bluuebunny/crossref_metadata_2025 huggingface dataset:
America, the 1949 Geneva Conventions, and War Crime Courts-Martial in the Vietnam Conflict
Authors: Solis Gary D.
Published: September 2017

Throughout the US-Vietnam conflict (1965–1973), American forces labored to comply with the Geneva Conventions and customary laws of war, though US war crimes largely overshadowed those efforts. This chapter relates the training US forces received on the law of war and describes how military lawyers practiced law “in country.” US combatants were constantly directed to report war crimes, known or suspected. Too often those directives were not obeyed. My Lai is fully examined, including its badly failed military prosecutions. Disturbing post-trial clemency by civilian authorities, in many cases, is also detailed. On the whole, however, the sentences of US personnel convicted by courts-martial of war crimes were sincere efforts to appropriately punish battlefield criminality. This chapter argues that, under difficult conditions, US military efforts in Vietnam to comply with the Geneva Conventions, and to punish known US war crimes, were more genuine and effective than have been generally recognized.
The Application of International Humanitarian Law by the Israel Defense Forces
Authors: Cohen Amichai , Ben-Ari Eyal
Published: September 2017

This chapter describes how increased juridification and demands to apply international humanitarian law (IHL) have influenced the Israel Defense Forces (IDF). The authors analyze the IDF’s compliance with IHL and other legal frameworks through a multilevel and multidimensional model of military compliance describing the law and external institutions involved in applying it. The past decades have seen the relatively autonomous sphere of the military increasingly come under judicial overview. Judicial and international pressures have also increased the role of the operational legal advisors. The chapter ends by discussing the ceremonies intended to promote compliance with IHL involving soldiers and junior officers. It is based on interviews (with Israeli academic experts, members of nongovernmental organizations [NGOs], and military commanders), off-the-record conversations with members of the IDF’s Military Advocate General, and newspaper articles, reports of NGOs, and secondary material.
Noncompliance with the Geneva Conventions in the Wars of Yugoslav Secession
Authors: Nation R. Craig
Published: September 2017

The wars of Yugoslav secession were characterized by multiple violations of the law of war and armed conflict. Understanding why these violations occurred is an important foundation for determining how such outcomes might be tempered looking forward. This chapter addresses the sources of war crimes during the Yugoslav wars from various perspectives, including the deficiencies of professional military education, ethnic mobilization on the basis of hate narratives in a context of state failure, the role of paramilitary forces, leadership failures, and ineffective legal constraint. In future armed conflicts of a comparable nature one must be aware of the gap between the conventional interstate conflicts for which the Geneva Conventions were originally devised and the demands of contemporary new wars, where sovereign states are no longer primary actors, irregular forces play a greater role, and emotionally laden discourses of identity and cultural integrity replace classic geostrategic goals.
Private Military and Security Companies
Authors: de Nevers Renée
Published: September 2017

Private military and security company (PMSC) employees are not soldiers, but their activities often place them in conflict zones. Their presence has complicated efforts to ensure the effectiveness of international humanitarian law (IHL) in fluid situations involving state and nonstate actors. This chapter explores how PMSCs fit in the framework of IHL and the broader legal framework governing PMSCs, along with state and international efforts to ensure PMSC compliance with IHL. Critical issues concern the status of PMSC contractors under IHL, which determines the protections they should be accorded; their training in the laws of war; and the rules regarding the use of force under which contractors operate. The legal framework holding PMSC employees accountable remains uneven in its global reach, and voluntary frameworks have emerged to develop and enforce good business practices and adherence to human rights standards. Whether these measures will be effective remains to be seen.
The Geneva Conventions
Authors: Wills Siobhán
Published: September 2017

This chapter examines what relevance international humanitarian law might have to peacekeeping missions in light of expansion in the size of UN missions since the end of the Cold War and the much broader range of mission objectives and situations to which missions are deployed. It argues that these changes require that much more detailed attention be paid to the differences between missions and the consequent differences in the applicable legal regimes. International humanitarian law is of important but limited relevance: international human rights law is the primary legal frame that should govern peacekeeping operations. The fact that mission rules of engagement are normally classified—including those dealing with law enforcement tasks such as providing security during election periods or supporting the host state government to combat crime—is a violation of the rule of law standards that the United Nations is committed to upholding.
Conquests, Kings, and Transformations
Authors: Ashe Laura
Published: September 2017

