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We evaluated the safety and feasibility of high-intensity interval training via a novel telemedicine ergometer (MedBIKE™) in children with Fontan physiology.
The MedBIKE™ is a custom telemedicine ergometer, incorporating a video game platform and live feed of patient video/audio, electrocardiography, pulse oximetry, and power output, for remote medical supervision and modulation of work. There were three study phases: (I) exercise workload comparison between the MedBIKE™ and a standard cardiopulmonary exercise ergometer in 10 healthy adults. (II) In-hospital safety, feasibility, and user experience (via questionnaire) assessment of a MedBIKE™ high-intensity interval training protocol in children with Fontan physiology. (III) Eight-week home-based high-intensity interval trial programme in two participants with Fontan physiology.
There was good agreement in oxygen consumption during graded exercise at matched work rates between the cardiopulmonary exercise ergometer and MedBIKE™ (1.1 ± 0.5 L/minute versus 1.1 ± 0.5 L/minute, p = 0.44). Ten youth with Fontan physiology (11.5 ± 1.8 years old) completed a MedBIKE™ high-intensity interval training session with no adverse events. The participants found the MedBIKE™ to be enjoyable and easy to navigate. In two participants, the 8-week home-based protocol was tolerated well with completion of 23/24 (96%) and 24/24 (100%) of sessions, respectively, and no adverse events across the 47 sessions in total.
The MedBIKE™ resulted in similar physiological responses as compared to a cardiopulmonary exercise test ergometer and the high-intensity interval training protocol was safe, feasible, and enjoyable in youth with Fontan physiology. A randomised-controlled trial of a home-based high-intensity interval training exercise intervention using the MedBIKE™ will next be undertaken.
In framing investment treaty claims against host states, foreign investors routinely assert that the state’s conduct was ‘politically’ motivated. Arbitral tribunals must then grapple with these allegations. Yet, tribunals lack both a coherent conception of what constitutes politically motivated conduct and a consistent understanding of the relevance, if any, of such motivations for the disposition of an investor’s legal claims. This uncertainty points to an underlying tension within the investment treaty regime between the protection of investors’ interests on the one hand, and the legitimate scope for democratic decision-making and responsive politics on the other.
Using concepts drawn from political science, we develop a new framework to map the variety of conduct that tribunals characterize as ‘political’. Our framework draws attention to different types of influence over government decision-making, as well as differences between government actors responsible for the conduct. We use this framework to show that tribunals have adopted different conceptions of what constitutes illegitimate political influence over government decision-making in factually similar cases. We then evaluate tribunals’ competing approaches in light of normative theories spanning both public law and private law. Engaging with multiple normative theories allows us to examine whether tribunals’ different approaches to politically motivated conduct might reflect diverse underlying normative commitments. We argue, however, that many arbitral tribunals demonstrate a reflexive distrust of domestic political contestation that is difficult to justify within any of the theories that we consider.
Seven half-day regional listening sessions were held between December 2016 and April 2017 with groups of diverse stakeholders on the issues and potential solutions for herbicide-resistance management. The objective of the listening sessions was to connect with stakeholders and hear their challenges and recommendations for addressing herbicide resistance. The coordinating team hired Strategic Conservation Solutions, LLC, to facilitate all the sessions. They and the coordinating team used in-person meetings, teleconferences, and email to communicate and coordinate the activities leading up to each regional listening session. The agenda was the same across all sessions and included small-group discussions followed by reporting to the full group for discussion. The planning process was the same across all the sessions, although the selection of venue, time of day, and stakeholder participants differed to accommodate the differences among regions. The listening-session format required a great deal of work and flexibility on the part of the coordinating team and regional coordinators. Overall, the participant evaluations from the sessions were positive, with participants expressing appreciation that they were asked for their thoughts on the subject of herbicide resistance. This paper details the methods and processes used to conduct these regional listening sessions and provides an assessment of the strengths and limitations of those processes.
