law in regard to ex parte ...communications, allowing patients to have more control over their medical records.20 However, in Hamilton, plaintiff never withdrew her initial permission or sought any type of modification or restriction of the medical record access authorization as permitted by HIPAA. Of note, the court added that the applicability of HIPAA to ex parte communications was not decided at the time when these ex parte communications occurred, and refused to impose sanctions on the defense.21 D. Kansas The Kansas Court of Appeals recently considered whether it was appropriate for the patient's treating physician to testify at trial regarding the care and treatment of the patient.\n"113 Reviewing that decision, the administrative appellate division also cited the emphasis placed by DMHS in its decision to grant the waiver that "the practice of telepsychiatry has been endorsed by the APA American Psychiatric Association as an appropriate component of a mental health delivery system to the extent its use is in the best use sic of the patient and complies with ethics and confidentiality laws. ... given the difficulty of hiring physicians for 'aroundthe-clock' availability in a rural area, telepsychiatry may be the only viable means of providing this needed service to consumers.
Typically, I research the background of every expert, both my own and that of opposing counsel, by obtaining information such as whether the expert previously was allowed or excluded from testifying, ...the area of expertise in which the testimony was offered, transcripts of trial or disposition testimony, copies of affidavits, and published articles by and news items about the expert. Because no one database contains all information about every expert witness, I use a variety of resources to effectively vet experts. Thomson Reuters has brought together the Round Table Group, Silicon Valley Expert Witness Group, and Health Litigation Support to provide comprehensive search services for experts in industry, corporate management, and academia; patent and high technology; and medical cases.
Adoptive T‐cell therapies (ATCTs) are increasingly important for the treatment of cancer, where patient immune cells are engineered to target and eradicate diseased cells. The biomanufacturing of ...ATCTs involves a series of time‐intensive, lab‐scale steps, including isolation, activation, genetic modification, and expansion of a patient's T‐cells prior to achieving a final product. Innovative modular technologies are needed to produce cell therapies at improved scale and enhanced efficacy. In this work, well‐defined, bioinspired soft materials are integrated within flow‐based membrane devices for improving the activation and transduction of T‐cells. Hydrogel coated membranes (HCM) functionalized with cell‐activating antibodies are produced as a tunable biomaterial for the activation of primary human T‐cells. T‐cell activation utilizing HCMs lead to highly proliferative T‐cells that express a memory phenotype. Further, transduction efficiency is improved by several folds over static conditions by using a tangential flow filtration (TFF) flow‐cell, commonly used in the production of protein therapeutics, to transduce T‐cells under flow. The combination of HCMs and TFF technology leads to increased cell activation, proliferation, and transduction compared to current industrial biomanufacturing processes. The combined power of biomaterials with scalable flow‐through transduction techniques provides future opportunities for improving the biomanufacturing of ATCTs.
Well‐defined, bioinspired soft materials are integrated within scalable, flow‐based membrane devices for improving the activation and transduction of T‐cells, which are essential steps in the production of adoptive T‐cell therapies. These innovative technologies provide opportunities for improving the manufacturing of cell therapies.
This thesis examines the remarkable ambivalence towards Cannabis sativa L. in Canada, evidenced in the high-stakes contest between competing public conceptions of, and private interests in, the ...drug-plant and cash crop. Official policy regarding the enigmatic substance over the first decade of the 21st century has been notably erratic, and during this period a number of dramatic shifts in Canada’s administrative and clinical approaches to cannabis have occurred. This has resulted in changes which stand out significantly in the history of the plant’s medicinal, recreational, and industrial use in this country.
Despite the recent surge in acceptance and legitimacy of its medical use in a number of jurisdictions, the definition, classification, regulation, prescription, cultivation, marketing, and consumption of cannabis for therapeutic purposes continue to pose, for many groups and individuals in this country, a medico-legal dilemma—with the boundary between licit and illicit a blurry one in deed, and in word. The many lingering questions about proper ethical and practical conduct within (and parallel to) the framework of the MMAR have made it exceedingly difficult for many participants to arrive at a comfortable fit between the activities pursuant to their roles and the uncertain, unqualifiable, or unappreciated value (or risk) entailed by those roles. I intend not only to improve understanding of the rhetorical, linguistic, and socio-cognitive basis of a particular drug-policy problem, but also to demonstrate, in so doing, the broad analytical reach of rhetorical theory and criticism, and the usefulness of applying rhetorical and cognitive-linguistic methodologies together. Through analysis of suasive elements of key terms and conceptual structures in the discourse, and of differently motivated role-value connections assumed by participants therein, I forward the claim that marijuana has played the part of the scapegoat in medicine and, more broadly, among all drugs.
