Preemptive Strikes and the Korean Nuclear Crisis: Legal and Political Limitations on the Use of Force

On January 29, 2002, President George W. Bush linked North Korea, Iran and Iraq as members of an Axis of Evil, alleging that North Korea\u27s attempts to acquire weapons of mass destruction constituted a threat to international peace and security. On September 20, 2002, the Bush Administration released its National Security Strategy ( Strategy ). The Strategy adopted a doctrine of preemptive action that, although recognized historically, has been significantly limited by the U.N. Charter. In doing so, the Bush Administration has challenged traditional limits on the use of force, attempting to adapt the concept of imminent threat to the danger posed by rogue states such as North Korea. Through the Strategy, the administration asserted a right to use unilateral military force to prevent harm to the United States or its citizens. Preemptive action has immense emotional appeal to the American public, particularly in the aftermath of September 11, 2002. Although the primary focus of the preemption doctrine relates to its application in Iraq, there is the potential that the Bush Administration could use this principle to justify the use of force against North Korea. The continued escalation of the nuclear crisis on the Korean peninsula makes the use of force increasingly possible. A preemptive strike based on the presence or attempted acquisition of nuclear weapons, however, is not justified as an exercise of the right of self-defense under customary international law or the U.N. Charter. Moreover, the unilateral exercise of a right to use force preemptively is in direct opposition to the collective security structure established under the U.N. Charter. Furthermore, the use of force would undoubtedly result in massive casualties throughout Northeast Asia. Because of the Strategy\u27s doubtful legality and potentially drastic consequences, a preemptive strike would not be justified in North Korea

Simulating Long-Term Impacts of Winter Rye Cover Crop on Hydrologic Cycling and Nitrogen Dynamics for a Corn-Soybean Crop System

Planting winter cover crops into corn-soybean rotations is a potential approach for reducing subsurface drainage and nitrate-nitrogen (NO3-N) loss. However, the long-term impact of this practice needs investigation. We evaluated the RZWQM2 model against comprehensive field data (2005-2009) in Iowa and used this model to study the long-term (1970-2009) hydrologic and nitrogen cycling effects of a winter cover crop within a corn-soybean rotation. The calibrated RZWQM2 model satisfactorily simulated crop yield, biomass, and N uptake with percent error (PE) within ±15% and relative root mean square error (RRMSE) \u3c30% except for soybean biomass and rye N uptake. Daily and annual drainage and annual NO3-N loss were simulated satisfactorily, with Nash-Sutcliffe efficiency (NSE) \u3e0.50, ratio of RMSE to standard error (RSR) \u3c0.70, and percent bias (PBIAS) within ±25% except for the overestimation of annual drainage and NO3-N in CTRL2. The simulation in soil water storage was unsatisfactory but comparable to other studies. Long-term simulations showed that adding rye as a winter cover crop reduced annual subsurface drainage and NO3-N loss by 11% (2.9 cm) and 22% (11.8 kg N ha-1), respectively, and increased annual ET by 5% (2.9 cm). Results suggest that introducing winter rye cover crops to corn-soybean rotations is a promising approach to reduce N loss from subsurface drained agricultural systems. However, simulated N immobilization under the winter cover crop was not increased, which is inconsistent with a lysimeter study previously reported in the literature. Therefore, further research is needed to refine the simulation of immobilization in cover crop systems using RZWQM2 under a wider range of weather conditions

Multi-wavelength observations of 2HWC J1928+177: dark accelerator or new TeV gamma-ray binary?

2HWC J1928+177 is a Galactic TeV gamma-ray source detected by the High Altitude Water Cherenkov (HAWC) Observatory up to ~ 56 TeV. The HAWC source, later confirmed by H.E.S.S., still remains unidentified as a dark accelerator since there is no apparent supernova remnant or pulsar wind nebula detected in the lower energy bands. The radio pulsar PSR J1928+1746, coinciding with the HAWC source position, has no X-ray counterpart. Our SED modeling shows that inverse Compton scattering in the putative pulsar wind nebula can account for the TeV emission only if the unseen nebula is extended beyond r ~ 4 [arcmin]. Alternatively, TeV gamma rays may be produced by hadronic interactions between relativistic protons from an undetected supernova remnant associated with the radio pulsar and a nearby molecular cloud G52.9+0.1. NuSTAR and Chandra observations detected a variable X-ray point source within the HAWC error circle, potentially associated with a bright IR source. The X-ray spectra can be fitted with an absorbed power-law model with $N_{\rm H} = (9\pm3)\times10^{22}$ cm$^{-2}$ and $\Gamma_X = 1.6\pm0.3$ and exhibit long-term X-ray flux variability over the last decade. If the X-ray source, possibly associated with the IR source (likely an O star), is the counterpart of the HAWC source, it may be a new TeV gamma-ray binary powered by collisions between the pulsar wind and stellar wind. Follow-up X-ray observations are warranted to search for diffuse X-ray emission and determine the nature of the HAWC source.Comment: accepted to ApJ, 8 pages, 7 figure

