The Internationalization of Sources of Labor Law

This article examines in depth an important but underappreciated development in international labor law: how norms promulgated by the International Labor Organization (ILO) have affected the development and implementation of domestic labor laws and practices since the early 1990s. The newly globalized focus of labor law—energized by substantial expansions in international trade and investment—has been recognized by scholars, practitioners, and governments, but it has not previously been explored and analyzed in this systematic way. The article focuses on two central regulatory areas—child labor and freedom of association—and relies on doctrinal and policy developments in these areas, as evidenced by the actions of legislatures, courts, and executive branches in more than 20 countries. In doing so, the article addresses how international labor standards have influenced national labor law and practice in the Americas (excluding the U.S.)—directly through the soft-law route of convention ratification and ILO supervisory monitoring, and indirectly through trade agreement labor provisions that incorporate ILO norms. The resultant changes in domestic laws and practices have been evolutionary rather than transformative, and developments in law outpace those in practice, but within these parameters the changes have been substantial. The article then places this internationalizing trend in the context of two recognized theories that seek to explain the socialization of human rights law

Radiological Characteristics of Pulmonary Hydatid Cysts

Hydatid disease is a parasitic infection caused by Echinococcus granulosus (EG), characterized by cystic lesions in the liver, lungs, and rarely in other parts of the body. Lungs and liver are the most frequent sites involved. Simultaneous lung and liver cysts are observed in less than 10% of the cases. Hydatid cysts are found more frequently in the lungs of children and adolescents than in their liver, while most cysts in adults are hepatic and relatively few are in the lungs. The hydatid serology results are often negative in patients with isolated pulmonary hydatidosis, and hence may not be helpful in problematic cases. Radiologic approach to the intact, complicated, or ruptured pulmonary hydatid cysts includes a CT scan following the chest radiograph. Thoracic CT may be supplemented with magnetic resonance (MR) imaging and occasionally with ultrasound (US) in clarifying a pleural-based hydatid cyst as extrapleural, pleural, or parenchymal

A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience

PURPOSEWe aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts.METHODSPercutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates.RESULTSOut of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374).CONCLUSIONThis novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Endovascular treatment of intracranial aneurysms using the woven endobridge (WEB) device: A retrospective analysis

