Reparation for Victims of Armed Conflict: Impulses from the Max Planck Trialogues

The international law on reparation for victims of armed conflict is complex. Numerous subfields of international law are involved, among them international human rights law, international criminal law, international humanitarian law, and the law on State responsibility. In addition to this complexity, reparation-related questions are often highly politically charged. They are focal points of contestation about moral values, different conceptions of justice, and approaches to international law, including the status of the individual human being in this order. Against this backdrop, the collection of short essays explores whether and under which circumstances individuals have a right to reparation under international law. The introduction unpacks the legal dimensions and identifies the currently most controversial issues. One set of essays then analyses, from different angles, whether a right to reparation for individuals exists as a matter of law. Another set recounts experiences with the implementation of reparation mechanisms and discusses the challenges. A third group of essays addresses the role of domestic courts. The essays (‘impulses’) are one outcome of the Max Planck Trialogue workshop on reparation for victims of armed conflict, held in November 2017 in Berlin

Burden of proof and its related issues: a study on evidence before international tribunals

NA(Doctorat spécial en droit) -- UCL, 199

Frequency and Predictors of Renal Artery Stenosis in Patients Undergoing Simultaneous Coronary and Renal Catheterization

Background: Atherosclerotic renal artery stenosis (ARAS) remains underdiagnosed due to its nonspecific demonstrations. We aimed to both estimate the frequency of ARAS in high-risk non-selected patients undergoing simultaneous coronary and renal catheterization and possibly identify a predictive model for ARAS using baseline clinical, laboratory, and coronary angiographic variables. Methods: The records of 866 patients aged ≥ 21 years undergoing simultaneous coronary and renal angiography were retrieved for analysis from our computerized database. The degree of ARAS was estimated visually by experienced attending interventional cardiologists. Lesions with an estimated stenosis of ≥ 50% were considered significant. Multivariable stepwise logistic regression models were used to identify the risk factors predicting the presence and extent of ARAS. Results:  Of a total of 866 consecutive patients undergoing renal angiography in conjunction with coronary angiography (mean age ± SD: 63.06 ± 10.32, ranging from 24 to 89 years), 454 (57%) were men. A total of 345 (39.8%) cases had significant ARAS, 77 (22.3%) of which were bilateral. Using significant ARAS as the dependent variable, six variables were identified as the independent predictors significantly associated with the presence of ARAS, namely age, female sex (male sex was found to be a protector), hypertension, history of renal failure, left anterior descending artery (LAD) stenosis > 50%, and left circumflex artery (LCX) stenosis > 50%. The Gensini score was not found to be a predictor of the presence of ARAS, but it was more likely associated with a trend towards a more extensive ARAS (adjusted OR = 1.00, 95% CI = 1.00-1.01; p value = 0.039). Other independent determinants of the ARAS extent were the same as the predictors of the ARAS presence. Conclusions: Although risk versus benefit was not tested in this study, it seems that clinicians could consider renal catheterization in combination with coronary angiography particularly in female patients with advanced age and with significant coronary artery stenoses in the LAD and LCX

Nd:YAG laser hardening of AISI 410 stainless steel: microstructural evaluation, mechanical properties, and corrosion behavior

In this paper, a pulsed Nd:YAG laser with a maximum power of 700 W, was utilized to investigate the laser surface hardening of AISI 410 martensitic stainless steel. Focal point position, scanning speed and pulse width were considered as process variable parameters. Corrosion behavior of laser surface hardened samples were investigated by IVIUMSTAT apparatus in a 3.5wt% NaCl solution. Maximum microhardness, depth, and width of hardness and percentage of ferrite phase of metallographic and FESEM pictures were evaluated. Results show that surface hardness increased up to 762 HV. Results also reveal that the laser focal point position and pulse width are effective parameters in laser hardening process. In potentiodynamic polarization tests potential stated to increase at a rate of 1 mV/s from -0.4 V to 0.2 V. Results indicate that the corrosion resistance increased due to laser hardening process

Relationship between Body Mass Index and Outcome of Elective Percutaneous Coronary Intervention

