The Beagle Channel Affair: A Failure in Judicial Persuasion

It has been demonstrated that although the Argentine Declaration of Nullity does not contain valid legal arguments for rejection, it does indicate weaknesses in the Court\u27s opinion that make it vulnerable to rejection for political reasons. Specifically, the Court\u27s remarks about Chilean possession of disputed islands outside the hammer were especially ill-advised. In addition, the Court failed to clearly articulate the reason for dividing the small Channel islands by appurtenance while refusing to do so for PNL. Finally, the Court\u27s refusal to apply an Oceanic principle, even in a narrow sense, was questionable in a case in which the legal arguments based upon the Treaty text were closely balanced. The Court\u27s lack of power to decide ex aequo et bono did not prevent a broad interpretation of the Treaty to include some version of the Oceanic principle. Although the Court\u27s refusal to apply the Oceanic principle was logically defensible, its broadside discrediting of the principle was not. The Court\u27s adverse findings were made even more unacceptable to Argentina by virtue of such flaws in style. If the members of the International Court of Justice are to play a more important role in resolving future heated international disputes, they will have to speed up the procedure of the bodies on which they serve, improve their judicial style, and pay more attention to the symbolism of international politics

Different aprotinin applications influencing hemostatic chances in orthotopic liver transplantation

The effect of different aprotinin applications on hemmtatic changes and blood product requirements in orthotopic liver transplantation was investigated in a prospective, open, and randomized study. From November 1989 to June 1990, 13 patients received aprotinin as a bolus of 0.5 Mill, kallikrein inac-tivator units (KIU) on three occasions in the course of an OLT, whereas 10 other patients were treated with continuous aprotinin infusion of 0.1-0.4 Mill. KIU/hr. Before and after reperfusion of the graft liver, signs of hyperfibrinolysis, measured by thrombelastography, were significantly lower in the infusion group. Tissue-type plasminogen activator (t-PA) activity increased during the anhepatic phase but to a significantly lesser extent in the infusion group. Blood product requirements during OLT were tendentiously higher in the bolus group but not significantly so. However, the use of packed red blood cells was significantly lower in the postoperative period, whereas there was no significant difference in fresh frozen plasma requirements between the two groups. All 23 patients have survived, and only one woman of each group required retransplantation due to severe host-versus-graft reactions. Furthermore, we investigated the perfusate of the graft liver in both groups and detected signs of a decreased t-PA release in the infusion group. Our results demonstrate an advantage of aprotinin given as continuous infusion over bolus application in OLT

Prescription patterns of direct oral anticoagulants and concomitant use of interacting medications in the Netherlands

Objectives To describe the prevalence, temporal and regional trends in prescribing direct oral anticoagulants (DOACs) in conjunction with interacting medications. Methods We performed a cross-sectional study of pharmacy dispensing data in the Foundation for Pharmaceutical Statistics (SFK) registry on patients who have had a prescription for a DOAC filled at one of 831 randomly selected pharmacies in the Netherlands between Jan 2014-Jan 2019. Results We identified 99,211 patients who had a first DOAC prescription filled. Mean age was 71.6 +/- 10.9 years, 58% were male. In 2014, 8,293 patients were treated with DOACs, in 2018, 35,415 were newly started on a DOAC. In 2018, the use of apixaban was most common (52%) in the Eastern region, whereas rivaroxaban was most frequently prescribed (32-48%) in the other regions. At time of first prescription, the vast majority (99.3%) used >= 1 concomitant interacting drug, and 3.2% used >= 3 interacting medications. Most common were digoxin (37.8%), atorvastatin (31.5%), verapamil (13.7%) and amiodarone (9.7%). While the number of interacting medications remained unchanged over time (median 1, interquartile range 1-1), there was a notable decrease in antiarrhythmic medications and an increase in non-cardiovascular interacting medications (e.g. dexamethasone from 0.9% to 7.1%, antiepileptic drugs from 2.5% to 3.8%, and haloperidol from 0.5% to 2.2% in 2014 and 2018, respectively). Conclusion DOAC use has quadrupled in Dutch clinical practice over the 5-year period from 2014 to 2018. While the number of patients who take interacting medications remained stable, the profile of interacting medications has changed over time from cardiovascular to medications affecting other organ systems.Clinical Pharmacy and Toxicolog

Rapid Etiological Classification of Meningitis by NMR Spectroscopy Based on Metabolite Profiles and Host Response

Bacterial meningitis is an acute disease with high mortality that is reduced by early treatment. Identification of the causative microorganism by culture is sensitive but slow. Large volumes of cerebrospinal fluid (CSF) are required to maximise sensitivity and establish a provisional diagnosis. We have utilised nuclear magnetic resonance (NMR) spectroscopy to rapidly characterise the biochemical profile of CSF from normal rats and animals with pneumococcal or cryptococcal meningitis. Use of a miniaturised capillary NMR system overcame limitations caused by small CSF volumes and low metabolite concentrations. The analysis of the complex NMR spectroscopic data by a supervised statistical classification strategy included major, minor and unidentified metabolites. Reproducible spectral profiles were generated within less than three minutes, and revealed differences in the relative amounts of glucose, lactate, citrate, amino acid residues, acetate and polyols in the three groups. Contributions from microbial metabolism and inflammatory cells were evident. The computerised statistical classification strategy is based on both major metabolites and minor, partially unidentified metabolites. This data analysis proved highly specific for diagnosis (100% specificity in the final validation set), provided those with visible blood contamination were excluded from analysis; 6-8% of samples were classified as indeterminate. This proof of principle study suggests that a rapid etiologic diagnosis of meningitis is possible without prior culture. The method can be fully automated and avoids delays due to processing and selective identification of specific pathogens that are inherent in DNA-based techniques

Validating risk models versus age alone for atrial fibrillation in a young Dutch population cohort:should atrial fibrillation risk prediction be expanded to younger community members?

