Legal Analysis: Daesh Control of Watercourses in Syria and Iraq

After years of turmoil, the volatile situation in Iraq and Syria erupted into chaos, setting the stage for the rise of Daesh. Under the leadership of Abu Bakr al-Baghdadi since 2013, Daesh has successfully gained control of territory and influence throughout vast regions of Iraq and Syria to create a new religious caliphate. In the water-scarce region, Daesh has executed a plan to capture the most precious resource available: water. The critical threat Daesh poses to watercourse installations along the Tigris and Euphrates in Syria and Iraq poses a pressing challenge to water security in the Middle East. How might state actors hold Daesh accountable for their control, depletion, and weaponization of the public resource of water? In the midst of multi-ethnic sectarian conflicts, what national laws in Iraq and Syria create obligations for a coordinated federal response to protect their watercourses? What duties does an Armed Non-State Actor owe within a positivist international legal system? Do those duties change when that actor draws new borders for a new self-proclaimed “state” made up of transnational sovereign territory? This note will examine the legal implications that are triggered by Daesh control over watercourses throughout Iraq and Syria. Part I contextualizes the threat Daesh poses to watercourses in Iraq and Syria as well as what type of legal personhood they possess. Part II examines the legal obligations of state actors under domestic, Islamic, and international law with respect to Daesh control of water installations in Iraq and Syria. After establishing the legal basis, Part III analyzes the extent to which Daesh, as an Armed Non-State Actor, can be legally bound under the same sources of law. Part IV applies the sources of law identified in Parts II and III to two case studies of Daesh control and explores mechanisms for enforcing these theories of accountability

The adrenergic control of corticotrophin secretion

1. A highly selective alpha-1 adrenoceptor agonist that crosses the blood brain barrier stimulated the secretion of corticotrophin (ACTH) in man and in the rat in a dose - dependent manner. The effect was blocked by selective alpha-1 antagonists which also cross the blood brain barrier. It was concluded that activation of alpha-1 adrenoceptors stimulates ACTH secretion. A considerable amount of evidence obtained in the rat and in man suggested that the stimulant alpha-1 adrenoceptors are located in the brain, rather than directly on the pituitary gland or in the periphery. In the rat, the alpha-1 adrenoceptors stimulate ACTH secretion predominantly by activating hypothalamic vasopressin neurones. 2. Intravenous infusions of adrenaline and dopamine did not stimulate ACTH secretion or enhance the ACTH response to the corticotrophin releasing factor (CRF-41) in man. It was concluded that circulating catecholamines do not stimulate ACTH secretion under physiological conditions, and the peripheral sympathoadrenal response to stress is not responsible for the accompanying increase in ACTH secretion. 3. Activation of endogenous catecholamines increased ACTH secretion, suggesting that the stimulant alpha-1 adrenoceptors are innervated by catecholaminergic neurones and are likely to be physiologically relevant. 4. The physiological significance of the stimulant alpha-1 adrenoceptors in man was demonstrated in two situations: the cortisol secretory pattern during waking hours and the ACTH and cortisol responses to food ingestion were both enhanced by an alpha-1 agonist and reduced by an alpha-1 antagonist. Cortisol secretion at night and in response to hypoglycaemia were unaffected by an alpha-1 antagonist, suggesting that alpha-1 adrenoceptors mediate some but not all of the stimuli to ACTH secretion. 5. During some conditions of increased ACTH secretion, inhibitory alpha-2 adrenoceptors are activated and they limit the ACTH response. 6. The potential clinical applications of this work are discussed

HEALTH OUTCOMES IN OLDER ADULTS WITH CARDIOVASCULAR DISEASE

In the United States, longevity is increasing, and more adults are living into old age, a stage of life when age-related biologic and physiologic mechanisms predispose individuals to cardiovascular disease (CVD) in a context of complexity related to their age.1 Two thirds of all patients with CVD are older than 60 years of age, and more than 85% of patients over age 85 years live with some form of CVD.2 Although acute CVD is a leading cause of morbidity and mortality for adults of any age, older patients are at higher risk for adverse outcomes2, 3 including mortality, re-hospitalizations, diminished quality-of-life, and functional decline. Many older adults with acute CVD are managed based on evidence derived from cohorts of younger patients with the goal of achieving optimal cardiovascular care. Yet broader contextual health challenges exit in older populations.4 For example, multimorbidity, polypharmacy, cognitive decline, sarcopenia, and frailty are among the geriatric syndromes common in this population that can be exacerbated during their acute cardiovascular illness. Because these geriatric conditions frequently coexist with acute cardiovascular disease, the care for older patients is complex and can have a major impact on the healthcare system as a whole. In this thesis, I attempted to study older population in two domains. First, I evaluated the influence of two geriatric syndromes, frailty and sarcopenia, on health outcomes among older adults with acute cardiovascular illness from patient perspective. Second, I evaluated the impact of acute cardiovascular illness on healthcare utilization and cost among older patients from epidemiologic perspective. Seven manuscripts are included in this dissertation. Domain 1: Assessment of geriatric syndromes in older adults with cardiovascular disease. Domain 2: Healthcare utilization and cost among older adults with cardiovascular disease

