International Laws of War and the African Child: Norms, Compliance, and Sovereignty

The Convention on the Rights of the Child of 1989 is one of the most prominent international humanitarian treaty in world history. It entered into force quicker than any other treaty and currently only two countries (the United States and Somalia) have not ratified it.1 Carol Bellamy, Executive Director of UNICEF, says that the Convention has become “the centerpiece of a global movement, a movement that reflects a growing awareness of the importance of safeguarding human rights—and child rights in particular.”2 Similarly, Lisbet Palme claimed, after travelling to some of the worst conflict zones in Africa, that, “For many of the children I have met and talked with, the Convention takes on a very meaningful reality.”3 Yet, during the 1990’s, more children in Africa became victims of, and combatants in, war than at any time in history. Partially as a result, a bitter Human Rights Watch Report assessing the state of children’s rights ten years after the Convention on the Rights of Children came into force was entitled Promises Broken.4 Indeed, to enhance further international humanitarian law protecting children during war, governments agreed in January 2000, after six years of negotiations, to an Optional Protocol to the Convention on the Rights of the Child that raises the minimum age of combatants to eighteen.

Pediatric Cardiac Surgical Patterns of Practice and Outcomes in Europe and China:An Analysis of the European Congenital Heart Surgeons Association Congenital Heart Surgery Database

Background: The European Congenital Heart Surgeons Association (ECHSA) Congenital Heart Surgery Database (CHSD) was founded in 1999 and is open for worldwide participation. The current dataset includes a large amount of surgical data from both Europe and China. Thepurposeofthisanalysisistocomparepatternsof practice and outcomes among pediatric congenital heart defect surgeries in Europe and China using the ECHSA-CHSD. Methods: We examined all European (125 centers, 58,261 operations) and Chinese (13 centers, 23,920 operations) data in the ECHSA-CHSD from 2006-2018. Operative mortality, postoperative length of stay, median patient age and weight were calculated for the ten benchmark operations for China and Europe, respectively. Results: Benchmark procedure distribution frequencies differed between Europe and China. In China, ventricular septal defect repair comprised approximately 70% of procedures, while Norwood operations comprised less than one percent of all procedures. Neonatal cardiac procedures were rare in China overall. For procedures in STAT mortality category 1, Chinese centers had lower operative mortality rates, while procedures in categories 3 and 5 mortality is lower in European centers. Operative mortality over the time period decreased from 3.89% to 1.64% for the whole cohort, with a sharper decline in China. This drop coincides with an increase of submitted procedures over this 13-year-period. Conclusion: Chinese centers had higher program-matic volume of congenital heart surgeries, while European centers have a more complex case mix. Palliation for patients with functionally univentricular heart was performed less commonly in China. These comparison of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement

SWOG S1400B (NCT02785913), a Phase II Study of GDC-0032 (Taselisib) for Previously Treated PI3K-Positive Patients with Stage IV Squamous Cell Lung Cancer (Lung-MAP Sub-Study).

BackgroundS1400B is a biomarker-driven Lung-MAP substudy evaluating the phosphatidylinositol 3-kinase (PI3K) inhibitor taselisib (GDC-0032) in patients with PI3K pathway-activated squamous NSCLC (sqNSCLC).MethodsEligible patients had tumoral phosphatidylinositol-4,5-biphosphate 3 kinase catalytic subunit alpha (PIK3CA) alterations by next-generation sequencing and disease progression after at least one line of platinum-based therapy. Patients received 4-mg taselisib orally daily. The primary analysis population (PAP) was a subset of patients having substitution mutations believed to be associated with clinical benefit of PI3K inhibitors. Primary endpoint was response by Response Evaluation Criteria in Solid Tumors version 1.1; secondary endpoints included progression-free survival, overall survival and duration of response.ResultsTwenty-six patients treated with taselisib comprised the full evaluable population (FEP); 21 patients comprised the PAP. Median age for patients in the FEP was 68 years (range: 53-83 years), 19 were male (73%). The study was closed for futility at interim analysis with one responder in the PAP (5% response rate, 95% confidence interval [CI]: 0%-24%). Two possibly treatment-related deaths (one respiratory failure, one cardiac arrest) were observed; one patient had grades 4 and 11 had grade 3 adverse events. Median progression-free survival and overall survival in the PAP group were 2.9 months (95% CI: 1.8-4.0 mo) and 5.9 months (95% CI: 4.2-7.8 mo), respectively. These numbers were nearly the same in the FEP.ConclusionsStudy S1400B evaluating taselisib in PIK3CA-altered sqNSCLC failed to meet its primary endpoint and was closed after an interim futility analysis. The trial is unique in cataloguing the diversity of PIK3CA mutations in sqNSCLC

