Wednesday Web Watch for January 28, 2015

WWWCenter for Law, Science & Innovation Faculty Fellow, Betsy Grey, was recently quoted in an article that considers whether it is appropriate for individuals with PTSD, which is still not fully understood, to receive the death penalty.  Grey outlines some of the concerns surrounding a PTSD diagnosis, namely that,

“Most of the evidence for the diagnosis comes from interviews with the defendant, which leads to concerns about the trustworthiness of a particular diagnosis. Put simply, there are concerns that an individual who raises a claim of PTSD after committing a crime might be faking symptoms in order to avoid criminal punishment. But even if concerns about malingering in particular cases and the validity of PTSD as a legitimate diagnosis can be overcome, it is difficult to establish a causal connection between the disorder and the alleged criminal act because a defendant’s claim that he suffered a PTSD dissociative flashback while committing a crime can only be demonstrated by the defendant’s own testimony. Further, some studies have suggested a potential for “confirmatory” bias when a clinician is aware of an individual’s exposure to a stressor. In other words, if, for example, an expert knows that a particular defendant served in combat while in the military, the expert is more likely to find symptoms and diagnose that defendant with PTSD.”

Arguing for a better understanding of PTSD and effective treatment options & access for those suffering from PTSD, the article’s author, Naomi Shavin, notes that, “[i]f our understanding of how PTSD affects veterans does not catch up to the rate at which we are producing veterans with PTSD (particularly from our ongoing engagements in the Middle East), we’re only likely to put more veterans clearly struggling with mental illness on death row.”

Concussion Biomarkers: Scientific and Legal Implications

By Gary E. Marchant

Concussions have emerged as a major public health problem. The CDC estimates that over one-and-a-half million American suffer a concussion each year, many in contact sports such as football, hockey and soccer, but also as a result of military combat, domestic abuse, vehicle crashes, falls, and other accidents. Our ability to predict, prevent, diagnose, treat and prognose concussive injuries is severely limited by the lack of valid and objective medical tests to detect and evaluate concussions. Health care providers primarily use simple tests of cognitive performance to diagnose concussions today, an imprecise system that relies heavily on the patient’s own subjective reporting and fails to accurately portray the severity and persistence of brain injury and the future risk of individuals suffering traumatic brain injuries.

There is an urgent need to find and put into practice reliable and objective biological tests of concussive injuries. With that goal in mind, the Center for Law Science & Innovation at ASU’s Sandra Day O’Connor College of Law recently convened on January 16 an interdisciplinary workshop of leading experts to address the scientific and legal aspects of concussion biomarkers. Law Professor Betsy Grey, who chaired the workshop and also chairs the Center’s new program on Neuroscience and the Law, opened the workshop by noting that “brains don’t fail in obvious ways, like bones do when they break or skin when it tears. Defining concussive brain injury is difficult.” She said that by developing valid biomarkers of brain injury, scientists “hope to make the invisible visible.” U.S. Federal District Court Judge Roslyn Silver noted that law also has an important role to play in preventing and ensuring adequate treatment of concussions, but it too requires scientifically reliable biomarkers of concussive injury that can provide a solid foundation for public policies and be admissible in court.

The morning session of the workshop focused on the scientific status of concussion biomarkers. The first presentation was a masterful overview by Dr. David Dodick of the Mayo Clinic on the various types of biomarkers under development for the diagnosis, prognosis and recovery from concussion. These include cerebral spinal fluid, blood, neuroimaging, clinical, electrophysiologic, and genetic biomarkers. Although there are many promising biomarkers under active development, he emphasized that these are a “work in progress,” in most cases not yet ready for routine clinical use.  Science has demonstrated that a concussed brain is metabolically and structurally vulnerable with the recovery time extending beyond physiological symptoms and varying between and within individuals, and may not always correlate with observable symptoms, and therefore more precise biological markers of brain status are critical for effectively managing concussion risk.  As more informative biomarkers become clinically available in the next few years, it will be important to establish individual baselines and robust data sets to better understand the clinical significance of detected biomarkers.

