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Decisions of international courts and arbitrators, as well as judgments of national courts, are fundamental elements of modern public international law. The International Law Reports is the only publication in the world wholly devoted to the regular and systematic reporting in English of such decisions. It is therefore an absolutely essential work of reference. Volume 184 is devoted to the 2018 judgment of the European Court of Human Rights in Ireland v. United Kingdom (Request for Revision of Judgment of 18 January 1978), the judgment of the European Court of Human Rights in Al Nashiri v. Poland (concerning the United States' Central Intelligence Agency rendition programme) and the judgment of the Court of Appeal of Northern Ireland in Re Application by Finucane for Judicial Review (concerning the enforceability under domestic law of the procedural obligation under Article 2 of the European Convention on Human Rights).
Decisions of international courts and arbitrators, as well as judgments of national courts, are fundamental elements of modern public international law. The International Law Reports is the only publication in the world wholly devoted to the regular and systematic reporting in English of such decisions. It is therefore an absolutely essential work of reference. Volume 183 is devoted to the 2018 judgment of Court of Justice of the European Union on whether the United Kingdom can unilaterally revoke the notification of its intention to withdraw from the European Union Treaties, together with the judgment of the Inner House of the Scottish Court of Session that had referred that question to the Court (Wightman v. Secretary of State for Exiting the European Union), the landmark judgment of the African Court on Human and Peoples' Rights concerning the rights of the Ogiek people (African Commission on Human and Peoples' Rights v. Kenya) and the judgment of the English Court of Appeal concerning the scope of the United Kingdom's duty to investigate allegations of wrongdoing by British forces in Iraq (Al-Saadoon v. Secretary of State for Defence).
Antimicrobial stewardship programs typically use days of therapy to assess antimicrobial use. However, this metric does not account for the antimicrobial spectrum of activity. We applied an antibiotic spectrum index to a population of very-low-birth-weight infants to assess its utility to evaluate the impact of antimicrobial stewardship interventions.
Decisions of international courts and arbitrators, as well as judgments of national courts, are fundamental elements of modern public international law. The International Law Reports is the only publication in the world wholly devoted to the regular and systematic reporting in English of such decisions. It is therefore an absolutely essential work of reference. Volume 182 is devoted to the 2018 decision of the ICSID arbitration tribunal on the effects of the judgment of the European Court of Justice in Achmea in Vattenfall AB and Others v. Federal Republic of Germany, the 2018 judgment of the English Court of Appeal in R (Freedom and Justice Party) v. Secretary of State for Foreign and Commonwealth Affairs and the 2016 decision of the Austrian Supreme Court in the International Atomic Energy Agency Immunity Case.
Decisions of international courts and arbitrators, as well as judgments of national courts, are fundamental elements of modern public international law. The International Law Reports is the only publication in the world wholly devoted to the regular and systematic reporting in English of such decisions. It is therefore an absolutely essential work of reference. Volume 181 is devoted to the 2018 judgment of the Grand Chamber of the Court of Justice of the European Union in Slovak Republic v. Achmea BV, the 2018 judgment of the Grand Chamber of Court of Justice of the European Union in R (Western Sahara Campaign UK) v. Commissioners for Her Majesty's Revenue and Customs and Another and the translated judgment of the Norwegian Borgarting Court of Appeal in Huseini v. Ministry of Justice and Public Security.