This chapter begins by considering the scattered writings produced in the decades following the Norman Conquest, and the role of their accounts of miracles and visions in re-creating a sense of English identity. It then returns to the reign of Cnut, to argue that his establishment of his rule as an ‘English’ king resolved the ideological impasse of Æthelred’s disastrous reign. Looking at the role of the Church in this crisis, it then considers the origins of the new theology of interiority and confession, and of the roots of affective piety. Turning back to kingship, it describes the patterns set in English government after the Norman Conquest, and turns toward the celebration of new secular and courtly ideals.
It Is Different with Us
Authors: Ashe Laura
Published: September 2017

This chapter considers the literary representation of love in both religious and secular texts in the twelfth and thirteenth centuries. It discusses the ‘sexuality’ of religious devotion, and the emergence of the love-plot in the romance as a figure for both social and economic success. It considers the differing representations of love inherited from classical authors, and developed by contemporaries into different narrative patterns. It discusses the role of privacy as a concept that enables a reorganization of social mores. Thomas of Britain’s Tristan receives extended analysis, alongside a comparison with Richard of Saint-Victor’s Four Degrees of Violent Love.
Epilogue
Authors: Ashe Laura
Published: September 2017

The epilogue offers a reading of the fourteenth-century poem St Erkenwald, discussing its implications for matters of civic and national identity, law, historical sense, memory, and social cohesion.
The Church of England, 1714–1783
Authors: Ingram Robert G.
Published: September 2017

This chapter surveys the history of the Church of England between the Hanoverian succession and the American Revolution. The religio-political questions that bedevilled the English nation during the 1530s remained live ones during the eighteenth century. What sort of Church should the Church of England be? What should the relation of Church to state be? What should constitute the Church’s doctrinal orthodoxy? Whom should the Church comprehend? What were the bounds of toleration? These questions had not been solved at the Glorious Revolution, so that the story of the eighteenth-century Church of England is the concluding chapter in the story of England’s long Reformation. What ultimately brought that particular story to a close was not Enlightenment secularism but the changes catalysed by war and the fear of relapse into seventeenth-century-like religious violence.
England
Authors: Jacob W. M.
Published: September 2017

This chapter reviews how the Church of England fared at the local, diocesan, and parochial levels in England during the long eighteenth century from 1662, when the Church was re-established as an episcopal and liturgically ordered Church, to 1828, when, with the repeal of the Test and Corporation Acts (and Roman Catholic emancipation in 1829), members of other Churches gained full citizen rights. The chapter examines the response of clergy and laypeople at the local level to contemporary intellectual and socio-economic changes and organizational reforms and renewal in the Church, noting regional variations. It considers the pastoral and disciplinary roles of bishops and clergy, and explores the focal role of the Church in communal life in towns and villages and the active engagement of laypeople, including women, with the Church. The relationship with Dissenters from the Established Church is also discussed, as well as the evidence for anti-clericalism.
Australia and New Zealand
Authors: Hardwick Joseph
Published: September 2017

The Church of England was present at the founding of European Australia. Richard Johnson, an Evangelical chaplain, accompanied the First Fleet in 1788, and one of his successors, Samuel Marsden, would help establish an Anglican mission in New Zealand in the 1810s. Chaplains were not the only vectors through which the Anglican faith was exported to Australasia. Convicts and free migrants carried their own understandings of Anglicanism overseas, and prayer books and other religious literature arrived in the colonies through a range of official and unofficial channels. This chapter shows how the early colonial Church of England cannot be considered as a monolithic institution: convicts, emancipated felons, free settlers, colonial officials, clergy, and indigenous communities all held different views on what a colonial Church should look like, and what its role and purpose should be. The tensions between these contested understandings of colonial Anglicanism are examined in this chapter.
The Book of Common Prayer, Liturgy, and Worship
Authors: Spinks Bryan D.
Published: September 2017

The Book of Common Prayer, proscribed during the Interregnum, was revised and reintroduced with a new Act of Uniformity in 1662. Regarded by many English divines as ‘an incomparable liturgy’, it survived the attempts at comprehension in 1689, the exotic dreams of enrichment of the non-jurors, and the doctrinal reductionism of the Newtonians as exemplified by William Whiston and Samuel Clarke. Wesley made a revision for Methodists in America, and then at home, and the American Episcopal Church would have to make revision suitable for the newly independent states. Not until the nineteenth century, with the Tractarian and Evangelical revivals, did its hegemony come under attack.
Where Our Protection Lies
Authors: Kyritsis Dimitrios
Published: September 2017