Herbicide resistance is ‘wicked’ in nature; therefore, results of the many educational efforts to encourage diversification of weed control practices in the United States have been mixed. It is clear that we do not sufficiently understand the totality of the grassroots obstacles, concerns, challenges, and specific solutions needed for varied crop production systems. Weed management issues and solutions vary with such variables as management styles, regions, cropping systems, and available or affordable technologies. Therefore, to help the weed science community better understand the needs and ideas of those directly dealing with herbicide resistance, seven half-day regional listening sessions were held across the United States between December 2016 and April 2017 with groups of diverse stakeholders on the issues and potential solutions for herbicide resistance management. The major goals of the sessions were to gain an understanding of stakeholders and their goals and concerns related to herbicide resistance management, to become familiar with regional differences, and to identify decision maker needs to address herbicide resistance. The messages shared by listening-session participants could be summarized by six themes: we need new herbicides; there is no need for more regulation; there is a need for more education, especially for others who were not present; diversity is hard; the agricultural economy makes it difficult to make changes; and we are aware of herbicide resistance but are managing it. The authors concluded that more work is needed to bring a community-wide, interdisciplinary approach to understanding the complexity of managing weeds within the context of the whole farm operation and for communicating the need to address herbicide resistance.
There is no consensus as to whether magnetic resonance imaging (MRI) should be used as part of the initial clinical evaluation of patients with first-episode psychosis (FEP).
(a) To assess the logistical feasibility of routine MRI; (b) to define the clinical significance of radiological abnormalities in patients with FEP.
Radiological reports from MRI scans of two FEP samples were reviewed; one comprised 108 patients and 98 healthy controls recruited to a research study and the other comprised 241 patients scanned at initial clinical presentation plus 66 healthy controls.
In the great majority of patients, MRI was logistically feasible. Radiological abnormalities were reported in 6% of the research sample and in 15% of the clinical sample (odds ratio (OR) = 3.1, 95% CI 1.26–7.57, χ2(1) = 6.63, P = 0.01). None of the findings necessitated a change in clinical management.
Rates of neuroradiological abnormalities in FEP are likely to be underestimated in research samples that often exclude patients with organic abnormalities. However, the majority of findings do not require intervention.
We agree with Bracken, Rose, and Church (2016) and others that a critical design feature of any 360° feedback process is accountability, where the goal is “creation of sustainable individual, group, and/or organizational change in behaviors valued by the organization” (p. 764). Though we acknowledge the important roles that the organization and raters play in holding leaders accountable for their development, the goal of our commentary is to expand on how the leader's boss and other key individuals can serve as powerful sources of accountability in the 360° feedback process and throughout a leader's development journey. We also want to note that although the Center for Creative Leadership (CCL) encourages leaders to share what they have learned from their 360° feedback with their bosses and other accountability partners (e.g., peers), it is the leader's choice as to whether he or she shares key feedback with others. This practice ensures confidentiality of the data, helping leaders trust the process and increasing the likelihood that individuals accept difficult feedback and use it for performance improvement (Fleenor, Taylor, & Chappelow, 2008; King & Santana, 2010).
We investigated the physiology of two closely related albatross species relative to their breeding strategy: black-browed albatrosses (Thalassarche melanophris) breed annually, while grey-headed albatrosses (T. chrysostoma) breed biennially. From observations of breeding fate and blood samples collected at the end of breeding in one season and feather corticosterone levels (fCort) sampled at the beginning of the next breeding season, we found that in both species some post-breeding physiological parameters differed according to breeding outcome (successful, failed, deferred). Correlations between post-breeding physiology and fCort, and links to future breeding decisions, were examined. In black-browed albatrosses, post-breeding physiology and fCort were not significantly correlated, but fCort independently predicted breeding decision the next year, which we interpret as a possible migratory carry-over effect. In grey-headed albatrosses, post-breeding triglyceride levels were negatively correlated with fCort, but only in females, which we interpret as a potential cost of reproduction. However, this potential cost did not carry-over to future breeding in the grey-headed albatrosses. None of the variables predicted future breeding decisions. We suggest that biennial breeding in the grey-headed albatrosses may have evolved as a strategy to buffer against the apparent susceptibility of females to negative physiological costs of reproduction. Future studies are needed to confirm this.
