Current legislation guiding withdrawal of life-sustaining treatment and organ donation after circulatory death (DCD) leaves regulatory gaps that are not optimal for honoring the wishes of patient-donors. We describe these gaps, their consequences, and the need for revision to prevent harm to all parties.

Gelman v. Uruguay (2011) was a watershed moment in Uruguayan civil society’s quest for accountability, prompting official repeal of the country’s 1986 Amnesty Law. Much scholarship about the case centres around the immediate aftermath of the decision, largely on initial compliance and cautious optimism for accountability. Yet the analysis of a longer timeframe reveals mixed results. The article examines how initial momentum unravelled as conditions for compliance weakened amid backlash against the judgment. It reveals the challenges with implementing criminal accountability measures, even in established democracies with otherwise strong human rights records, and argues for the importance of understanding compliance as a non-linear process.

The canonical reading of Jaurès’s L’Armée nouvelle presents this work as an outdated reflection on the establishment of a socialist society supervised by intermediary bodies whose military training would be a major asset. Our reading goes beyond this historically situated approach to Jaurès’s book. We show that The New Army is not just a response to the General Staff, even less a ‘theorisation’ of the transition to socialism, but that its aim is to rehabilitate the founding principles of democratic institutions (ancient and modern), which rest on the constitution of an army of citizens: The ‘proletarian-soldier’ of Jaurès is none other than the ‘farmer-soldier’ of the ancient city and of Year 2 of the French Revolutionary calendar, transposed to the Industrial Age. Relying on a game-theoretical model, we highlight that this defence of democratic institutions is backed by a discourse of the economics of war prevention in terms of self-protection.

Objectives/Goals: MyCTSC harmonizes data from many sources into one database for evaluation, marketing, and CTSC member management to address current disparate collection and siloed use of data. It simplifies report creation with real-time dashboards so administrators and leadership can view progress quickly and plan for improvements based on real-time data. Methods/Study Population: MyCTSC is built using open-source software like Python, Django, MariaDB, Bootstrap, and Chart.js, and integrates data from sources such as systems for consult requests, pilot/voucher applications, and REDCap surveys. Each data source is imported into the warehouse either automatically via API, if available, or via manual file upload. De-duplication and other data cleaning are performed as well. Customized, real-time dashboards are developed based on the needs of administrators and leadership. While MyCTSC does not have a study population, it does have the stakeholders mentioned above as well as leadership. The development timeline spans three years: initial development and data warehouse population in Year 1, data cleaning and dashboard creation in Year 2, and full rollout to all CTSC members in Year 3. Results/Anticipated Results: MyCTSC aims to create a seamless data and member management system to resolve issues stemming from multiple data sources. Demographic challenges are addressed by implementing data cleaning and consolidating duplicate identities into a single profile. The initiative will enhance stakeholder buy-in by presenting evaluation use cases that show the impacts of CTSC resources. For example, workforce development needs will be met through surveys and integration of a course catalog. MyCTSC will also facilitate targeted resource and event advertising, and support investigator outreach and collaboration by utilizing dashboards and reports. Furthermore, it will serve as the consolidated data source for all CTSC modules, promoting greater interaction and collaboration across administration and modules. Discussion/Significance of Impact: MyCTSC integrates multiple sources, consolidates identities, and simplifies reporting for outreach and collaboration. It enhances interaction with researchers and community members, advancing translational science by linking projects and publications. MyCTSC, built with open-source software, can be made available to other CTSA hubs.

What factors explain compliance with monetary damages awarded by the Inter-American Court of Human Rights (IACtHR)? States comply with the payment of monetary damages at higher rates than other forms of reparation. However, the higher compliance rate belies the significant variation in time to compliance with the payment of monetary awards. We identify three case-level characteristics that explain this variation: size of awards, number of victims, and victim identity. We test our hypotheses utilizing original datasets on compliance with monetary damages and case characteristics in IACtHR judgments through 2019, and find support for all three factors on time to compliance.

The history of Italian general psychiatry and forensic psychiatry over the last 50 years has been unique in the European and Western healthcare landscape. Western politicians often visit Italy to observe the successful community-based systems that have developed in that country.

This article represents a first step toward a necessary attempt, to explore how specific political decisions, such as the Italian one, have produced positive outcomes for patients with psychotic disorders, outcomes not observed in many Western countries, which are instead grappling with negative outcomes such as the complicated management of homelessness and the incarceration of people who would instead require psychiatric care.

In its historical context, the 1978 decision to abandon the asylum tradition in favor of socialization for patients living with severe mental disorders represented a difficult choice. This choice led to inevitable critical issues, which today are still not completely dormant.

This choice has also, undoubtedly, restored dignity to people living with serious mental illness, even when that person commits a crime.