In this book Dimitrios Kyritsis advances an original account of constitutional review of primary legislation for its compatibility with human rights. Key to it is the value of separation of powers. When the relationship between courts and the legislature realizes this value, it makes a stronger claim to moral legitimacy. Kyritsis steers a path between the two extremes of the sceptics and the enthusiasts. Against sceptics who claim that constitutional review is an affront to democracy he argues that it is a morally legitimate institutional option for democratic societies because it can provide an effective check on the legislature. Although the latter represents the people and should thus be given the initiative in designing government policy, it carries serious risks, which institutional design must seek to avert. Against enthusiasts he maintains that fundamental rights protection is not the exclusive province of courts but the responsibility of both the judiciary and the legislature. Although courts may sometimes be given the power to scrutinize legislation and even strike it down, if it violates human rights, they must also respect the legislature’s important contribution to their joint project. Occasionally, they may even have a duty to defer to morally sub-optimal decisions, as far as rights protection is concerned. This is as it should be. Legitimacy demands less than the ideal. In turn, citizens ought to accept discounts on perfect justice for the sake of achieving a reasonably just and effective political order overall.
Are Courts the Forum of Constitutional Principle?
Authors: Kyritsis Dimitrios
Published: September 2017

This chapter examines a number of positions that defend the legitimacy of constitutional review on grounds of a special connection between courts and fundamental rights. It starts by insisting that the issue cannot be settled by appeal to any constitutional logic but must make reference to political morality. It then critically assesses the view that sees in courts a forum for the realization of a general procedural right to lodge complaints against political decisions setting back our interests. Such a procedural right, though, is dubious and does not straightforwardly apply to constitutional design. The chapter then turns to Ronald Dworkin’s thesis that courts ought to decide questions of principle and not policy and are better suited for this purpose than legislatures. However, this thesis cannot account for the dependence of the judicial role on legislative decisions.
Against the Democratic Objection
Authors: Kyritsis Dimitrios
Published: September 2017

This chapter critically examines sceptical views about constitutional review of primary legislation. Sceptics argue that constitutional review is illegitimate because it negates political equality. Political equality requires that political decisions be made following procedures that give every citizen’s view equal weight. But constitutional review gives a small group of unelected officials the power to overrule the decisions of democratically accountable legislators. Against the sceptics it is argued that they ignore the significant imbalance of power that exists between elected legislators and the citizens they represent. The former have the power to decide according to their own independent judgment of what is the right thing to do. They act as trustees, not proxies, of their constituents. If we do not object to representative democracy of the kind we are familiar with, we cannot object to constitutional review in the name of political equality.
A Little Less Conversation, a Little More Action
Authors: Kyritsis Dimitrios
Published: September 2017

This chapter criticizes constitutional dialogue theories, which treat constitutional review as an iteration in a dialogic process. Such theories are often invoked to explain the moral appeal of so-called weak constitutional review, which reserves the ‘last word’ on constitutional matters for the legislature. It is argued that constitutional dialogue theories stress the discursive element of judicial decisions at the expense of their authoritative impact and thus cannot adequately account for the limits we tend to impose on the courts’ reviewing power. More fundamentally, they overlook that political orders are not there to discover moral truth. First and foremost, they go well when they do not wrong us. Accordingly, constitutional review is not judged primarily by its discursive value, its ability to enhance public—and more specifically legislative—deliberation, but rather by its ability to thwart infringements of our fundamental rights.
Some Marks of Mental Phenomena
Authors: Textor Mark
Published: September 2017

Brentano, following Mill, conceived of psychology as the science of mental phenomena. In the framework of this conception of psychology, he made proposals about how to distinguish physical from mental phenomena. The chapter introduces and assesses three such proposals: Non-Spatiality, Inner Perception, and Consciousness. Brentano’s Inner Perception turns out to be immune to objections that are often directed against epistemic marks of the mental. His Non-Spatiality and Consciousness turn out to be controversial and subject to regress threats, respectively. The chapter prepares the stage for a discussion of Brentano’s Thesis that intentionality is the mark of the mental. It also introduces key concepts of Brentano’s philosophy.
Intentionality Primitivism
Authors: Textor Mark
Published: September 2017

Brentano endorsed (conceptual) primitivism about intentionality and the view that intentionality is fully revealed to us in its instantiations. The pros and cons of Brentano’s view that intentionality is a conceptually primitive property of every mental act are discussed. On the one hand, it makes clear why we need to distinguish between the immanent object (intentional correlate) and the external object. But, on the other hand, propositional attitudes turn out to be a major problem for intentionality primitivism. Meinong accepted Brentano’s Thesis as well as the existence of ‘propositional attitudes’ but one cannot defend Brentano’s Thesis by saying that propositional attitudes are directed on objectives or the like. A plausible mark of the mental needs to disentangle being a mental act (process) from having an object.
Brentano on Awareness and Observation
Authors: Textor Mark
Published: September 2017