BACKGROUND: Advancing age is the primary selection criterion for community screening for atrial fibrillation (AF), with selection often restricted to those aged ≥65 years. If multivariable models were shown to have considerable additional value over age alone in predicting AF risk among younger individuals, AF screening could be expanded to patients with lower age, but with high AF risk as per a validated risk model. METHODS: We validated risk models CHARGE-AF (Cohorts for Heart and Aging Research in Genomic Epidemiology model for AF) and FHS-AF (Framingham Heart Study model for AF), and risk scores CHA(2)DS(2)-VASc and CHA(2)DS(2)-VA, and presented their predictive abilities for 5-year and 10-year AF risk versus that of age alone in a young Dutch population cohort (PREVEND) free from AF at baseline. We assessed discrimination by the C-statistic and calibration by the calibration plot and stratified Kaplan-Meier plot using survey-weighted Cox models. RESULTS: During 5-year and 10-year follow-up there were n=98 (2.46/1000 person-years) and n=249 (3.29/1000 person-years) new AF cases, respectively, among 8265 participants with mean age 49±13 years. CHARGE-AF and FHS-AF both showed good discrimination for 5-year and 10-year AF (C-statistic range 0.83–0.86) with accurate calibration for 5-year AF, but overestimation of 10-year AF risk in highest-risk individuals. CHA(2)DS(2)-VASc and CHA(2)DS(2)-VA relatively underperformed. Age alone showed similar discrimination to that of CHARGE-AF and FHS-AF both in the overall, young PREVEND cohort and in subgroups for lower age and lower stroke risk. CONCLUSION: Multivariable models accurately discriminate for 5-year and 10-year AF risk among young European community-dwelling individuals. However, their additional discriminatory value over age alone was limited. Selection strategies for primary AF screening using multivariable models should not be expanded to younger individuals

"Silver" mode for the heavy Higgs search in the presence of a fourth SM family

We investigate the possible enhancement to the discovery of the heavy Higgs boson through the possible fourth SM family heavy neutrino. Using the channel h-> v4 v4->mu W mu W, it is found that for certain ranges of Higgs boson and v4 masses LHC could discover both of them simultaneously with 1 fb^-1 integrated luminosity

“Conline” Teaching: Creative pedagogy as a conduit to EAP practitioners’ agency

Whilst an important 21st century graduate attribute, creativity is difficult to define because of its multi-dimensional nature and variety of epistemological perspectives adopted in scholarly discussions. Some have focused on the subjectivity behind the output as demonstrated in expressivist writing pedagogies (Elbow, 1991), while others have explored collaborative knowledge production and its social context (Montuori, 2006; Goldsmith, 2011; Hafner, 2015). When it comes to EAP, scholarship on how creativity is understood and deployed is fragmented, with studies exploring the use of specific techniques such as gaming, creative arts or object handling for the development of individual competencies (e.g., Saliés, 2002; Carson&Murphy, 2012; Bond, 2018; Richards&Pilcher, 2020), the focus largely remaining text-oriented (Hyland, 2018) and delimited by the “pragmatic” nature of EAP. In this presentation, we will provide an overview of an ongoing multi-methods arts-informed inquiry into EAP practitioners’ creative voices through a snapshot analysis of the findings from one pilot dataset. We will focus on the prominence of the theme of collaboration and co-construction as fundamental to creative practices in EAP, but also consider the extent to which creative pedagogy as a paradigm opens up a fuzzy yet enabling “third space” (Bhabha, 1994) for the enactment of EAP practitioners’ agency. References: Bhabha, H. 1994. The Location of Culture. London and New York: Routledge. Bond, M. 2018. Teaching referencing and plagiarism awareness Using LEGO® SERIOUS PLAY®. International Journal of Management and Applied Research. 5 (4), pp. 232–37. Carson, L. and Murphy, D. 2012. Design and implementation of dramatic tasks in an English for Academic Purposes programme. Language Learning in Higher Education. 1 (1), pp.127–42. Elbow, P. 1991. Some thoughts on “expressive discourse”: A review essay. Journal of Advanced Composition. 11 (1), pp.83–93. Goldsmith, K. 2011. Uncreative Writing. New York: Columbia University Press. Hafner, C. A. 2015. Remix Culture and English Language Teaching: The Expression of Learner Voice in Digital Multimodal Compositions. TESOL Quarterly. 49 (3), pp.486–509. Montuori, A. 2006. The quest for a new education: From oppositional identities to creative inquiry. ReVision. 28(3), pp.4–20. Richards, K. and Pilcher, N. 2020. Using physical objects as a portal to reveal academic subject identity and thought. The Qualitative Report. 25(1), pp.127–44. Saliés, T. G. 2002. Simulation/Gaming in the EAP Writing Class: Benefits and Drawbacks. Simulation & Gaming. 33(3), pp.316–29