The second science speaker was Dr. Kendall Van Keuren-Jensen of the Translational Genomics Institute (TGEN), who reported on an ongoing study to correlate concussive injury with RNA biomarkers. This ongoing study is a collaborative effort of TGEN, Barrow Neurological Institute, Ridell (helmet manufacturer),  ASU, and other partners. The study involves monitoring ASU football players, some of whom incur concussions, whose real-time head impact data is collected using Riddell’s Sideline Response System (SRS). The researchers correlate the head impact data and concussion reports with RNA markers in the player’s blood and urine. The initial results from the 2014 college football season are currently being analyzed, and the results may help identify RNA markers in players’ bodily fluids that can track the pathology underlying brain injury and disease. Such biomarkers may provide a convenient and accessible marker to diagnose concussions in a more objective manner and to inform health care providers of the severity, progression, biology of disease, and response to treatment of concussions.

The final science presentation described an innovative pilot program where concussion biomarkers are being applied in the real world.  Dr. Kent Kiehl of the Mind Research Network  (MRN) described the “Brain Safe” pilot program he and his colleagues are running at the University of New Mexico (UNM). The program conducts a baseline analysis of UNM college athletes in a variety of sports such as football, basketball (male and female) and soccer (male and female) using noninvasive brain imaging techniques such as functional MRI, structural MRI, diffusion tensor imaging, and other assays. The results from these various tests are then integrated using a proprietary algorithm developed by the MRN to identify hidden data patterns across imaging methods and to provide for unique bio-signatures of concussion in each individual. The athletes are evaluated using the same techniques at the end of each season, and also immediately after they incur a concussion. The program is completing its first year, and one of the most interesting initial findings is the high rate of incidental findings in the baseline screens of incoming athletes. Dr. Kiehl and his team are exploring expanding the Brain Safe program to other colleges and high schools, and the program is setting a new standard of care for concussion detection and management.

The afternoon session focused on legal and policy aspects of concussion biomarkers, with three framing presentations and roundtable discussion. ASU law professor Gary Marchant first discussed biomarkers of susceptibility, which indicate an individual who may be at greater risk of concussive injury. A previous traumatic brain injury is the most established marker of an increased risk of a subsequent injury, but this is a crude measure that fails to capture individual variability without a more discriminatory molecular or imaging marker. Much attention has focused on the APOE4 genetic allele as a susceptibility risk factor for concussions, just as it is for its better known association with Alzheimer’s. A number of relatively small studies have evaluated the increased concussion risk for APOE4 carriers, with inconsistent results. The evidence seems stronger that APOE4 carriers are at greater risk for more severe concussions than more frequent concussions. The identification of an athlete with the APOE4 variant may impose a greater duty on a school or team to protect that player, in much the same way the NCAA has been compelled to protect sickle cell carriers from stressful environmental conditions.

Professor Betsy Grey then addressed the legal implications of biomarkers of effect. As blood-based or neuroimaging markers are validated that can provide an objective measure of brain disruption, the “return to play” laws enacted by all 50 states will no doubt need to be updated to incorporate these useful new tools. Given the variability between individuals in many of the parameters measured using biomarkers, it will be critical to establish a baseline measurement for each individual that can be used to document adverse changes. An interesting discussion resulted about the incentives (or disincentives) of a school or team to establish baseline measurements for its athletes. In addition to affecting return to play decisions, biomarkers of concussion effect are likely to lead to increased use of the courts to obtain private remedies. For example, many individuals who have detectable biomarkers may seek to obtain tort compensation for those effects, similar to plaintiffs in toxic tort cases who seek compensation for latent risk claims, such as increased risk of disease, fear of disease, and medical monitoring. Biomarkers of effect are also likely to have important applications in proving or disproving causation.

Finally, attorney Larry Cohen addressed the admissibility of biomarker evidence. Cohen and his research team have conducted an exhaustive study of the admissibility of biomarker evidence, seeking to identify relevant factors that will be influential for the successful court use of concussion biomarkers. The Daubert factors such as published peer-reviewed studies, a known rate of error, and general acceptance will be critical factors for admissibility. Even with these criteria to apply, there is much variability and inconsistency between judicial opinions on admissibility of biomarkers, suggesting the need for a more predictable and consensus approach for the use of biomarker evidence in court cases.

The final segment of the workshop addressed follow-up activities, and there was strong support for a larger follow-up conference on concussion injuries and biomarkers. Plans were also discussed for preparing one or more manuscripts to be submitted for publication co-authored by workshop participants.