When we are aware of our perceiving, we cannot attend to (observe) our perceiving, only the object which we (seem to) perceive. The perceiving is therefore the secondary, the object perceived the primary object. The chapter develops and evaluates Brentano’s grounds for the distinction between the primary and the secondary object. This project is of independent philosophical interest because Brentano’s view promises to shed light on the distinctive character of awareness. Awareness cannot become observation, because mere awareness of a mental phenomenon cannot contrast it with others. I argue further that Brentano’s account of noticing and observation has room for an ‘anatomy of the soul’ that proceeds by noticing the elements of our mental life.
The Nature of Enjoyment
Authors: Textor Mark
Published: September 2017

According to Brentano, enjoying an activity is loving or liking it. Brentano’s conception of love and hate is expounded by way of the analogies he draws with positive and negative judgement and I compare Brentano’s view with its main competitors: enjoying is appraisive attention to (Ryle, Gallie), propositional pleasure that something is the case (Feldman), or desire for the occurrence of a sensation (Heathwood). I discuss Hamilton’s Argument from Temporal Direction against the desire view of enjoyment and propose that a modified version of the argument, the Argument from Awareness of Satisfaction, speaks in favour of Brentano’s view of enjoyment.
Brentano’s Mental Monism
Authors: Textor Mark
Published: September 2017

We simultaneously perceive many things—colours, tastes, sounds, etc.—and are aware that we do so. Are the mental acts that we are simultaneously conscious of distinct mental acts, independent of each other? In Psychologie Brentano’s answer was an adamant No. All mental acts that we are jointly aware of are conceptual parts of one and the same mental activity (Mental Monism). Soon afterwards he changed his mind to Yes, our simultaneous mental acts are distinct and mutually independent, but co-conscious acts are accidents of one soul. I explore Brentano’s Mental Monism and defend it against Brentano’s own critique. At any time, there is only one mental act that we partially describe when we talk about seeing and hearing and consciousness of these activities.
Psychology and the Neoliberal Self
Authors: Bhatia Sunil
Published: September 2017

This chapter investigates how neoliberal globalization is not just an economic concept or an economic condition; rather, it brings with it shifts in the spheres of culture psychology and identity. It specifically analyzes how personality and assessment tests and cross-cultural workshops on identity and difference that are primarily developed from Euro-American psychology are utilized in the Indian information technology and call center industry. The cross-cultural framework developed primarily by Western psychologists provided the most important tools, concepts, and vocabularies to understand “culture” in cultural sensitivity workshops and extended training seminars held for offshore companies, such as in India. These workshops promoted highly reified ideas about culture in which Indian work culture was viewed as inefficient, hierarchical, feudal, and indirect, whereas European culture was framed as egalitarian, professional, assertive, and non-hierarchical. This chapter reveals how neoliberal psychological discourses of self, identity, and happiness are becoming a mainstay of Indian culture and society.
Stories and Theories
Authors: Bhatia Sunil
Published: September 2017

Narrative inquiry is particularly suited to capture how individuals make meaning of their identities as they engage with mutually shifting global–local cultural interactions. This chapter lays out the conceptual framework that examines how globalization shapes the narrative imagination and how it provides insights into understanding the psychology of globalization in urban India. It argues that individuals use narrative and stories as language-based equipment to express their subject positions and give meaning to the uniqueness and singularity of their experiences. Being interpellated by power structures or created through systems of cultural power does not mean there is no room for individual story-making or agency. The urban Indian youth make and remake their identities as they narrate stories of their lives through the lens of their social class; rootedness in history of colonization and postcolonial culture; exposure to discourses of globalization; and embeddedness in social practices of education, employment, and traditions.
Traveling Transnational Identities
Authors: Bhatia Sunil
Published: September 2017

This chapter describes how the transnationally oriented elite and upper-class urban Indian youth are negotiating their everyday experiences with globalization. It shows how the college-age elite youth psychologically imagine themselves as being world-class citizens not just by going abroad but also by reimagining new forms of Indianness through their active participation in specific cultural practices of watching American media, shopping at exclusive malls, and constructing emancipatory narratives of globalization. The transnational urban youth’s narratives are hybrid and are organized around an Indianness that is mobile, multicultural, connected to consumption practices, and crosses borders easily. Being a global Indian means displaying a kind of transnational cultural difference that has the right currency and credibility and that can be transported to other countries, where it is accepted as legitimate, valid, and as having a world-class standing. Selected parts of Indian culture can be adopted in their travels and study-abroad stints.
Women in UN Peacebuilding Discourse
Authors: Shepherd Laura J.
Published: September 2017