Differences in treatment and clinical outcomes in patients aged ≥75 years compared with those aged ≤74 years following acute coronary syndromes: a prospective multicentre study

\ua9 Author(s) (or their employer(s)) 2023.Objective This study describes the differences in treatment and clinical outcomes in patients aged ≥75 years compared with those aged ≤74 years presenting with acute coronary syndrome (ACS) and undergoing invasive management. Methods A large-scale cohort study of patients with ST-elevation/non-ST-elevation myocardial infarction (MI)/unstable angina underwent coronary angiography (January 2015-December 2019). Patients were classified as older (≥75 years) and younger (≤74 years). Regression analysis was used to yield adjusted risks of mortality for older versus younger patients (adjusted for history of heart failure, hypercholesterolaemia, peripheral vascular disease, chronic obstructive pulmonary disease, ischaemic heart disease, presence of ST-elevation MI on presenting ECG, female sex and cardiogenic shock at presentation). Results In total, 11 763 patients were diagnosed with ACS, of which 39% were aged ≥75 years. Percutaneous coronary intervention was performed in fewer older patients than younger patients (81.2% vs 86.2%, p<0.001). At discharge, older patients were prescribed less secondary-prevention medications than younger patients. Median follow-up was 4.57 years. Older patients had a greater risk of in-hospital mortality than younger patients (adjusted OR (aOR) 2.12, 95% CI 1.62 to 2.78, p<0.001). Older patients diagnosed with ST-elevation MI had greater adjusted odds of dying in-hospital (aOR 2.47, 95% CI 1.79 to 3.41, p<0.001). Older age was not an independent prognostic factor of mortality at 1 year (adjusted HR (aHR) 0.95, 95% CI 0.82 to 1.09, p=0.460) and at longer term (aHR 0.98, 95% CI 0.87 to 1.10, p=0.684). Conclusions Older patients are discharged with less secondary prevention. Patients aged ≥75 years are more likely to die in-hospital than younger patients

DYNAMIC SOIL-STRUCTURE RESPONSE ANALYSIS OF AN IRAQI SOIL BASED ON GEOPHYSICAL TESTING

In this paper, soil – pore fluid behavior of a silo under an earthquake loading is investigated. To predict the response of the silo with the soil surrounding it, ‘the linear-elastic constitutive model’ is adopted with soil properties; shear modulus and damping ratio; are strains and cycle independent. A computer program using dynamic stiffness matrix analyses (DSMA) for predicting and analyzing the model was established using FORTRAN coding. The program is based on geophysical values (such as primary velocity (vp), shear velocity (vs), modulus of elasticity (E), mass density (), shear modulus (G),….etc). The values were obtained from field test results for the soil under a silo located in Kirkuk, Iraq. To check and compare the obtained results, the computer program (MSC/NASTRAN) is used also for predicting and analyzing the same problem. This second program uses input values such as shear modulus (G), modulus of elasticity (E), mass density () and damping ratio () obtained from conventional laboratory tests. From the two aforementioned analyses, comparisons between the results of the relevant two programs are made. Though program “MSC/NASTRAN” visualizes a realistic behavior of the silo under dynamic loading, due to full response results are expressed for each node, the dynamic stiffness matrix analyses program (DSMA) gives only the maximum value for the horizontal and vertical displacements at that node. Despite of that, program DSMA relies on realistic values of geophysical tests obtained from the field directly.As a conclusion from this study, the soil-structure interaction zone for the silo at Kirkuk under investigation using both analyses show excellent agreement between the results. The agreement in this study turns out to be more than 95% close between the two algorithms. The easiness through which geophysical field tests are conducted, the simplicity of carrying out the required calculations and the reliability of the results makes the dynamic stiffness matrix analysis method (DSMA) highly recommended. It can give an excellent directive about the response of structures resting on soils and subjected to dynamic loads

