The Application of Analogical reasoning in International Criminal Law System; Perhaps, Dos and Don'ts

Analogy as an applied matter does not have the same credibility in the logic and the different areas of the contemporary international law system. In international criminal law, like most domestic legal systems which interdict analogical reasoning in criminal law, according to art.22 (2) Rome Statute of the ICC:the definition of a crime shall be strictly construed and shall not be extended by analogy. Nevertheless, in the international community as evolving, Criminal rules are not always able to accommodate all the crimes that occur.Hence,the lack of comprehensiveness of law and the emergence of new issues,as well as the use of ambiguous terms such as "other inhuman acts" in most of international criminal documents, made it inevitable to use analogy in international criminal law,not only as a useful tool in identifying applicable rules, but also as a form of interpretation.However,the authors believe that the use of analogy in international criminal proceedings does not have the power to make new crimes and imposes punishment without resorting to a valid criminal code. In addition to expressing a normative framework for analogical reasoning in international criminal law,this article analyzes the role of analogy in the decision-making processes of the international criminal courts and Tribunal

Epidural hematoma in computed tomography scan-based scoring systems of traumatic brain injury

Dear Editor Traumatic brain injury (TBI) is a harmful condition that permanently or temporarily damages brain functions and imposes enormous costs on health systems. Computed tomography (CT) scan is the preferred modality to detect injuries and determine TBI patients' prognoses in emergency departments. Thus far, some scoring systems have been introduced for grading TBI based on CT scan findings, including the Marshal,[1] Rotterdam,[2] Helsinki,[3] Stockholm,[4] and NeuroImaging Radiological Interpretation System (NIRIS) [Table 1].[5] This letter aims to briefly raise issues regarding the scoring of epidural hematoma (EDH) in CT scan-based scoring systems of TBI.Epidural hematoma is the gathering of blood between the dura mater and the skull. This intracranial hematoma usually occurs following the bleeding from the middle meningeal artery and, less commonly, from the dural venous sinuses.[6] Some studies have shown that EDH positively affects the outcome, so patients with EDH would have a better overall prognosis.[2] A typical EDH's prognosis is good if diagnosed early and managed before deterioration. Gennarelli et al., showed that the EDH death rate is approximately one-tenth of subdural hematoma.[7] Bricolo et al., reported that mortality should be zero in uncomplicated EDH.[8]On the other hand, EDH can be potentially life-threatening. EDH of venous origin can gradually spread, and its findings may appear late, leading to a delayed diagnosis and treatment. Consequently, EDH expansion can lead to herniation, permanent neurological damage, and death.[9] EDH with a size greater than 30 ml or a midline shift of more than 10 mm does not have a good prognosis.[9] The swirl sign indicating active bleeding also worsens the prognosis.[10]The presence or absence of EDH is evaluated in four CT scan-based scoring systems of TBI [Table 1]. Three scoring systems, including Rotterdam, Helsinki, and Stockholm, consider the presence of EDH as a favorable prognostic factor, i.e., patients with EDH on their brain CT scans get a lower score. However, in the NIRIS, EDH is scored as an adverse prognostic factor based on its volume, leading to a higher score.Hence, EDH cannot always be a favorable prognostic indicator. For instance, the presence of EDH along with diffuse axonal injury (DAI) worsens the outcome.[11] However, according to Rotterdam, Helsinki, and Stockholm systems, the association of EDH with DAI would have a lower score than DAI alone. Besides, high-volume EDH can worsen the situation by causing a midline shift and brain herniation.[9] Nonetheless, the specific size of EDH is not checked in any of these three systems.The scoring systems have been developed from the statistical weighting of variables. However, it is necessary to look at the issue more dynamically and comprehensively for a more accurate outcome prediction. Adjusting CT scoring systems with clinical characteristics and scales such as the Glasgow Coma Scale (GCS) and head injury biomechanics may also be helpful

Effects of pre-training injection of orexin A into dorsal raphe nucleus in passive avoidance acquisition on male rats

AbstractEndogenous orexins, especially orexin A, play an important role in spatial learning and memory. A recent study has shown the effect of orexinergic system in hippocampus on avoidance learning. Orexinergic receptors are distributed in dorsal raphe nucleus (DRN). The aim of this study was to evaluate the role of dorsal raphe orexinergic system in passive avoidance learning (PA). Rats were implanted with the cannula aimed at dorsal raphe nucleus. Orexin A or saline were injected into the DRN prior to avoidance training. Pre-training orexin type 1 receptors activation in DRN impaired passive avoidance acquisition but had no effect on PA retention

Targeting Multiple Signal Transduction Pathways of SARS-CoV-2: Approaches to COVID-19 Therapeutic Candidates

Due to the complicated pathogenic pathways of coronavirus disease 2019 (COVID-19), related medicinal therapies have remained a clinical challenge. COVID-19 highlights the urgent need to develop mechanistic pathogenic pathways and effective agents for preventing/treating future epidemics. As a result, the destructive pathways of COVID-19 are in the line with clinical symptoms induced by severe acute coronary syndrome (SARS), including lung failure and pneumonia. Accordingly, revealing the exact signaling pathways, including inflammation, oxidative stress, apoptosis, and autophagy, as well as relative representative mediators such as tumor necrosis factor-α (TNF-α), nuclear factor erythroid 2-related factor 2 (Nrf2), Bax/caspases, and Beclin/LC3, respectively, will pave the road for combating COVID-19. Prevailing host factors and multiple steps of SARS-CoV-2 attachment/entry, replication, and assembly/release would be hopeful strategies against COVID-19. This is a comprehensive review of the destructive signaling pathways and host–pathogen interaction of SARS-CoV-2, as well as related therapeutic targets and treatment strategies, including potential natural products-based candidatesJ.E. gratefully acknowledges funding from CONICYT (PAI/ACADEMIA N°79160109)S