This chapter explores the representation of women in UN peacebuilding discourse that the author has curated and outlines the various ways in which women are associated with, and determined as subjects by, peace and security practices. The chapter develops an analysis of women as victims of violence and the representation of women as “agents of change,” with particular reference to the constitution of women’s economic agency, and the construction of women as rights-bearing subjects upon whom various expectations are placed in the peacebuilding context. The author argues, ultimately, that the association of women with civil society, and the depoliticization of their roles as economic actors, even as great emphasis is placed on the centrality of women’s empowerment to peacebuilding success, function to heavily circumscribe women’s meaningful participation in peacebuilding.
Civil Society in UN Peacebuilding Discourse
Authors: Shepherd Laura J.
Published: September 2017

Chapter 5 outlines the ways in which civil society is largely associated with “women” and the “local,” as a spatial and conceptual domain, and how this has implications for how we understand political legitimacy and authority. The author argues that close analysis reveals a shift in the way in which the United Nations as a political entity conceives of civil society over time, from early engagement with non-governmental organisations (NGOs) to the more contemporary articulation of civil society as consultant or even implementing partner. Contemporary UN peacebuilding discourse, however, constitutes civil society as a legitimating actor for UN peacebuilding practices, as civil society organizations are the bearers/owners of certain forms of (local) knowledge.
Training and Knowledge of Transgender Health Among Obstetrics and Gynecology Residents
Authors: Bukowski Kyle , Haymer Michael , Sridhar Aparna
Published: September 2017

BACKGROUND:

Transgender individuals experience significant health disparities, including stigma and lack of provider knowledge. The Council on Resident Education in Obstetrics and Gynecology (CREOG) has specific educational objectives regarding care for transgender individuals; however, the extent to which OB/GYN residents meet these objectives is not known.

METHODS:

We invited all current US OB/GYN residents to complete an electronic, anonymous 42-item survey including questions regarding transgender health training, experiences caring for transgender patients, and comfort meeting the CREOG educational objectives.

RESULTS:

Of programs that had at least one respondent, 313 of 2,276 eligible trainees completed the survey for a corrected response rate of 13.8%. The majority (76%) of respondents had received at least some form of training on transgender health topics. Forty-two percent of respondents had cared for a transgender individual as a resident. Although most residents (80%) felt comfortable with basic trans-sensitivity protocols, only 22% of respondents felt competent to provide trans-relevant services. More than 90% of respondents felt this was an important topic for OB/GYN residents to learn and desired to receive more training.

DISCUSSION:

While many respondents felt comfortable with basic topics regarding terminology and sensitivity protocols, a minority of respondents reported feeling prepared to provide care for transgender individuals independently. Given the high desire among respondents for more training, creation of high-quality educational materials for OB/GYN residents should be a priority for residency programs and national organizations, such as CREOG.
Biomarkers in vasculitis
Authors: Hatemi Gulen , Esatoglu Sinem N. , Yazici Yusuf
Published: September 2017

Purpose of review

Biomarkers are considered to be helpful in diagnosing, monitoring, predicting treatment response, and prognosis in clinical practice and as outcomes in clinical trials. In this article, we review the recent literature on new biomarkers and the expanding use of older ones in vasculitic conditions.

Recent findings

In antineutrophil cytoplasmic antibody-associated vasculitis patients antineutrophil cytoplasmic antibody type may be useful as a predictor of relapse and response to rituximab. Moreover, serial measurements of proteinase-3 titer may help to predict relapse. Urinary soluble CD163 levels are promising for identifying active renal vasculitis. Imaging modalities such as positron emission tomography, computerized angiography tomography, and temporal artery ultrasound maintain their role in diagnosis and disease assessment in large vessel vasculitis. Fecal calprotectin is a useful marker of active gastrointestinal involvement in Behçet's syndrome.

The publications reviewed here potentially may help to move the field of biomarkers in vasculitis management. However, more work toward understanding the underlying pathophysiology and effects of an intervention on the disease process are needed before true biomarkers can be realized. Further studies with appropriate control groups, using good definitions for disease states such as activity and remission are needed to guide our use of these markers correctly in the management of our patients.
Can Repeated Ponseti Management for Relapsed Clubfeet Produce the Outcome Comparable With the Case Without Relapse? A Clinical Study in Term of Gait Analysis
Authors: Liu Yu-Bin , Jiang Shu-Yun , Zhao Li , Yu Yan , Zhao Da-Hang
Published: September 2017

Background:

The prevention and treatment of relapsed clubfoot remained challenging tasks. There were controversies as to treatment options and management, such as complete subtalar release, application of an Ilizarov external frame, or repeated Ponseti method; and different options were available in different treatment centers. This study was designed to evaluate the clinical outcome of relapsed clubfeet treated by repeated Ponseti method in comparison with the cases without relapse in term of gait analysis and to clarify the clinical efficacy of repeated Ponseti method in treating the relapsed clubfeet.

