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Network and Connections in Legal History examines networks of lawyers, legislators and litigators, and how they shaped legal development in Britain and the world. It explores how particular networks of lawyers - from Scotland to East Florida and India - shaped the culture of the forums in which they operated, and how personal connections could be crucial in pressuring the legislature to institute reform - as with twentieth century feminist campaigns. It explores the transmission of legal ideas; what happened to those ideas was not predetermined, but when new connections were made, they could assume a new life. In some cases, new thinkers made intellectual connections not previously conceived, in others it was the new purposes to which ideas and practices were applied which made them adapt. This book shows how networks and connections between people and places have shaped the way that legal ideas and practices are transmitted across time and space.
Emergency Medical Services (EMS) systems have developed protocols for prehospital activation of the cardiac catheterization laboratory for patients with suspected ST-elevation myocardial infarction (STEMI) to decrease first-medical-contact-to-balloon time (FMC2B). The rate of “false positive” prehospital activations is high. In order to decrease this rate and expedite care for patients with true STEMI, the American Heart Association (AHA; Dallas, Texas USA) developed the Mission Lifeline PreAct STEMI algorithm, which was implemented in Los Angeles County (LAC; California USA) in 2015. The hypothesis of this study was that implementation of the PreAct algorithm would increase the positive predictive value (PPV) of prehospital activation.
This is an observational pre-/post-study of the effect of the implementation of the PreAct algorithm for patients with suspected STEMI transported to one of five STEMI Receiving Centers (SRCs) within the LAC Regional System. The primary outcome was the PPV of cardiac catheterization laboratory activation for percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The secondary outcome was FMC2B.
A total of 1,877 patients were analyzed for the primary outcome in the pre-intervention period and 405 patients in the post-intervention period. There was an overall decrease in cardiac catheterization laboratory activations, from 67% in the pre-intervention period to 49% in the post-intervention period (95% CI for the difference, -14% to -22%). The overall rate of cardiac catheterization declined in post-intervention period as compared the pre-intervention period, from 34% to 30% (95% CI, for the difference -7.6% to 0.4%), but actually increased for subjects who had activation (48% versus 58%; 95% CI, 4.6%-15.0%). Implementation of the PreAct algorithm was associated with an increase in the PPV of activation for PCI or CABG from 37.9% to 48.6%. The overall odds ratio (OR) associated with the intervention was 1.4 (95% CI, 1.1-1.8). The effect of the intervention was to decrease variability between medical centers. There was no associated change in average FMC2B.
The implementation of the PreAct algorithm in the LAC EMS system was associated with an overall increase in the PPV of cardiac catheterization laboratory activation.
This book examines the ways the Syrian conflict has served as the genesis of new rules of customary international law. Though it has only been nine years since the conflict began, Syria has already brought about profound changes to international law.
To set the stage for the chapters that follow, this chapter traces the historic roots of the strife in Syria as well as the major events during the conflict from 2011 to 2019. It also describes the major actors within and outside of Syria that have played a significant role in the fray. Finally, it discusses the sources of international law applicable to the Syrian conflict.
Since 2011, Syria has been engulfed in a protracted civil war that began as part of the wave of Arab Spring protests against Middle East tyrants. The Syrian conflict has seen the rise and fall of the ISIS terrorist organization, the largest refugee migration since World War II, and the repeated use of chemical weapons against a civilian population. The situation is complicated by the fact that Russia, Syria’s long-time ally, has repeatedly used its veto in the UN Security Council to prevent the Council from taking actions related to the crisis. With all that, Syria has become a dynamic laboratory for the rapid creation of new international law.
As the Syrian civil war presses on, the need for accountability for atrocities committed by Syrian officials, rebel commanders, and terrorist leaders grows. As documented by the UN Human Rights Council’s Independent and International Commission of Inquiry, the atrocities in Syria are among the worst in history. They include mass executions, widespread rapes, systematic torture, intentionally targeting hospitals, and repeated use of chemical weapons against civilians. The vast majority of international crimes have been committed in a methodical fashion by the Syrian government, encouraged by the long-standing culture of impunity. These crimes require prosecution to bring justice for the victims, deter vigilantism, and prevent recurrence.
In 2014, a militant group calling itself the Islamic State (ISIS) rapidly took over more than 30 percent of the territory of Syria and Iraq. In the process, it captured billions of dollars (US) worth of oil fields and refineries, bank assets and antiquities, tanks, and armaments, and became one of the greatest threats to peace and security in the Middle East. In an effort to “degrade and defeat” ISIS, the United States, assisted by a handful of other Western and Arab countries, launched thousands of bombing sorties and cruise missile attacks against ISIS targets in Iraq and Syria since August 2014. While the Iraqi government had consented to foreign military action against ISIS within Iraq, the Syrian government did not. Rather, Syria protested that the air strikes in Syrian territory were an unjustifiable violation of international law.