Woven EndoBridge (WEB) özellikle geniş boyunlu bifurkasyon anevrizmalarında kullanılan görece yeni bir tedavi modalitesidir. Çalışmamızın amacı hastanemizin WEB deneyimini sunmaktır. Yöntem: Eylül 2014 – Eylül 2017 tarihleri arasında intrakraniyal anevrizmaları hastanemizde WEB ile tedavi edilen 35 hasta çalışmaya dahil edilmiştir. Tedavi sonrası ortalama 10 ay (aralık: 1 – 33 ay) takip edilen edilen hastaların oklüzyon oranları MR anjiyografi ve dijital subtraksiyon anjiyografisi ile değerlendirilmiştir. Bulgular: Yirmi kadın, on beş erkek hastaya (ortalama yaş: 55; aralık: 32 – 76) ait 35 anevrizma (ortalama çap: 6,4 mm; aralık: 3,5 – 12 mm) WEB ile tedavi edilmiştir. Anevrizmaların 30'unda (%85) boyun ≥4 mm olarak bulunmuştur. Anevrizmaların 24'ü (%68) orta serebral arter bifurkasyonu, 5'i (%14) baziler tepe, 4'ü (%12) anterior komunikan, biri (%3) internal karotid arter tepe, biri de (%3) orta serebral arter M1 segmenti yerleşimli idi. Üç hastada rüptüre bağlı subaraknoid kanama vardı. Vakaların hepsinde cihaz başarılı bir şekilde yerleştirilebilmiştir. Takip incelemeleri olan 24 hastanın 23'ünde (%95) yeterli oklüzyon tespit edilmiştir. Bir hastada anevrizma kalıntısı saptanmış ve hasta akım çevirici stent ile tedavi edilmiştir. Hastalarda tedaviye bağlı morbidite ya da mortalite saptanmamıştır. Sonuç: Görece yeni bir modalite olduğu için uzun dönem takip verileri henüz mevcut olmamakla beraber WEB'in özellikle geniş boyunlu bifurkasyon anevrizmaları için orta vadeli takiplerde güvenli ve etkin bir tedavi modalitesi olduğu görülmektedir. Anahtar kelimeler: intrakraniyal anevrizma, endovasküler tedavi, woven endobridgeWoven EndoBridge is an innovative device for the treatment of intracranial aneurysms especially wide-necked bifurcation aneurysms. Here we present our experience with the WEB device. Methods: Thirty-five patients treated using the WEB device between September 2014 and September 2017 were included in the study. The patients were followed up for a mean of 10 months (range: 1 – 33 months) after the treatment and occlusion of the aneurysms were evaluated with MRA or DSA. Results: Thirty-five aneurysm of thirty-five patients (twenty female; fifteen male; mean age: 55; range: 32 – 76) were treated using the WEB device. The mean diameter of the aneurysms was 6,4 mm (range: 3,5 – 12 mm). The neck diameter was ≥4 mm in 85% of the aneurysms. The locations of the aneurysms were the middle cerebral artery bifurcation (%68), basilar tip (14%), anterior communicating artery (12%), internal carotid artery tip (3%), and M1 segment of the middle cerebral artery (3%). Three patients had subarachnoid hemorrhage due to aneurysm rupture. The device could be successfully deployed in all of the cases. Among the twenty-four patients who had follow up imaging by MRA or DSA, adequate occlusion was observed in twenty-three (95%). One patient who had aneurysm remnant on follow up imaging was treated with a flow diverter. There was no treatment related morbidity or mortality. Conclusion: Although long term follow-up data are not available due to its recent introduction, WEB intrasaccular flow disruptor seems to be effective and safe for intracranial wide necked, bifurcation aneurysm treatment in the midterm follow up. Keywords: intracranial aneurysm, endvascular treatment, woven endobridg

Dendritic growth of the binary succinonitrile-camphor system

Succinonitrile (SCN)-2wt% Camphor (CAMP) alloy was unidirectionally solidified with a constant temperature gradient (G=3.01 K/mm) at different growth rates (V=6.5- 113 mu m/s) and with a constant growth rate (V=6.5 mu m/s) at different temperature gradients (G=1.93- 3.01 K/mm). Microstructural parameters (primary dendrite arm spacings, lambda(1), secondary dendrite arm spacings, lambda(2), dendrite tip radius, R, and mushy zone depth, d) were measured as a function of growth rate and temperature gradient. The experimental results have been compared with theoretical models and previous experimental works. The stability constant (sigma) for this alloy system was calculated and compared with similar experimental results.Succinonitrile (SCN)–2wt% Camphor (CAMP) alloy was unidirectionally solidified with a constanttemperature gradient (G = 3.01K/mm) at different growth rates (V = 6.5–113 µm/s)and with a constant growth rate (V = 6.5 µm/s) at different temperature gradients (G =1.93-3.01 K/mm). Microstructural parameters (primary dendrite arm spacings, ?1, secondarydendrite arm spacings, ?2, dendrite tip radius, R, and mushy zone depth, d) were measuredas a function of growth rate and temperature gradient. The experimental results have beencompared with theoretical models and previous experimental works. The stability constant (?)for this alloy system was calculated and compared with similar experimental results

Directional cellular growth of Al-2 wt% Li bulk samples

Al-2 wt% Li alloy was prepared using metals of 99.99% high purity in the vacuum atmosphere. The bulk samples were directionally solidified upward with a constant growth rate, V, (similar to 8.30 mu m/s) and different temperature gradients, G, (3.11-6.06 K/mm) and also with a constant G (6.06 K/mm) and different V (8.3-164.70 mu m/s) in the directional solidification apparatus. The cellular spacings, lambda, were measured from both transverse and longitudinal section of the specimens and expressed as functions of solidification processing parameters, G and V, by using a linear regression analysis. The effects of the G and V on lambda, were investigated. The experimental results were compared with the current theoretical and numerical models, and similar previous experimental results