Because horsenettle and tall ironweed are difficult to control in cool-season grass pastures, research was conducted in Tennessee and Kentucky in 2010 and 2011 to examine the efficacy of aminocyclopyrachlor on these weeds. Aminocyclopyrachlor was evaluated at 49 and 98 g ai ha−1 alone and in mixtures with 2,4-D amine at 371 and 742 g ae ha−1. Aminopyralid was also included as a comparison treatment at 88 g ai ha−1. Treatments were applied at three POST timings to horsenettle and two POST timings to tall ironweed. By 1 yr after treatment (YAT) horsenettle was controlled 74% with aminocyclopyrachlor plus 2,4-D applied late POST (LPOST) at 98 + 742 g ha−1. By 1 YAT, tall ironweed was controlled ≥ 93% by aminocyclopyrachlor applied early POST (EPOST) or LPOST, at rates as low as 49 g ha−1. Similar control was achieved with aminopyralid applied LPOST. Both aminocyclopyrachlor and aminopyralid were found to reduce horsenettle and tall ironweed biomass the following year. Moreover, all LPOST applications of aminocyclopyrachlor alone or in mixtures with 2,4-D prevented regrowth of tall ironweed at 1 YAT. Based on these studies, a LPOST herbicide application in August or September when soil moisture is adequate is recommended for control of horsenettle and tall ironweed in cool-season grass pastures.
Joseph Bonaparte was arguably the best of the Bonaparte clan, and Napoleon undoubtedly hoped that the Spanish people would accept him as a welcome replacement for the feckless Bourbons. He was wrong. By the time that Joseph arrived at the frontier, a spontaneous revolt against the French invasion had already begun. The rising began in Madrid on May 2, in reaction to news that the royal family had left for France. General Murat put down a riot in the Puerta del Sol quickly and brutally, using the Mameluke cavalry that Napoleon had recruited in Egypt. Given the long Spanish history of conflict with Muslim forces, the sight of turbaned horsemen charging a crowd of men and women in the heart of Madrid had a shocking effect. The next day, Murat's soldiers executed the supposed leaders of the riot on the hill of Príncipe Pío, at the western edge of Madrid near the royal palace. Various Spanish artists would paint their interpretations of those two actions, but the versions that history remembers are two arresting canvases by Goya, which capture the events in all their horror. In The Charge of the Mamelukes on the 2nd of May, the mad look on the face of the horseman in the center of the composition, and the tangle of bloodied bodies and enraged citizens in front of him, evoke the violent movement, confusion, and savagery of the confrontation. By contrast, the composition of The Executions on the Hill of Príncipe Pío on the 3rd of May is eerily still, as a terrified man in a white shirt raises his arms in surrender, while a contingent of faceless uniformed French soldiers aim their weapons at him in perfect formation. The viewer is left to complete the action, imagining the white shirt splattered in blood and the man collapsing in death to join the bodies of comrades who have fallen all around him.
In all, some 400 Spaniards were killed in those two days, and the stunning news spread to all corners of the country in record time. Although Murat thought he had ended the rebellion by his swift actions and exemplary punishments, in fact he had ensured fierce resistance to the French occupation would continue.
The fall of the Visigothic monarchy marked the beginning of the Islamic phase of Spain's history. From 711 to 1492, Muslims controlled varying portions of Iberia, and their long presence had a profound influence on Spanish culture long after they lost political control. From their origins in the Arabian Peninsula during the time of the prophet Muhammad (c. 570–632), the Muslims spread quickly and widely throughout the Middle East and across North Africa. They conquered cities as they went, fighting when they had to and making deals with local authorities when they could. People who came under Muslim authority had the option of converting to Islam, but they did not have to do so to live peaceably under their new overlords. Christians and Jews, considered “People of the Book” or fellow monotheists, could retain their religion and customs if they refrained from proselytizing, if they paid special taxes, and if they agreed to political restrictions preventing them from having authority over Muslims.
The historical sources, both Christian and Muslim, for the end of the Visigothic monarchy and the conquest and establishment of Islamic Spain are not abundant and come from later periods. Contemporary accounts are not available, and later ones are contradictory and contain legendary accretions. Nonetheless, scholars generally agree on the main outlines of the early years of Muslim consolidation in Spain.