The association between the outcomes of trauma, education and some socio-economic indicators

Background: There are many debates on socioeconomic indicators influencing trauma outcomes.Objectives: This study aimed to determine the association between education as a socioeconomic indicator and trauma outcomes.Methods: This descriptive-analytical study was conducted on 30,448 trauma patients during 2016-2021. The data were based on the minimum dataset of the National Trauma Registry of Iran (NTRI) from six different trauma centers in various cities of the country. The variables used in this study included age, education level, marital status, cause of injury, Glasgow Coma Scale (GCS), intensive care unit (ICU) admission, Injury Severity Score (ISS), and in-hospital mortality. Logistic regression was used to investigate the association between independent variables and trauma outcomes.Results: The study included 30,448 trauma patients with male predominance (75.8%). The mean age was 36.9 years. The most frequent education level was secondary education, with 14,228 (46.6%). Education levels had significant relationships with ISS, death, and ICU admission (P<0.001). Moreover, after applying the multiple logistic regression, the odds of deaths for trauma patients with no formal, primary, and secondary education levels were 3.36, 5.03, and 3.65 times, respectively, more than the odds of deaths at the higher education level after controlling for other factors (all Ps<0.05). However, there were no such relationships between education levels and the odds of ICU admission.Conclusion: Findings of the present study showed a significant association between the education levels and trauma outcomes. Adjusted for other covariates, the chance of death for trauma patients with no formal, primary, or secondary education levels was higher than that at the higher education level

Standards of Review of the Host State’s Conduct in Investment Arbitration Law

In cases regarding investment, the first duty of an arbitrator is to consider whether the action by a State hosting property of a foreign investor, is in breach of its international agreement-based obligations or not. The duties of the host state are usually broad in wording which makes it difficult for arbitrators to investigate and settle such cases. In this line, the approach that is taken to assess a breach of state's obligation with regards to the protection of foreign investors to a great extent is similar with the methods employed in other legal cases. The aim of this article is to examine and analyze the effectiveness of such methods in order to test their applicability in international investment arbitration. Since the measures taken by host state are considered as the administration of its sovereignty against a foreign investor and the decision of the international investment arbitration, this article concludes that the legal regime for international investment arbitration calls for particular elements that brings about a distinct regulating regime as well as the application of special standards of review

Disseminated tuberculosis presented with explicit hypercalcemia: A clinical case report

Key Clinical Message Tuberculosis (TB) is a rare but known reason for hypercalcemia usually in those with underlying conditions such as renal failure, diabetes, or severe anemia. It is essential to consider TB in those with refractory or resistant hypercalcemia. Abstract Hypercalcemia or a calcium level above 10.5 mg/dL can be a manifestation of TB that only became symptomatic in a small percentage of the patients. Patients with underlying diseases such as renal failure are more prone to poor prognosis. It is essential to use anti‐TB drugs besides hypercalcemia standard treatment to maintain a normal calcium level in TB‐related hypercalcemia. In thisstudy, we have presented a young adult with disseminated TB and persistent hypercalcemia who responded finally to anti‐TB drugs

Cost-Effectiveness of Cardiac Biomarkers as Screening Test in Acute Chest Pain

Introduction: Acute chest pain is an important and frequently occurring symptom in patients. Chest pain is often a sign of ischemic heart disease. Associated findings of electrocardiograph (ECG) are rather heterogeneous, and traditional cardiac biomarkers such as Creatine Kinase-MB (CK-MB) suffer from low cardiac specificity and sensitivity. In this study cost effectiveness of cardiac biomarkers single quantitative measurement was examined.Methods: The present descriptive-analytic study conducted on patients who were asked for troponin I and CK-MB. All patients who referred to Emergency unit of Tabriz Imam Reza educational-medical center during January 2012 to July the 2013 were included in study. All patients included in the study were documented in terms of age, sex, working shift of referring, main complaint of patient, symptoms in referring, ECG findings, and results of troponin I and CK-MB tests.Results: In this study, 2900 patients were studied including 1440 (49.7%) males and 1460 (50.3%) females. Mean age of patients was 62.91 (SD=14.36). Of all patients 1880 (64.8%) of patients referred during 8 a.m. to 8 p.m. and 1020 (35.2%) patients were referred during 8 p.m. to 8 a.m. The sensitivity of cardiac biomarkers’ test in diagnosing Acute Coronary Syndrome (ACS) disease was calculated as 44.8% and its specificity was 86.6%. For diagnosing Acute Myocardial Infarction (AMI), sensitivity of cardiac biomarkers’ test was 72.2% and its specificity was 86%. None of patients who were finally underwent unstable angina diagnosis showed increase in cardiac enzymes.Conclusion: In conclusion, cardiac biomarkers can be used for screening acute chest pains, also cost effectiveness of cardiac biomarkers, appropriate specificity and sensitivity can guarantee their usefulness in emergency room

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PRISMA checklist for the systematic review and meta-analysis of early prediction of pre-eclampsia using fetal-placental axis biomarkers