OBJECTIVES/SPECIFIC AIMS: Chemotherapy-related cognitive impairment (CRCI) affects 15-35% of breast cancer survivors and constitutes a significant challenge for survivor quality of life. Among older breast cancer survivors who received chemotherapy treatment, carriers of at least one ɛ4 allele of the APOE gene, which encodes apolipoprotein E, are at higher risk for developing CRCI than non-carriers. APOE4 is well characterized as the strongest genetic risk factor for Alzheimer’s disease, but how it contributes to CRCI is not yet understood, and no animal models of APOE genotype and CRCI have yet been established. To better understand how APOE4 acts as a risk factor for CRCI, we used APOE targeted replacement (TR) mice to develop a model of its effects on cognition following treatment with doxorubicin, a chemotherapy drug commonly used in breast cancer treatment. METHODS/STUDY POPULATION: Twelve-to-thirteen month old APOE3 and APOE4 targeted replacement mice expressing human APOE3 or human APOE4 under control of the endogenous murine promoter were treated with 10 mg/kg doxorubicin or equivolume saline given via two IP injections spaced one week apart. One week post-treatment, mice were tested using Open Field and Elevated Zero apparatuses to assess baseline locomotive activity and anxiety and exploratory behaviors. Five weeks post-treatment, mice were assessed using the Barnes Maze over four days of training trials and one 72 hour memory probe. RESULTS/ANTICIPATED RESULTS: We found no differences in Open Field and Elevated Zero behavior, indicating limited influence of doxorubicin treatment on locomotive and anxiety behaviors in both genotypes. During Barnes Maze training, APOE4 mice treated with doxorubicin showed increased latency compared to untreated APOE4 mice as well as treated and untreated APOE3 mice, indicating deficiencies in spatial learning. In APOE3 mice, no differences in performance were seen between doxorubicin-treated and untreated mice (n = 15-16/group, p <.0001). DISCUSSION/SIGNIFICANCE OF IMPACT: These results indicate that APOE4 targeted replacement mice have specific cognitive vulnerabilities to doxorubicin treatment that can be reliably detected using the Barnes Maze assessment. Future directions include experiments to determine how other chemotherapy drugs or drug combinations impact cognition of APOE4 mice. Ultimately this model may be used to assess preventive measures or therapies for CRCI in the vulnerable APOE4 carrier population with the ability to validate cognitive impacts of these interventions.
The impact of dementia-related stressors and strains have been examined for their potential to threaten the well-being of either the person with dementia or the family care partner, but rarely have studies considered the dyadic nature of well-being in dementia. The purpose of this study was to examine the dyadic effects of multiple dimensions of strain on the well-being of dementia care dyads.
Using multilevel modeling to account for the inter-relatedness of individual well-being within dementia care dyads, we examined cross-sectional responses collected from 42 dyads comprised of a hospitalized patient diagnosed with a primary progressive dementia (PWD) and their family care partner (CP). Both PWDs and CPs self-reported on their own well-being using measures of quality of life (QOL-Alzheimer’s Disease scale) and depressive symptoms (Center for Epidemiological Studies Depression Scale).
In adjusted models, the PWD’s well-being (higher QOL and lower depressive symptoms) was associated with significantly less strain in the dyad’s relationship. The CP’s well-being was associated with significantly less care-related strain and (for QOL scale) less relationship strain.
Understanding the impact of dementia on the well-being of PWDs or CPs may require an assessment of both members of the dementia care dyad in order to gain a complete picture of how dementia-related stressors and strains impact individual well-being. These results underscore the need to assess and manage dementia-related strain as a multi-dimensional construct that may include strain related to the progression of the disease, strain from providing care, and strain on the dyad’s relationship quality.
To determine the efficacy of 2 types of antimicrobial privacy curtains in clinical settings and the costs involved in replacing standard curtains with antimicrobial curtains.
A prospective, open-labeled, multicenter study with a follow-up duration of 6 months.
This study included 12 rooms of patients with multidrug-resistant organisms (MDROs) (668 patient bed days) and 10 cubicles (8,839 patient bed days) in the medical, surgical, neurosurgical, orthopedics, and rehabilitation units of 10 hospitals.
Culture samples were collected from curtain surfaces twice a week for 2 weeks, followed by weekly intervals.
With a median hanging time of 173 days, antimicrobial curtain B (quaternary ammonium chlorides [QAC] plus polyorganosiloxane) was highly effective in reducing the bioburden (colony-forming units/100 cm2, 1 vs 57; P < .001) compared with the standard curtain. The percentages of MDRO contamination were also significantly lower on antimicrobial curtain B than the standard curtain: methicillin-resistant Staphylococcus aureus, 0.5% vs 24% (P < .001); carbapenem-resistant Acinetobacter spp, 0.2% vs 22.1% (P < .001); multidrug-resistant Acinetobacter spp, 0% vs 13.2% (P < .001). Notably, the median time to first contamination by MDROs was 27.6 times longer for antimicrobial curtain B than for the standard curtain (138 days vs 5 days; P = .001).
Antimicrobial curtain B (QAC plus polyorganosiloxane) but not antimicrobial curtain A (built-in silver) effectively reduced the microbial burden and MDRO contamination compared with the standard curtain, even after extended use in an active clinical setting. The antimicrobial curtain provided an opportunity to avert indirect costs related to curtain changing and laundering in addition to improving patient safety.