Methods:

Thirty-seven patients (53 feet) were retrospectively identified from our database according to the inclusion and exclusion criteria. Among the 37 patients, 17 cases (25 relapsed clubfeet) were assigned to group I, whereas 20 cases (28 clubfeet without relapse) were assigned to group II. Clinical examination, gait analysis, and kinematic gait deviation criteria from Texas Scottish Rite Hospital for Children were used for evaluation.

Results:

There was statistically significant difference in the parameters of foot length, stride length, and single limb support time (%gait cycle) between the 2 groups (P<0.05). No statistically significant difference was found in the kinematic parameters of total hip, knee, and ankle excursion, peak knee and ankle flexion and extension, and internal foot progression (P>0.05). There was no statistically significant difference in peak hip, knee, and ankle flexion moment, peak knee valgus moment, and peak ankle power (P>0.05). No statistically significant difference was found in equinus and calcaneus gait, increased ankle dorsiflexion, foot drop, and internal foot progression angle (P>0.05).

Conclusions:

Repeated Ponseti method for relapsed clubfeet can yield good or excellent clinical results. We recommend repeated Ponseti method as the treatment choice for relapsed clubfeet in the early stage.

Level of Evidence:

Level III—retrospective comparative study.
Laser Treatment of Professional Tattoos With a 1064/532-nm Dual-Wavelength Picosecond Laser
Authors: Kauvar Arielle N.B. , Keaney Terrence C. , Alster Tina
Published: September 2017

BACKGROUND

Picosecond-domain laser pulses improve the photomechanical disruption of tattoos.

OBJECTIVE

This study evaluates the efficacy and safety of a novel, dual-wavelength, 1,064/532-nm, picosecond-domain laser for tattoo clearance.

MATERIALS AND METHODS

This was a prospective, self-controlled, clinical study of 34 subjects with 39 tattoos treated at 2 sites with an interval of 4.8 ± 1.6 weeks and up to 10 treatments (mean, 7.5). Blinded evaluation and investigator assessment of serial digital images was performed to evaluate treatment efficacy in the 36 tattoos that received at least 3 treatments. Investigators also assessed efficacy before each treatment visit up to 10 treatments. Safety and tolerability was evaluated for all 39 tattoos that underwent at least 1 treatment.

RESULTS

Blinded evaluation demonstrated that lightening of tattoos was achieved in all subjects, with 86% (31 of 36 tattoos) showing at least a 50% clearance after 3 treatments. Adverse events were few and transient in nature. Patient satisfaction and treatment tolerability were high.

CONCLUSION

Treatment of single-colored and multicolored tattoos with this novel 1,064/532-nm picosecond laser is highly safe and effective.
Intracranial Penetration During Temporal Soft Tissue Filler Injection—Is It Possible?
Authors: Philipp-Dormston Wolfgang G. , Bieler Lara , Hessenberger Mathias , Schenck Thilo L. , Frank Konstantin , Fierlbeck Johann , Cotofana Sebastian
Published: September 2017

BACKGROUND

Treating temporal volume loss for aesthetic and reconstructive purposes can be achieved by superficial or deep injections of soft tissue fillers into the temples. The latter is performed with bone contact that can lead to intracranial penetration when the bone is accidentally penetrated.

OBJECTIVE

Based on a clinical case, the potential risk of accidental intracranial penetration was investigated.

MATERIALS AND METHODS

Twenty fresh-frozen hemi-faces (all Caucasian ethnicity, 10 women, 10 men, mean age 72.8 ± 11.2 years) were investigated. Shape of pterion and bone-stability parameters of the temporal fossa were investigated. Bone stability was tested using uniaxial mechanical indentation (18-G, 1.25-mm diameter, 15-mm length blunt-tip device) until intracranial perforation occurred.

RESULTS

Variations in the shape of the pterion, bone thickness, and density correlates were detected, however, without statistical significant differences in side symmetry. Minimum force necessary to penetrate intracranially was 40.4 N. Maximum force generated by an 18-g, 70-mm length blunt-tip cannula was 32.1 ± 4.2 N in 70 mm length and 75.3 ± 10.2 N in 15 mm length.

CONCLUSION

Based on the results of this investigation, it can be concluded that there is a risk for intracranial penetration performing the deep temple injection technique with direct pressure on the bone.
Contraceptive counseling for continuation and satisfaction
Authors: Schivone Gillian B. , Glish Laura L.
Published: September 2017

Purpose of review

Quality contraceptive counseling has been identified as a potential means to reduce unintended pregnancy and to increase contraceptive continuation and satisfaction. Past approaches that focused on autonomous decision making and directive counseling have not been shown to meet these goals consistently. Women's health organizations globally are calling for improved counseling through more thorough discussion of side-effects and bleeding changes, and renewed focus on shared decision making and patient-centered care.