Tuesday Triple Trivia for January 27, 2015

TTT53 Questions. 3 Hints. 3 Answers. Every Tuesday.

1. What do you get when you cross a parachute with biology and a sisal?

Hint:

Answer:  parabiosis involves conjoining two live entities to form a single circulatory system.  Why do such a thing?  For years scientists have experimented with lab rats to determine whether there are benefits to be gained by infusing young blood into separate systems — especially one old and one young.  The practice has had its ups and downs popularity-wise but its recent resurrection has quite a few researchers paying close attention as joining the circulatory systems of an aging mouse to that of a youngster has yielded impressive restorative results.  Examined tissues show that the blood of young mice appears to bring new life to the organs and tissues of older mice, rejuvenating them as a whole.  A few months ago, with the backing of successful lab results, a California-based clinical trial began testing the circulation of young blood in persons with Alzheimer’s disease.   That is always the bottom line: will it work and is it safe for human beings?  Imagine the great possibilities resulting from bringing new life into an aging heart, brain, liver and so forth.  A testament, perhaps, to the old saying that blood is thicker than water.  Read the details here.

2. What recent upload is the first of its kind?

Hint:

Answer: a recent study’s data is now part of a first upload of  ∼1,000 autism genomes to the Autism Speaks MSSNG portal.   Autism Speaks is making the data globally available for research to promote expedited understanding and personalized treatments for autism.  The study’s leader emphasized the importance of the upload, stating “[t]his is a historic day, as it marks the first time whole genome sequences for autism will be available for research on the MSSNG open-science database. This is an exemplar for a future when open-access genomics will lead to personalized treatments for many developmental and medical disorders.”  The largest-ever autism genome study itself revealed autism’s complexity in that most siblings with autism have unique autism-linked genes requiring different types of therapeutic treatment, highlighting that one size does not fit all.  While known autism-risk genes showed up in 42 percent of the families participating in the study, given the recorded differences, a complete assessment of each individual’s genome is necessary in order to prescribe more effective treatments.  Read more here.

3. Under what circumstances does an eye-dropper come in handy?

Hint:

Answer: contrary to misguided information, farmers growing genetically modified (GM) crops do not “drown” them in herbicides and pesticides.  As one Iowa farmer points out, “next time you’re at Dunkin Donuts or Starbucks picking up an extra large of your favorite coffee, that’s approximately the amount of herbicide we spread on a football field sized area of a field.”  When it comes to his corn crop, that farmer applies the equivalent of 1/3 of a drop per square foot.  On soybeans it’s about  1/12 of a drop.   So next time you see an anti-GM story accompanied by an image of a plane flying over a field, giving the impression it is chemically drowning the crops below, think of that eye dropper.   Read the story here.

 

 

 

Guston on Genetic Containment

ASU‘s David Guston was a guest on NPR’s Science Friday yesterday weighing in on E. coli bacteria engineered with genetic kill switches to prevent escape of genetically modified organisms (GMOs) into the environment.  The milestone was very big news, stemming from a study published in Nature a few days ago.  The study involved the design of E. coli bacteria that can only survive in the presence of a synthetically engineered amino acid.  Without this amino acid, as a food source, the bacteria dies.  Given the amino acid is not found in nature, one can control where GMOs containing the synthetic safeguard should live and thrive.   According to Daniel Mandell (the study’s lead, also featured on NPR with Guston), the E. coli bacteria was tested and found to be unable to evolve to avoid dependency on the synthetic amino acid.

On a parallel, the study indicates a potential significant breakthrough for GMO crops in terms of curbing or eliminating fears of cross-pollination of GMO seeds onto organic or conventional farms.   Nonetheless, Mandell points out that such a development may be a few years off in that the genome of a plant is  ∼nine times the size of a bacteria genome resulting in a technological challenge to increase the size of the synthetic DNA to be created in order to be effective.  However, Mandell is quick to point out that there is no reason not to believe the same science may one day be applied to crops.  Guston, when asked about likely public reaction or reassurance provided by this novel application of genetic engineering, is himself a little skeptical, noting that at present, it is unlikely to be the silver bullet.  For instance, Guston considers the potential for the synthetic amino acid to persist in the environment to be one area of concern.  Another issue, says Guston, relates to benefit perceptions — in terms of how people perceive where the benefit of a technology goes.  In terms of GMOs [crops], Guston claims that in many cases, the profits of plant technologies have accrued to the producers, not the farmer — which is debatable, plus, profits make up only a portion of the total benefits derived from GMO farming.  In this instance, given the potential for abatement of cross-pollination, there appears to be a case to be made to move the public to not reject this particular advancement.

