Be Reasonable! Thoughts on the Effectiveness of State Criticism in Enforcing International Law

This Note examines the effectiveness of diplomatic criticism in enforcing international law, particularly in the counter-terrorism (or anti-insurgency) context. It is not concerned with determining what international law does or does not in fact allow States to do in combating terrorism and other existential threats

Healing indicators after pterygium excision by optical coherence tomography

PurposeTo establish the sequence of tomographic changes in the tissue recovery process after pterygium excision and to propose healing indicators.; MethodsOptical coherence tomography (OCT) images were taken at 1week, 1, 3 and 6months after lesion excision in 73 eyes of 73 patients (33 male, 40 female; mean age 50, S.D. 5.0, range 40-70years) with primary nasal pterygium. Biomicroscopy was performed at each visit and at 12months, to diagnose clinical healing or lesion recurrence. The presence of well demarcated corneal epithelium, conjunctival epithelium, limbal demarcation area, and graft thickening were analysed. Comparisons between tomographic data of both clinical situations were made at each time point using contingency tables.; ResultsEleven eyes displayed lesion recurrence (R group) and 62 eyes showed no recurrence (NR group). Normal anatomical structures, corneal and conjunctival epithelium and limbal demarcation area, were identified by OCT images in a higher percentage of NR cases over time, compared to the R group where most of the cases presented without these markers of tissue recovery. In contrast, the variable graft thickening, which analysed a pathological event, revealed similar results in both groups (p>0.05; Fisher's exact statistic), with a clear decrease of cases which showed graft thickening over time. Differences between groups started at 1month, when no eye had yet presented clinical recurrence, with greater identification of corneal epithelium in the NR group (p=0.04; Fisher's exact statistic). At 3months, corneal and conjunctival epithelium identification tended to be more frequent in the NR than in the R group (in both cases, p=0.0001; Fisher's exact statistic). Finally, at 6months these different patterns consolidated, with a significantly higher number of limbal demarcation areas being identified in the NR group (p=0.001; Fisher's exact statistic). In fact, this landmark of a normally structured limbus was never found in the R group.; ConclusionsThe sequence of tissue restoration, according to OCT images, seems to start in the cornea and end in the limbal area, similar to the process of pterygium injury in reverse. Although the visualisation of corneal epithelium could be an early indicator of successful surgery, identification of the limbal demarcation area, as a normal limbal pattern in OCT images, seems to be a better positive predictive value in diagnosing healing.Postprint (author’s final draft

Numerical Analysis of Ca2+ Signaling in Rat Ventricular Myocytes with Realistic Transverse-Axial Tubular Geometry and Inhibited Sarcoplasmic Reticulum

The t-tubules of mammalian ventricular myocytes are invaginations of the cell membrane that occur at each Z-line. These invaginations branch within the cell to form a complex network that allows rapid propagation of the electrical signal, and hence synchronous rise of intracellular calcium (Ca2+). To investigate how the t-tubule microanatomy and the distribution of membrane Ca2+ flux affect cardiac excitation-contraction coupling we developed a 3-D continuum model of Ca2+ signaling, buffering and diffusion in rat ventricular myocytes. The transverse-axial t-tubule geometry was derived from light microscopy structural data. To solve the nonlinear reaction-diffusion system we extended SMOL software tool (http://mccammon.ucsd.edu/smol/). The analysis suggests that the quantitative understanding of the Ca2+ signaling requires more accurate knowledge of the t-tubule ultra-structure and Ca2+ flux distribution along the sarcolemma. The results reveal the important role for mobile and stationary Ca2+ buffers, including the Ca2+ indicator dye. In agreement with experiment, in the presence of fluorescence dye and inhibited sarcoplasmic reticulum, the lack of detectible differences in the depolarization-evoked Ca2+ transients was found when the Ca2+ flux was heterogeneously distributed along the sarcolemma. In the absence of fluorescence dye, strongly non-uniform Ca2+ signals are predicted. Even at modest elevation of Ca2+, reached during Ca2+ influx, large and steep Ca2+ gradients are found in the narrow sub-sarcolemmal space. The model predicts that the branched t-tubule structure and changes in the normal Ca2+ flux density along the cell membrane support initiation and propagation of Ca2+ waves in rat myocytes

Organizational democracy: A quality mandate for health care organizations

In response to the current health care crisis, health care organizations have experimented with new management forms. Of these, Total Quality Management (TQM)/Continuous Quality Improvement (CQI) programs propose staff empowerment, democratic decision-making, and work processes to enhance care delivery outcomes. Thousands of hospitals have adopted variants of TQM/CQI at costs exceeding billions of dollars nationally. Many programs are unsuccessful, and drain resources for services to the indigent and uninsured.Investigations on quality management systems focus primarily on executive management and physician integration. These data limit evaluations to structural changes, and rarely report the effects of "totalizing" management forms on line staff, i.e., those ultimately charged with implementation of program initiatives.The purpose of this study was to examine TQM/CQI process variables at the clinical staff level, where patient care is most affected. Critical ethnography provided the research framework. This approach triangulates dialogic, empirical, and institutional process variables in data collection methods and analyses. The goal of such methodology is to explore the political economy and interpersonal dynamics that shape organizational culture and activities.Five hospitals made up the cases in this study: three academic medical centers, one non-profit community hospital (800+ beds), and one non-profit rural hospital (220+ beds). These facilities are located in New York State, North Carolina, and Florida. Open-ended interviews culminated in a sample of fifty-five participants.Analyses of case ethnographies exposed numerous limitations to the implementation of TQM/CQI ideology. Caregivers consistently reported being isolated inter-and intraprofessionally, and believed their ability to provide "safe" and "quality" care had diminished. The use of pragmatic, interpretative philosophy guided theoretical assessment of the social and interpersonal contexts reported by participants. Through examination of the culture of bureaucracy that directs care organizations, reconceptualization of the social process of alienation was proffered for pedagogic and research consideration in organizational sociology.Recommendations for the democratic restructure of care organizations are presented. Efforts for transformation must include the integration of social philosophy and theoretical praxis. These findings suggest such endeavors be redirected from management to line staff who actualize care processes, for it is at this level that theory and practice are conceptualized for application.</p

Mapping representational mechanisms with deep neural networks

Funder: Gates Cambridge Trust; doi: http://dx.doi.org/10.13039/501100005370AbstractThe predominance of machine learning based techniques in cognitive neuroscience raises a host of philosophical and methodological concerns. Given the messiness of neural activity, modellers must make choices about how to structure their raw data to make inferences about encoded representations. This leads to a set of standard methodological assumptions about when abstraction is appropriate in neuroscientific practice. Yet, when made uncritically these choices threaten to bias conclusions about phenomena drawn from data. Contact between the practices of multivariate pattern analysis (MVPA) and philosophy of science can help to illuminate the conditions under which we can use artificial neural networks to better understand neural mechanisms. This paper considers a specific technique for MVPA called representational similarity analysis (RSA). I develop a theoretically-informed account of RSA that draws on early connectionist research and work on idealization in the philosophy of science. By bringing a philosophical account of cognitive modelling in conversation with RSA, this paper clarifies the practices of neuroscientists and provides a generalizable framework for using artificial neural networks to study neural mechanisms in the brain.</jats:p