To understand these changes, it is appropriate to mention the regulations that finally led to Law number 180 of 1978, which decreed the closure of psychiatric hospitals (Ospedale Psichiatrico) throughout Italy and continued after 2015 with the closure of high-security psychiatric hospitals (Ospedale Psichiatrico Giudiziario) as well.

Culturally, much has changed throughout this time in assistance to the mentally ill in Europe.

Background: Proper hand hygiene is the most important practice to reduce the transmission of infections in healthcare settings. Despite this, healthcare institutions continue to struggle to achieve and maintain high rates of hand hygiene compliance among healthcare workers with some studies estimating national healthcare worker hand hygiene compliance to be approximately 50%. Methods: We conducted an anonymous one-time survey of our Lifespan Hospital System employees to evaluate barriers and facilitators to performing hand hygiene as well as interventions to improve hand hygiene compliance. The survey was designed with guidance from the Consolidated Framework for Implementation Research and input from Lifespan infection prevention staff. Result: Over four weeks 985 (6%) Lifespan employees completed the survey. Figure 1 shows the aggregate results of the first 4 survey questions which focused on hand hygiene infrastructure at Lifespan, including availability of sanitizer, staff to manage hand hygiene supplies, and educational materials/reminders. One significant finding was >70% of respondents reported that they either did not know if their unit/department has a person assigned to replace/monitor hand hygiene supplies, or if so, who that person is. We also asked employees to rate how effective different interventions would be at improving hand hygiene compliance. Figure 2 shows of five proposed interventions, three were rated as either “moderately effective” or “very effective” by >50% of respondents. These included displaying hand hygiene instructions, making hand hygiene data available to employees, and displaying materials/reminders promoting hand hygiene. There were also 977 free-text responses regarding “barriers or facilitators to proper hand hygiene”. Major barriers identified were a lack of staff to monitor and refill supplies, slow replacement of hand hygiene products, lack of sanitizer dispensers and sinks, inconsistency of sink location and dispenser placement, lack of hand hygiene reminders/educational materials, time constraints, skin irritation from sanitizer, and an inability to have dispensers in behavioral health units. Survey responses led us to enhance the following: educational materials and reminders in work areas; staff education; leadership involvement in hand hygiene initiatives; routine auditing and feedback; conveniently placed sanitizer dispensers and sinks at the point of care; and making hand hygiene compliance data readily available to staff. Conclusion: This survey identifies important barriers and facilitators to achieving high rates of hand hygiene compliance among healthcare workers and provides the basis for interventions aimed at improving hand hygiene compliance in a large multicenter academic hospital system.

Airspace control plays an important role in the safety and fluidity of air traffic. A fundamental service for this purpose is audio communication through frequencies in the VHF bands. This paper describes the evaluation of the audio degradation of voice transmissions from control centre to the aircraft. The effects of more than one station broadcasting on the same frequency with carrier offset (climax mode) are analysed using perceptual evaluation of speech quality (PESQ) perceptual model. Comparative studies are performed to verify the degree of degradation of different audio transport systems and climax situation.

The aim of the present study was to report canid attacks on sea turtles in northeastern Brazil. The study was conducted on the Sergipe-Alagoas Basin coastline between March 2010 and October 2019. Injured-stranded sea turtles or carcasses were recorded through systematic beach monitoring. The specimens were submitted for clinical or postmortem assessments, providing evidence for the identification of injuries caused by canids. In the study period, 9841 stranded sea turtles were recorded, with the diagnosis of canid attacks in 55 (0.55%) events. Lepidochelys olivacea was the species with the largest number of events (90.90%), followed by Chelonia mydas (7.27%), and Caretta caretta (1.81%). The attacked sea turtles were clinically healthy, with a good body score and no apparent diseases; most were in the reproductive stage. The injuries were mainly found on the front flippers, with considerable loss of musculature affecting the brachial plexus, with the rupture of large blood vessels, and in some cases, exposure of the humerus or oesophagus. Thus, these events hampered the reproductive cycle, limiting the egg-laying process and preventing the hatching of hundreds of new turtles. Therefore, mitigating measures should be implemented, addressing the consequences of abandoning pets and their unsupervised presence on beaches.

NEXAFS is shown to be an excellent technique, of potentially widespread application, for the determination of the orientation of organic molecules intercalated in preferentially oriented thin films of polycrystalline, layered minerals. A NEXAFS study of [Mg2Al(OH)6]+C7H5O2 · nH2O, a layered anionic clay, is described. This material shows a transition from a layer spacing of 15.4 Å to only 9 Å at a remarkably low temperature (below 100°C). This is shown to be accompanied by a change in the angle of the plane of the benzoate molecule to the 00ℓ planes from 35° ± 10° to 0° ± 10°. The tilt of the benzoate anion in the room temperature structure demonstrates the presence of an interaction between the phenyl ring and the positively charged, brucite-like layers. Furthermore it is suggestive of the importance of hydrogen bonding in determining the interlayer spacing and stability.