Effects of Internal Gas Explosion on an Underwater Tunnel Roof

An underwater reinforced concrete tunnel roof is subjected to an internal gas explosion. Dynamic analyses are performed for three cases, namely, (1) an uncoupled solution, (2) class II coupling analysis and (3) full model with class I and II couplings. Three load cases are considered, dead (gravity) load, uniformly distributed vertical loads from sand and water and finally an internal pressure gas explosion. Linear and non-linear constitutive relationships are considered for the materials constituting the gas explosion problem. Results include time deflection of tunnel roof, time histories of stresses in vertical reinforcing bars and contours of concrete stresses for tunnel roof. By conducting analyses from various models, the question whether the tunnel would be damaged to such an extent that its serviceability would be impaired is investigated

THREE-DIMENSIONAL FINITE ELEMENT ANALYSES OF A SINGLE PILE IN AN ELASTOPLASTIC CLAYEY SOIL

A three-dimensional coupled finite element analysis algorithm is developed to predict the behaviour of single piles in clay. Three dimensional 20-noded brick elements are used in the analyses carried out on three documented field studies. Each node carries four degrees of freedom, three being for displacements in the three perpendicular space dimensions while the fourth is allocated for pore water pressure. The behaviour of the material of the pile is idealized through a linear elastic constitutive relationship while that for the soil by the Modified Cam-Clay model both extended to cover three-dimensional characteristics. The load-displacement results from the developed algorithm on the three selected problems from literature show a very good agreement with the observations. Moreover, the build-up of pore fluid pressures and their dissipations were found to be consistent with field measurements also.

Modified Stability Functions with Shear Effects for Non-PrismaticMembers in Steel Plane Frames

The mathematical model of the tapered struts subjected to axial load is solved to obtain the modified stability functions due to shear effect as well as bending effects. The stability functions are derived for a wide range of non-prismatic struts then compared in graphical curves with stability functions excluding shear effects. The stability functions for non-prismatic members under compressive and tensile axial loads are developed for the purpose of expressing both effects of bending and shear in a beamcolumn stiffness at any value of axial force under the buckling limi

DETERMINATION OF DEPTH OF PLACEMENT OF TUNNELS AND CAVITIES BY THE BOUNDARY ELEMENT METHOD

A boundary element numerical algorithm has been developed for the determination of stresses and deformations around cavities and tunnels. A study of the influence of depth below the ground surface on the distribution of stresses and deformations around cavities and tunnels is presented in this paper. The soil is assumed to behave linearly elastic. A computer program has been built to perform the numerical computations. The results show that with increasing the depth of placement of tunnel or opening below the ground surface, the settlements decrease. The maximum stresses occur at the haunches of the tunnel rather than at the crown. For the circular cavity that is considered in this paper, it was found that with increasing the depth below the ground surface (depth/tunnel diameter > 3), the surface settlements do not exceed 6 % from those obtained for the case of no-cavity condition

The Association of Intensive Blood Pressure Treatment and Non-Fatal Cardiovascular or Serious Adverse Events in Older Adults With Mortality: Mediation Analysis in Sprint

AIMS: Randomized clinical trials of hypertension treatment intensity evaluate the effects on incident major adverse cardiovascular events (MACEs) and serious adverse events (SAEs). Occurrences after a non-fatal index event have not been rigorously evaluated. The aim of this study was to evaluate the association of intensive (\u3c120 \u3emmHg) to standard (\u3c140 \u3emmHg) blood pressure (BP) treatment with mortality mediated through a non-fatal MACE or non-fatal SAE in 9361 participants in the Systolic Blood Pressure Intervention Trial. METHODS AND RESULTS: Logistic regression and causal mediation modelling to obtain direct and mediated effects of intensive BP treatment. Primary outcome was all-cause mortality (ACM). Secondary outcomes were cardiovascular (CVM) and non-CV mortality (non-CVM). The direct effect of intensive treatment was a lowering of ACM [odds ratio (OR) 0.75, 95% confidence interval (CI): 0.60-0.94]. The MACE-mediated effect substantially attenuated (OR 0.96, 95% CI: 0.92-0.99) ACM, while the SAE-mediated effect was associated with increased (OR 1.03, 95% CI: 1.01-1.05) ACM. Similar patterns were noted for intensive BP treatment on CVM and non-CVM. We also noted that SAE incidence was 3.9-fold higher than MACE incidence (13.7 vs. 3.5%), and there were a total of 365 (3.9%) ACM cases, with non-CVM being 2.6-fold higher than CVM [2.81% (263/9361) vs. 1.09% (102/9361)]. The SAE to MACE and non-CVM to CVM preponderance was found across all age groups, with the ≥80-year age group having the highest differences. CONCLUSION: The current analytic techniques demonstrated that intensive BP treatment was associated with an attenuated mortality benefit when it was MACE-mediated and possibly harmful when it was SAE-mediated. Current cardiovascular trial reporting of treatment effects does not allow expansion of the lens to focus on important occurrences after the index event