SPORT NEWS ROUND-UP ROB STEEN and JONATHAN WILSON
The Financial times (London ed.),
09/2005
Newspaper Article
Organisers said Sebastien Loeb did not want to win in such circum-stances and he finished third behind Belgian team mate Francois Duval. It was Solberg's fourth British win in a row for Subaru but he ...will not consider it a victory. There were no celebrations and the drivers and crowd held a minute's silence when the leading cars arrivedat the finish in Cardiff. Park, from Newent, Gloucestershire, leaves wife Marie and children William and Victoria. Park, nicknamed "Beef" and Martin won five world rallies together.*Two early successes, then a long and unproductive struggle. Bristol must hope that their Guinness Premiership season, which has exceeded expectation with opening wins over Bath and Newcastle, does not follow the pattern of yesterday's 41-9 home defeat by old enemy Gloucester, writes Huw Richards. Outside-half Jason Strange kicked two early penalties and veteran Samoan wing Brian Lima came within five yards of a debut try, but then the Premiership reality of which Bristol coach Richard Hill had warned kicked in. Most of all it took the form of Gloucester outside-half Ludovic Mercier. He may be a rotund, balding figure but he is a ruthlessly effective kicker, who punished Bristol indiscretions. Five penalties in 18 minutes, the first with a trajectory suggesting that the art of reverse swing has reached French outside-halves, erased that early optimism. Three months ago Michael Campbell and Paul McGinley had the same flight to the US Open, practised and played the first two rounds together. After winning his first major, Campbell complimented McGinley on the support he had given him. That victory lifted Campbell to golf's world stage and when the pressure arrived yesterday it was his greater ability to cope that won the day, leaving McGinley to contemplate his 14th runners-up finish and his second at Wentworth in2005 after the BMW PGA Championship. Campbell's eagle three at the par five 18th hole was all that separated them in the morning round and although Campbell won two of the first three holes after lunch, McGinley fought back tigerishly to be level with nine holes to play. Disaster, however, struck the Irishman when he missed the green with his approach to the 15th and then drove into trees at the following hole leaving Campbell to wrap up the match with a birdie at the par five 17th.
The penalties were unbearably dramatic. Serginho blazed over and Jerzy Dudek saved from Andrea Pirlo, but just as Liverpool looked in control, John Arne Riise's kick was clawed away by Dida. Kaka ...then converted to level, but Vladimir Smicer sent Dida the wrong way to restore Liverpool's advantage. That left Dudek to claim the glory, diving to his right to save from Andriy Shevchenko. An unlikely hero perhaps, but Dudek, who even adopted Bruce Grobbelaar's wobbly legs tactics at one point in the shoot-out, deserved the glory. He has been maligned at times, but he was integral to Liverpool's success last night. Three minutes from the end of extra-time he had made a frankly unbelievable double save to deny the luckless Shevchenko, parrying his header, and then, quite incredibly, diverting his point-blank follow-up over the bar. First Gerrard, given licence to advance with Dietmar Hamann and Xabi Alonso to cover, headed John Arne Riise's cross into the top corner. Then Vladimir Smicer sent a low shot skidding just inside Dida's right-hand post, before, with an hour played, Gerrard was tripped in his shooting stride by Gennaro Gattuso. Dida blocked Alonso's penalty, but the Spaniard reacted sharply enough to thrash the rebound into the roof of the net.
T cells infiltrating follicular lymphoma (FL) tumors are considered dysfunctional, yet the optimal target for immune checkpoint blockade is unknown. Characterizing coinhibitory receptor expression ...patterns and signaling responses in FL T-cell subsets might reveal new therapeutic targets.
Surface expression of 9 coinhibitory receptors governing T-cell function was characterized in T-cell subsets from FL lymph node tumors and from healthy donor tonsils and peripheral blood samples, using high-dimensional flow cytometry. The results were integrated with T-cell receptor (TCR)-induced signaling and cytokine production. Expression of T-cell immunoglobulin and ITIM domain (TIGIT) ligands was detected by immunohistochemistry.
TIGIT was a frequently expressed coinhibitory receptor in FL, expressed by the majority of CD8 T effector memory cells, which commonly coexpressed exhaustion markers such as PD-1 and CD244. CD8 FL T cells demonstrated highly reduced TCR-induced phosphorylation (p) of ERK and reduced production of IFNγ, while TCR proximal signaling (p-CD3ζ, p-SLP76) was not affected. The TIGIT ligands CD112 and CD155 were expressed by follicular dendritic cells in the tumor microenvironment. Dysfunctional TCR signaling correlated with TIGIT expression in FL CD8 T cells and could be fully restored upon
culture. The costimulatory receptor CD226 was downregulated in TIGIT
compared with TIGIT
CD8 FL T cells, further skewing the balance toward immunosuppression.
TIGIT blockade is a relevant strategy for improved immunotherapy in FL. A deeper understanding of the interplay between coinhibitory receptors and key T-cell signaling events can further assist in engineering immunotherapeutic regimens to improve clinical outcomes of cancer patients.
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