Recent findings

Reproductive life planning can help initiate contraceptive counseling but does not resonate with all patients. A client-centered approach using shared decision making, building trust, and eliciting client preferences has been shown to increase satisfaction and continuation. Patient preferences vary widely and may or may not prioritize extremely high effectiveness. Decision support tools have mixed results, but generally can help improve the method choice process when they are well designed.

Clinicians should strive for good interpersonal relationships with patients, and elicit patient experiences and preferences to tailor their counseling to each individual's needs. Shared decision making with input from both the patient and clinician is preferred by many women, and clinicians should be cognizant of perceptions of pushing any method too strongly, especially among marginalized populations. More research on long-term satisfaction and continuation linked to different counseling practices is needed.
Accelerated Epi-On Versus Standard Epi-Off Corneal Collagen Cross-Linking for Progressive Keratoconus in Pediatric Patients
Authors: Henriquez Maria A. , Rodríguez Ana M. , Izquierdo Luis
Published: September 2017

Purpose:

To evaluate and compare the effectiveness and safety of accelerated transepithelial (A-epi-on) corneal collagen cross-linking (CXL) with standard CXL (epi-off) for children with progressive keratoconus.

Methods:

Prospective, cohort study including 61 eyes of 51 patients younger than 18 years with progressive keratoconus at Oftalmosalud Instituto de Ojos, Lima, Peru. A-epi-on CXL was performed for 36 eyes using 30 minutes of impregnation (0.25% riboflavin, 1.0% phosphate hydroxypropyl methylcellulose, 0.007% benzalkonium chloride) and 5 minutes of irradiation (18 mW/cm2). Epi-off CXL was performed for 25 eyes using 30 minutes of impregnation (riboflavin 0.1% solution plus 20% dextran 500) and 30 minutes of irradiation (3 mW/cm2). Scheimpflug imaging parameters were evaluated preoperatively and at 6 and 12 months postoperatively.

Results:

Mean uncorrected visual acuity improvement was 0.12 logarithm of the minimum angle of resolution (logMAR) for both groups (P = 0.09 for A-epi-on and P = 0.16 for Epi-off). Mean improvements in the best-corrected visual acuity were 0.09 logMAR (P = 0.05) and 0.06 logMAR (P = 0.05) at 12 months postoperatively for the A-epi-on group and the epi-off group, respectively. Mean maximum keratometry changes were +0.1 D (P = 0.62) and −0.94 D (P = 0.11) for the A-epi-on group and the epi-off group, respectively, at 12 months postoperatively. There were no significant differences between groups regarding changes in pachymetry and posterior elevation values (P > 0.05). Keratoconus progression was observed in 5.6% and 12% of eyes in the A-epi-on group and the epi-off group, respectively.

Conclusions:

Accelerated epi-on CXL and standard epi-off CXL are safe and effective for stopping the progression of keratoconus at 12 months postoperatively.
Cryptosporidium Species are Frequently Present But Rarely Detected in Clinical Samples From Children with Diarrhea in a Developed Country
Authors: Skovgaards Daniel M. , Hartmeyer Gitte N. , Skov Marianne N. , Hoegh Silje V. , Kemp Michael
Published: September 2017

Two studies were done on cryptosporidiosis in children. A retrospective survey showed that from 2005 to 2015, Cryptosporidium species was detected by microscopy of stool from 0.25% of children with diarrhea. In a subsequent prospective study, polymerase chain reaction detected Cryptosporidium species in 4 (1.3%) of 304 children. Cryptosporidium species is as frequent as other intestinal pathogens in childhood diarrhea. Testing is relevant.
Different Clinical Course and Complications in Interagency Registry for Mechanically Assisted Circulatory Support 1 (INTERMACS) Patients Managed With or Without Extracorporeal Membrane Oxygenation
Authors: Han Jason J. , Chung Jennifer , Chen Carol W. , Gaffey Ann C. , Sotolongo Alex , Justice Christyna , Ameer Alyse E. , Rame J. Eduardo , Bermudez Christian , Acker Michael A. , Atluri Pavan
Published: September 2017