Background: Studies have shown controversial effects of obesity on major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). We sought to investigate the impact of the body mass index (BMI) on the mid-term outcome following successful PCI. Methods: Between March 2006 and August 2008, 3948 patients underwent successful elective PCI in Tehran Heart Center, Tehran, Iran, and were retrospectively included in this study. Patients who underwent PCI on the same day as the occurrence of myocardial infarction were excluded. The demographic, procedural, in-hospital, and follow-up information of these patients was extracted from the PCI Data Registry of our institution. The patients were divided into three groups:  normal weight (No. 1058, BMI < 25 kg/m2 age = 58 ± 10 years); overweight (No. 1867, 25 ≤ BMI < 30 kg/m2, age = 57 ± 10 years); and obese (No. 1023, BMI ≥ 30 kg/m2, age = 56 ± 10 years). MACE included death, myocardial infarction, target vessel revascularization, and target lesion revascularization. Results: Compared with the other patients, the obese individuals were significantly younger and more frequently female, had a higher ejection fraction, and more frequently presented with hypertension, diabetes, and hyperlipidemia. There was no association between the BMI and the angiographic and procedural findings in the univariate analysis. While no difference was found in the rate of in-hospital death between the groups, the number of the obese patients undergoing emergent cardiac surgery was marginally different in the univariate analysis (p value = 0.06). At 9 months' follow-up, MACE had occurred in 92 (2.3%) patients and cardiac mortality was 9 (0.2%). After adjustments for confounders, no significant difference was observed in terms of MACE between the BMI groups. Conclusion: The BMI had no significant effect on the rate of MACE at 9 months' follow-up in our study population. Interventionists' recommendations for patients undergoing PCI should, therefore, not be significantly influenced by the BMI status

One-Year Outcome of Everolimus-Eluting Stents versus Biolimus-Eluting Stents in Patients Undergoing Percutaneous Coronary Intervention

Background: The biolimus-eluting stent (BES), with a biodegradable polymer, has not been previously compared with the everolimus-eluting stent (EES), as a second-generation drug-eluting stent (DES).We sought to compare the 1-year outcome between the PROMUS™ stent (EES type) and the BioMatrix™ stent (BES type). Methods: From March 2008 to September 2011, all patients treated with the PROMUS™ stent or the BioMatrix™ stent for coronary artery stenosis at Tehran Heart Center were enrolled. The primary end points were 1-year adverse events, comprising death, myocardial infarction, target vessel revascularization, and target lesion revascularization.  The secondary end point was stent thrombosis. The Cox proportional hazard model was used to assess the adjusted association between the stent type and the follow-up outcome. Results: From 949 patients (66.3% male, mean age =59.48 ± 10.46 y) with 1,018 treated lesions, 591 patients (630 lesions, 65.1% male, mean age = 59.24 ± 10.23 y) received the PROMUS™ stent and 358 patients (388 lesions, 68.2% male, mean age = 59.88 ± 10.83 y) were treated with the BioMatrix™ stent. Before adjustment, the rate of the primary end points was 3.2% and 3.4% in the EES and BES, respectively (p value = 0.925, HR (EES to BES) = 1.035, 95% CI: 0.50 to 2.13). The rate of stent thrombosis was 2% and 1.7% in the EES and BES, respectively (p value = 0.698). After adjustment on confounder variables, there was no statistically significant difference in major adverse cardiac events between the PROMUS™ stent and the BioMatrix™ stent (p value = 0.598, HR (EES to BES) = 0.817, 95% CI: 0.39 to 1.73). Conclusion: At 1 year’s follow-up, the BES and EES showed similar safety and efficacy rates in the patients undergoing percutaneous coronary intervention with a relatively low rate of adverse events in the 2 groups.   

Stem Cell Transplantation in Patients with Acute Myocardial Infarction: a Single Center Registry

Background: Early clinical investigations indicate that an infusion of autologous bone-marrow cells into the infarct-related coronary artery is feasible after acute myocardial infarction. There is increasing evidence that cell transplantation may improve the perfusion and contractile function of the ischemic myocardium. The present study reports primarily the safety of intracoronary bone marrow mononuclear cell (BMMNC) injections and secondarily the hypothesis that intracoronary injections of autologous BMMNC in patients with acute myocardial infarction may have a favorable impact on tissue perfusion and contractile performance. Methods: Twelve patients with acute ST-elevation myocardial infarction of the anterior wall treated with percutaneous coronary intervention were enrolled in this prospective, nonrandomized, open-label study. Left ventricular function and number of nonviable segments were assessed with the use of echocardiography and Technetium-sestamibi single photon emission tomography respectively at baseline and after a 4-month follow-up.Results: At 4 months’ follow-up, global left ventricular ejection fraction in echocardiography increased from a mean of 31.78±7.56% at baseline to 38.89±6.97% (p=0.018). Mean wall motion score in rest echocardiography was 29.5±6.67 in basal and 26.75±5.44 at 4 months’ follow-up (p=0.05). Nuclear perfusion imaging studies in the patients for the mean number of nonviable segments were 6.5 at baseline and 6 in 4 months’ follow-up (p=0.17). Three patients were lost to follow-up and did not undergo the 4-month evaluations. Conclusion: This study is small and very preliminary. Data from large, randomized, controlled trials are needed to clarify the effect of stem-cell injection in myocardial functio