As the above chapters have described, the UN High Commissioner for Refugees has recognized the Syrian refugee crisis as the world’s single largest refugee crisis since World War II. This chapter will analyze how the international community has attempted to deal with more than six million Syrians who have sought refuge around the globe while still protecting against the infiltration of terrorists. The global approach to the Syrian migration crisis, described in this chapter, includes novel legislation, executive and judicial actions, as well as new policy approaches related to the rights of Syrian refugees. This chapter will also examine how the Syrian refugee crisis affected the negotiation of the Global Compact on Refugees and the Global Compact on Safe, Orderly and Regular Migration, which were adopted in 2018. Finally, this chapter will assess whether the Syrian migration crisis has contributed to the development of new Grotian moments.
Historically, crystallization of new rules of customary international law was viewed as a protracted process that took decades, if not centuries, to complete. But, sometimes, during periods of sweeping geopolitical change, customary international law can ripen quite rapidly. Often those periods correspond with major wars. Named in honor of Hugo Grotius, whose masterpiece De Jure Belli ac Pacis helped usher in the modern system of international law at the end of the Eighty Years’ War, “Grotian moments” are transformative developments that generate the unique conditions for accelerated formation of customary international law. Has this book proved that the Syrian conflict was a Grotian moment? And, if so, what will the legacy of Syria be?
This chapter examines whether the allied air strikes against Syria on April 14, 2018 may have crystalized an emerging customary norm of humanitarian intervention, thereby representing a historic development in international law.
Carbapenem-resistant Enterobacterales (CRE) are common causes of healthcare-associated infections and are often multidrug resistant with limited therapeutic options. Additionally, CRE can spread within and between healthcare facilities, amplifying potential harms.
To better understand the burden, risk factors, and source of acquisition of carbapenemase genes in clinical Escherichia coli and Klebsiella spp isolates from patients in Washington to guide prevention efforts.
Multicenter prospective surveillance study.
Escherichia coli and Klebsiella spp isolates meeting the Washington state CRE surveillance case definition were solicited from clinical laboratories and tested at Washington Public Health Laboratories using polymerase chain reaction (PCR) for the 5 most common carbapenemase genes: blaKPC, blaNDM, blaIMP, blaVIM, and blaOXA-48. Case patients positive by PCR were investigated by the public health department.
From October 2012 through December 2017, 363 carbapenem-resistant E. coli and Klebsiella spp isolates were tested. Overall, 45 of 115 carbapenem-resistant K. pneumoniae (39%), 1 of 8 K. oxytoca (12.5%), and 28 of 239 carbapenem-resistant E. coli (11.7%) were carbapenemase positive. Of 74 carbapenemase-positive isolates, blaKPC was most common (47%), followed by blaNDM (30%), blaOXA-48 (22%), and blaIMP (1%). Although all cases had healthcare exposure, blaKPC acquisition was associated with US health care, whereas non-blaKPC acquisition was associated with international health care or travel.
We report that blaKPC, the most prevalent carbapenemase in the United States, accounts for nearly half of carbapenemase cases in Washington state and that most KPC-cases are likely acquired through in-state health care.
Written as the decade-long Syria conflict nears an end, this is the first book-length treatment of how the Syrian war has changed international law. In The Syrian Conflict's Impact on International Law, the authors explain the history of the current conflict in Syria and discuss the principles and process of customary international law formation and the phenomenon of accelerated formation of customary international law known as Grotian Moments. They then explore specific examples, including how use of force against ISIS in Syria has changed the law of self-defense against non-state actors, how the allied airstrikes in response to Syria's use of chemical weapons have changed the law of humanitarian intervention, and others. This book seeks to contribute both to understanding the concept of accelerated formation of customary international law and the specific ways the Syria conflict has led to development of new norms and principles in several areas of international law.
This article presents a brief review of our case studies of data-driven Integrated Computational Materials Engineering (ICME) for intelligently discovering advanced structural metal materials, including light-weight materials (Ti, Mg, and Al alloys), refractory high-entropy alloys, and superalloys. The basic bonding in terms of topology and electronic structures is recommended to be considered as the building blocks/units constructing the microstructures of advanced materials. It is highlighted that the bonding charge density could not only provide an atomic and electronic insight into the physical nature of chemical bond of materials but also reveal the fundamental strengthening/embrittlement mechanisms and the local phase transformations of planar defects, paving a path in accelerating the development of advanced metal materials via interfacial engineering. Perspectives on the knowledge-based modeling/simulations, machine-learning knowledge base, platform, and next-generation workforce for sustainable ecosystem of ICME are highlighted, thus to call for more duty on the developments of advanced structural metal materials and enhancement of research productivity and collaboration.