After the defeat of King Roderick in southern Spain, the Muslim commander Ṭāriq ibn Ziyād, commanding a mainly Berber army, sent troops toward Córdoba. They defeated a remnant of the Visigoths on the way and took the city after a long siege. Ṭāriq accepted the allegiance of disaffected groups in the area, including significant elements of the Jewish communities, a segment of the population oppressed by the Visigoths and especially discontented. Ṭāriq himself moved on Toledo, the Visigothic capital, which his forces easily captured, while a detachment of his army secured Córdoba. His immediate overlord Mūsā ibn Nasayr, governor of northwest Africa, arrived in Spain with a force of 18,000, many of them Arabs, and conquered Carmona, Seville, and Mérida. Ṭāriq and Mūsā joined forces in Toledo and wintered there. During the following year Ṭāriq went to the northwest while Mūsā secured the Ebro valley, thanks in part to the conversion to Islam of two prominent Christian families, who remained in control of the local area as the Banū Qasī and the Banū Amrūs.
The administrative structure that the Catholic Monarchs implanted across the Atlantic Ocean laid the basis for the empire that Spain created in the sixteenth century. They improvised that structure from past precedents, responding to the changing situation as Spaniards explored the new lands across the sea. For several centuries Spain also held an empire in Europe, though Spaniards more often referred to the whole collection of diverse territories as a monarchy – lands ruled by a single person. Ironically, Spain's European empire was even more accidental than its American one – the product of bad luck more than conscious planning, as we have seen.
Carlos I was proclaimed king of Spain in Brussels in 1516, ignoring the traditions and prerogatives of the various Spanish kingdoms, and prepared to take up his inheritance. In Spain Cardinal Francisco Ximénez de Cisneros, the driving force behind the reformation of the Spanish church and many aspects of the Spanish Renaissance, performed one last service for the crown by keeping the political situation stable until Carlos arrived in 1517.
Fernando's regency had allowed a generation of explorers to continue tracing the outlines of Castile's New World across the ocean, and Spanish settlers had founded colonies on Hispaniola, Cuba, and various small outposts of the mainland of Central and South America. Whether the embryonic empire would turn out to be profitable remained to be seen. In the meantime, the crown simply gave permission for lands to be explored and settled in its name, but invested little money in the enterprise.
The seventeen-year-old Carlos took great interest in Castile's overseas ventures. Shortly after arriving in Spain, he personally approved a proposal by the Portuguese explorer Ferdinand Magellan to sail westward to Asia to establish a Spanish presence on the far side of the globe. Magellan departed from Spain in 1519 on what would turn out to be the first voyage around the world, but that was not its original aim. Magellan was killed in the Philippines while intervening in a local conflict, and the survivors of the expedition could not find the winds and currents to take them back across the Pacific. Instead, they were forced to return to Spain by sailing around Africa through the half of the world that the Portuguese claimed as their sphere of influence.
Few things changed in the immediate aftermath of the Bourbon restoration of 1975. Most of the political figures who had served in the last years of the Franco regime continued to serve under King Juan Carlos, including Carlos Arias Navarro, the Prime Minister. The continuity dismayed Spaniards and outsiders hoping for dramatic change, but it provided stability and reassurance for Spaniards who feared change and the disruption it might bring. Newspapers and magazines debated the future of Spain in serious articles and political cartoons alike. The new daily newspaper El País began as a voice for change, strongly allied to the still clandestine Socialist Party but aiming to provide analysis rather than polemic. Farther to the left, the weekly magazine Cambio16 emerged as a harsher critic of the government and its continuity with the Franco regime.
Beneath the surface, however, the king and his close advisers prepared to transform Spanish political life. Inadvertently, the assassins of Admiral Carrero Blanco in 1973 had made a transition toward democracy easier, removing a powerful opponent of change. One of the first indications of that transformation occurred seven months after Juan Carlos came to the throne. Carlos Arias met with the king on July 1, 1976, at the latter's request, and resigned as Prime Minister after the meeting. Arias had taken on a difficult and thankless task two and a half years earlier and had presided over the administration during a crucial period. Pressured from all sides and visibly exhausted, he once reputedly commented that he felt as if he were walking a tightrope, while someone kept oiling the rope.
Two days after Arias resigned, the king chose Adolfo Suárez to form a new government, stunning political observers both inside and outside Spain. Relatively young, handsome, and politically astute, Suárez had risen through the ranks of the Francoist political machine to head the national radio and television network, RTVE. The public knew his face and his background, and conservative forces in Spanish society thought they knew his political stance. They were mistaken. The king had come to know Suárez through official and social contact and recognized in him an ideal partner for his political agenda.
Like the king, Suárez took his oath of office promising to uphold the Francoist constitution, but both of them knew that Spain had to change.