To listen to the NPR interview, click here.  Guston was also quoted on this topic in a recent Washington Post article and, in the same vein, is this New Yorker article.

Among other capacities, David Guston serves as Director of ASU’s Center for Nanotechnology in Society, which on occasion co-sponsors events organized by the Center for Law, Science & Innovation, such as the Center’s upcoming Third Annual Conference on Governance of Emerging Technologies: Law, Policy and Ethics, May 26-28, 2015 in Scottsdale, Arizona.

 

 

“Experience ASU” – Featuring Gary Marchant, Lawrence Krauss, Kyle Longley & Valana Wells

ASU PE

PLEASE JOIN US TO “EXPERIENCE ASU”
Tuesday, February 17
9:00 a.m.-4:00 p.m.
SkySong, Building No. 3
1365 N. Scottsdale Road
Scottsdale, 85257 map
Cost: $140 | Full-day participation
Register today

“Experience ASU” is your opportunity to take part in the knowledge and talent that thrive at a major research university. Gain new insight and deepen your involvement in Arizona State University’s outstanding work by engaging with the scholars and researchers on the frontlines of discovery.

During this daylong program, you will hear four 70-minute lectures given by top ASU faculty and participate in a Q&A session for each one. Don’t miss this opportunity to enrich your knowledge of the world and your relationship with ASU.

Courses
________________________________________
Who Wants Your Genetic Information? And for What?
This presentation will describe the trend of and reasons for population-wide whole genome sequencing, and identify the many potential uses your DNA may have – some beneficial, some worrisome, some entertaining and some mind-boggling.
Presenter:
Gary Marchant, Regents Professor and Lincoln Professor of Emerging Technologies, Law and Ethics
________________________________________
Life, the Universe and Everything: From the Beginning of Time to the Origins of the Future
Hear about exciting new developments in our understanding of the universe and how the Origins Project facilitates and broadcasts these important discoveries to the public in an accessible, innovative format.
Presenter:
Lawrence Krauss, Foundation Professor, School of Earth and Space Exploration and director, Origins Project
________________________________________
The War to End All Wars: The Lasting Legacies of World War I
This presentation will look at the long-lasting effects of the Great War that engulfed the world in 1914. It will emphasize how the war shaped the 20th century and changed the world political order, leading to the creation of the Soviet Union and the Cold War.
Presenter:
Kyle Longley, Dean’s Faculty Fellow, College of Liberal Arts and Sciences
________________________________________

As a Matter of Fact, it IS Rocket Science …
Discover the breadth and depth of research and innovation stemming from the field of aerospace engineering. This presentation will introduce ASU’s vibrant aerospace engineering program and include topics ranging from testing of rocket fuels to the interaction of humans and robots.
Presenter:
Valana Wells, program chair, Aerospace Engineering and Mechanical Engineering, School for Engineering of Matter, Transport and Energy

Registration required | Lunch and complimentary parking provided
See the entire spring season of PEP
For more information, contact Vanessa Barrera de Leyvas at
480-965-4814 or vanessa.barrera@asu.edu

Introducing: What Could Possibly Go Wrong?

WCPGW

A NEW bLAWg FEATURE: WHAT COULD POSSIBLY GO WRONG?

Courtesy of Joel Garreau

Fall foliage. A beautiful sight, but not for trains.  In fact, fallen leaves can accumulate and adhere to a train track like tarred feathers, resulting in a potentially dangerous situation — not to mention delays.  Commuters really dislike delays.   What to do?  How about annihilating leaves with lasers?  Laser-outfitted rail wheels take care of (think Tony Soprano)  compacted leaves before a train makes contact, thanks to Dutch Railways.  The lasers also act as blow-dryers — drying rails to prevent new leaves from adhering, increasing a train’s functionality.  So what could go wrong?  A train’s vibration could direct a laser’s attention elsewhere … but people are working on that issue, given the laser’s advantages over other options.  Read more here.