The Al-clay-rich rock units at Mawrth Vallis, Mars, have been identified as mixtures of multiple components based on their spectral reflectance properties and the known spectral character of pure clay minerals. In particular, the spectral characteristics associated with the ~2.2 μm feature in Martian reflectance spectra indicate that mixtures of AlOH- and SiOH-bearing minerals are present. The present study investigated the spectral reflectance properties of the following binary mixtures to aid in the interpretation of remotely acquired reflectance spectra of rocks at Mawrth Vallis: kaolinite-opal-A, kaolinite-montmorillonite, montmorillonite-obsidian, montmorillonite-hydrated silica (opal), and glass-illite-smectite (where glass was hydrothermally altered to mixed-layer illite-smectite). The best spectral matches with Martian data from the present study’s laboratory experiments are mixtures of montmorillonite and obsidian having ~50% montmorillonite or mixtures of kaolinite and montmorillonite with ~30% kaolinite. For both of these mixtures the maximum inflection point on the long wavelength side of the 2.21 μm absorption feature is shifted to longer wavelengths, and in the case of the kaolinite-montmorillonite mixtures the 2.17 μm absorption found in kaolinite is of similar relative magnitude to that feature as observed in CRISM (Compact Reconnaissance Imaging Spectrometer for Mars) data. The reflectance spectra of clay mixed with opal and of hydrothermally altered glass-illite-smectite did not represent the Martian spectra observed in this region as well. A spectral comparison of linear vs. intimate mixtures of kaolinite and montmorillonite indicated that for these sieved samples, the intimate mixtures are very similar to the linear mixtures with the exception of the altered glass-illite-smectite samples. However, the 2.17 μm kaolinite absorption is stronger in the intimate mixtures than in the equivalent linear mixture. Modified Gaussian Modeling of absorption features observed in reflectance spectra of the kaolinite-montmorillonite mixtures indicated a strong correlation between percent kaolinite in the mixture and the ratio of the area of the 2.16 μm band found in kaolinite to the area of the 2.20 μm band found in montmorillonite.

SARS-CoV-2 is a novel coronavirus that has rarely been associated with chylothorax. Patients with Noonan syndrome are at risk for developing chylothorax, especially after cardiothoracic interventions. We present the case of SARS-CoV-2 infection triggering the underlying tendency of a patient with Noonan syndrome to develop chylothorax who did not develop it even after prior cardiothoracic interventions. Patient presented in respiratory distress without hypoxia and was found, on imaging, to have a large right-sided pleural effusion, which was eventually classified as chylothorax. The patient was then started on a low-fat diet. Chest tube drainage substantially reduced the effusion in size, and it remained stable. Our report highlights that SARS-CoV-2 infection can cause the development of a chylothorax or a chylous effusion in patients with Noonan syndrome or among populations with a similar predisposition. A high index of suspicion in vulnerable patients or those not responding to traditional therapy should exist with providers, thus leading to the testing of the fluid to confirm the diagnosis.

Environmental and natural resource economics lies inherently at the interface between economic and natural dynamics (e.g., geological constraints, climate change, biodiversity evolution). Building models in that field often means building integrated models, calling on knowledge and methods from economics and physics, climatology, biology, or ecology. Howard Scott Gordon’s 1954 article on fishery economics is considered to be seminal in the history of bioeconomic modeling, integrating biological and economic variables in a microeconomic model. Yet the precise role played by biology in Gordon’s initial work remains unclear. On the basis of archival material and thorough analysis of Gordon’s early research, this paper examines Gordon’s model building and his persistent oscillation between two objectives—the production of a heuristic economic model with standard assumptions, and the conception of a predictive policy tool relevant from a fishery-biology standpoint—and how he finally favored the first over the second. Moreover, contrary to received wisdom, we show that it was not Gordon but biologist Milner B. Schaefer who transformed Gordon’s model into an integrated model. These results shed new light not only on Gordon’s 1954 contribution but also on a whole tradition of integrated environmental and natural resource economics models, based on his work.

The legislative deferral hypothesis posits that elected policy makers, anxious to avoid the political repercussions of taking clear positions on controversial issues, will actively seek to involve the judiciary in resolving these disputes. This study seeks to further test the legislative deferral theory by considering its applicability to the state level. What is revealed from an examination of the development of abortion policy in New York is that, despite the controversial nature of the issue, lawmakers did not seem to attempt to involve the courts in its resolution, and virtually no policy was created by the state’s judicial branch. I propose an alternative explanation for judicial noninvolvement, borrowing from path-dependence theory, that emphasizes the importance of the initial location of policy change and the issue frames that first took hold around this issue.