The Lantern Vol. 66, No. 1, Fall 1998

• Curled • Bruised • Accident Prone • Bob or Beatrice or Something • Burrow • The French Door • Before the War: On Earth as it is in Texas • Love Seat • Delusionus Prime • Delineate • The Color of Coffee • A Memory • August Snapshots • The Eulogy and Judgement of My Friend, the Philosophe • Haunted • Being • Playing Children • Her Name is in the Breeze • Aftermath • A Meal for the Brown Philadelphia Twilighthttps://digitalcommons.ursinus.edu/lantern/1153/thumbnail.jp

Pediatric Cardiac Surgical Patterns of Practice and Outcomes in Japan and Europe

Objectives: The Japan Cardiovascular Surgery Database-Congenital section (JCVSD-Congenital) and the European Congenital Heart Surgeons Association (ECHSA) Congenital Heart Surgery Database (CHSD) share the same nomenclature. We aimed at comparing congenital cardiac surgical patterns of practice and outcomes in Japan and Europe using the JCVSD-Congenital and ECHSA-CHSD. Methods and Results: We examined Japanese (120 units, 63,365 operations) and European (96 units, 90,098 operations) data in JCVSD-Congenital and ECHSA-CHSD from 2011 to 2017. Patients' age and weight, periprocedural times, mortality at hospital discharge, and postoperative length of stay were calculated for ten benchmark operations. There was a significantly higher proportion of ventricular septal defect closures and Glenn operations and a significantly lower proportion of coarctation repairs, tetralogy of Fallot repairs, atrioventricular septal defect repairs, arterial switch operations, truncus repairs, Norwood operations, and Fontan operations in JCVSD-Congenital compared to ECHSA-CHSD. Postoperative length of stay was significantly longer following all benchmark operations in JCVSD-Congenital compared to ECHSA-CHSD. Mean STAT mortality score (Society of Thoracic Surgeons European Association for Cardio-Thoracic Surgery mortality score) was significantly higher in JCVSD-Congenital (0.78) compared to ECHSA-CHSD (0.71). Mortality at hospital discharge was significantly lower in JCVSD-Congenital (4.2%) compared to ECHSA-CHSD (6.0%, P < .001). Conclusions: The distribution of the benchmark procedures and age at the time of surgery differ between Japan and Europe. Postoperative length of stay is longer, and the mean complexity is higher in Japan compared to European data. These comparisons of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement

Efficacy of the Young Women's CoOp: An HIV Risk-Reduction Intervention for Substance-Using African-American Female Adolescents in the South

HIV/sexually transmitted infection (STI) risk-reduction interventions are needed to address the complex risk behaviors among African-American female adolescents in disadvantaged communities in North Carolina. In a two-group randomized trial, we reached 237 sexually active, substance-using African-American female adolescents, to test a risk-reduction intervention, the Young Women’s CoOp (YWC), relative to a nutrition control. In efficacy analyses adjusting for baseline condom use, at three-month follow-up participants in the YWC were significantly less likely to report sex without a condom at last sex relative to control. There were mixed findings for within-group differences over follow-up, underscoring the challenges for intervening with substance-using female youths

The Geography of the International System: The CShapes Dataset

We describe CShapes, a new dataset that provides historical maps of state boundaries and capitals in the post-World War II period. The dataset is coded according to both the Correlates of War and the Gleditsch and Ward (1999) state lists, and is therefore compatible with a great number of existing databases in the discipline. Provided in a geographic data format, CShapes can be used directly with standard GIS software, allowing a wide range of spatial computations. In addition, we supply a CShapes package for the R statistical toolkit. This package enables researchers without GIS skills to perform various useful operations on the GIS maps. The paper introduces the CShapes dataset and structure and gives three examples of how to use CShapes in political science research. First, we show how results from quantitative analysis can be depicted intuitively as a map. The second application gives an example of computing indicators on the CShapes maps, which can then be used in statistical tests. Third, we illustrate the use of CShapes for generating different weights matrices in spatial statistical applications. All the examples can be replicated using the freely available R package and do not require specialized GIS skills. The dataset is available for download from the CShapes website (http://nils.weidmann.ws/projects/cshapes). © Taylor & Francis Group, LLC