Mobilising knowledge in complex health systems: A call to action

Worldwide, policymakers, health system managers, practitioners and researchers struggle to use evidence to improve policy and practice. There is growing recognition that this challenge relates to the complex systems in which we work. The corresponding increase in complexity-related discourse remains primarily at a theoretical level. This paper moves the discussion to a practical level, proposing actions that can be taken to implement evidence successfully in complex systems. Key to success is working with, rather than trying to simplify or control, complexity. The integrated actions relate to co-producing knowledge, establishing shared goals and measures, enabling leadership, ensuring adequate resourcing, contributing to the science of knowledge-to-action, and communicating strategically. This is the final version of the article. It first appeared from Policy Press via http://dx.doi.org/10.1332/174426416X1471255375031

Mobilising knowledge in complex health systems: a call to action

Worldwide, policymakers, health system managers, practitioners and researchers struggle to use evidence to improve policy and practice. There is growing recognition that this challenge relates to the complex systems in which we work. The corresponding increase in complexity-related discourse remains primarily at a theoretical level. This paper moves the discussion to a practical level, proposing actions that can be taken to implement evidence successfully in complex systems. Key to success is working with, rather than trying to simplify or control, complexity. The integrated actions relate to co-producing knowledge, establishing shared goals and measures, enabling leadership, ensuring adequate resourcing, contributing to the science of knowledge-to-action, and communicating strategically

Critical Role of Nutrition in Improving Quality of Care: An Interdisciplinary Call to Action to Address Adult Hospital Malnutrition

AbstractThe current era of health care delivery, with its focus on providing high-quality, affordable care, presents many challenges to hospital-based health professionals. The prevention and treatment of hospital malnutrition offers a tremendous opportunity to optimize the overall quality of patient care, improve clinical outcomes, and reduce costs. Unfortunately, malnutrition continues to go unrecognized and untreated in many hospitalized patients. This article represents a call to action from the interdisciplinary Alliance to Advance Patient Nutrition to highlight the critical role of nutrition intervention in clinical care and to suggest practical ways to promptly diagnose and treat malnourished patients and those at risk for malnutrition. We underscore the importance of an interdisciplinary approach to addressing malnutrition both in the hospital and in the acute post-hospital phase. It is well recognized that malnutrition is associated with adverse clinical outcomes. Although data vary across studies, available evidence shows that early nutrition intervention can reduce complication rates, length of hospital stay, readmission rates, mortality, and cost of care. The key is to systematically identify patients who are malnourished or at risk and to promptly intervene. We present a novel care model to drive improvement, emphasizing the following six principles: (1) create an institutional culture where all stakeholders value nutrition; (2) redefine clinicians' roles to include nutrition care; (3) recognize and diagnose all malnourished patients and those at risk; (4) rapidly implement comprehensive nutrition interventions and continued monitoring; (5) communicate nutrition care plans; and (6) develop a comprehensive discharge nutrition care and education plan

Urinary ATP and visualization of intracellular bacteria: a superior diagnostic marker for recurrent UTI in renal transplant recipients?

Renal transplant recipients (RTR) are highly susceptible to urinary tract infections (UTIs) with over 50% of patients having at least one UTI within the first year. Yet it is generally acknowledged that there is considerable insensitivity and inaccuracy in routine urinalysis when screening for UTIs. Thus a large number of transplant patients with genuine urine infections may go undiagnosed and develop chronic recalcitrant infections, which can be associated with graft loss and morbidity. Given a recent study demonstrating ATP is released by urothelial cells in response to bacteria exposure, possibly acting at metabotropic P2Y receptors mediating a proinflammatory response, we have investigated alternative, and possibly more appropriate, urinalysis techniques in a cohort of RTRs.Mid-stream urine (MSU) samples were collected from 53 outpatient RTRs. Conventional leukocyte esterase and nitrite dipstick tests, and microscopic pyuria counts (in 1 ?l), ATP concentration measurements, and identification of intracellular bacteria in shed urothelial cells, were performed on fresh unspun samples and compared to ‘gold-standard’ bacterial culture results.Of the 53 RTRs, 22% were deemed to have a UTI by ‘gold-standard’ conventional bacteria culture, whereas 87%, 8% and 4% showed evidence of UTIs according to leukocyte esterase dipstick, nitrite dipstick, and a combination of both dipsticks, respectively. Intracellular bacteria were visualized in shed urothelial cells of 44% of RTRs, however only 1 of the 23 RTRs (44%) was deemed to have a UTI by conventional bacteria culture. A significant association of the ‘gold-standard’ test with urinary ATP concentration combined with visualization of intracellular bacteria in shed urothelial cells was determined using the Fisher’s exact test.It is apparent that standard bedside tests for UTIs give variable results and that seemingly quiescent bacteria in urothelial cells are very common in RTRs and may represent a focus of subclinical infection. Furthermore, our results suggest urinary ATP concentration combined with detection of intracellular bacteria in shed urinary epithelial cells may be a sensitive means by which to detect ‘occult’ infection in RTRs