Extracorporeal membrane oxygenation (ECMO) as a bridge to left ventricular assist device (LVAD) implantation has shown promise in improving end-organ function and optimizing outcomes in some critically ill patients, but the practice remains controversial. Retrospective review of patients who received LVADs from May 2008 to September 2016 at a high-volume, tertiary care cardiovascular center was performed. Subjects were Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) class 1 patients divided into ECMO bridge and non-ECMO bridge cohorts. Patient demographics, adverse events, and survival at immediate and 1 year postoperative time points were compared between groups. In total, 235 patients received a HeartMate II or HVAD during the study period. Among INTERMACS 1 patients, 18 were ECMO bridge and 17 were non-ECMO bridge. Age, gender and bridge-to-transplant proportions (50% vs. 53%) were similar between groups. The ECMO bridge group had lower hemoglobin (7.9 ± 1.1 vs. 10.2 ± 2.2; p < 0.01), platelet (101 [70] vs. 176 [115]; p < 0.05), and prealbumin levels (10.6 ± 4.3 vs. 17.3 ± 7.7; p < 0.01). Nearly half (n = 8; 44%) of the ECMO bridge patients required packed red blood cell transfusions before VAD and were more likely to be on an epinephrine drip (78% vs. 12%; p < 0.01). However, along with these adjunctive measures, the ECMO bridge did effectively improve hemodynamic profiles by the time of VAD implant resulting in lower central venous pressure (7.7 ± 2.5 vs. 10.4 ± 4.8; p < 0.01) and mean pulmonary arterial pressure (18 ± 9 vs. 32 ± 8; p < 0.01). It also allowed for restoration of end-organ function as noted by comparable creatinine (1.0 [1.2] vs. 1.4 [0.6]) and total bilirubin levels (1.6 ± 1 vs.1.5 ± 1.7) between the two groups. There was no difference in rates of adverse events. Survival at 30 days postoperative and at 1 year (77% vs. 88%; p = 0.6) was similar. This study demonstrates that ECMO bridge is a central component of a multifaceted strategy for stabilization of select patients with severe hemodynamic instability before LVAD implantation. Further studies to optimize patient selection should be further explored.
Fertility restoration with spermatogonial stem cells
Authors: de Michele Francesca , Vermeulen Maxime , Wyns Christine
Published: September 2017

Purpose of review

This review evaluates the state of the art in terms of challenges and strategies used to restore fertility with spermatogonial stem cells retrieved from prepubertal boys affected by cancer. Although these boys do not yet produce spermatozoa, the only option to preserve their fertility is cryopreservation of spermatogonial stem cells in the form of testicular cell suspensions or whole tissue pieces. Different techniques have been described to achieve completion of spermatogenesis from human, spermatogonial stem cells but none is yet ready for clinical application. A crucial point to address is gaining a full understanding of spermatogonial stem cell niche pathophysiology, where germ cells undergo proliferation and differentiation. Various fertility restoration approaches will be presented depending on the presence of an intact niche, dissociated niche, or reconstituted niche.

Recent findings

Testicular organoids open the way to providing further insights into the niche. They can recreate the three-dimensional architecture of the testicular microenvironment in vitro, allowing a large number of applications, from physiology to drug toxicity investigations.

In addition to the full elucidation of the niche microenvironment, achieving fertility restoration from cryopreserved human spermatogonial stem cells implies overcoming other important challenges. Testicular organoids might prove to be essential tools to progress in this field.
Body Composition Changes in Severely Burned Children During ICU Hospitalization*
Authors: Cambiaso-Daniel Janos , Malagaris Ioannis , Rivas Eric , Hundeshagen Gabriel , Voigt Charles D. , Blears Elizabeth , Mlcak Ron P. , Herndon David N. , Finnerty Celeste C. , Suman Oscar E.
Published: September 2017

Objectives:

Prolonged hospitalization due to burn injury results in physical inactivity and muscle weakness. However, how these changes are distributed among body parts is unknown. The aim of this study was to evaluate the degree of body composition changes in different anatomical regions during ICU hospitalization.

Design:

Retrospective chart review.

Setting:

Children’s burn hospital.

Patients:

Twenty-four severely burned children admitted to our institution between 2000 and 2015.

Interventions:

All patients underwent a dual-energy x-ray absorptiometry within 2 weeks after injury and 2 weeks before discharge to determine body composition changes. No subject underwent anabolic intervention. We analyzed changes of bone mineral content, bone mineral density, total fat mass, total mass, and total lean mass of the entire body and specifically analyzed the changes between the upper and lower limbs.

Measurements and Main Results:

In the 24 patients, age was 10 ± 5 years, total body surface area burned was 59% ± 17%, time between dual-energy x-ray absorptiometries was 34 ± 21 days, and length of stay was 39 ± 24 days. We found a significant (p < 0.001) average loss of 3% of lean mass in the whole body; this loss was significantly greater (p < 0.001) in the upper extremities (17%) than in the lower extremities (7%). We also observed a remodeling of the fat compartments, with a significant whole-body increase in fat mass (p < 0.001) that was greater in the truncal region (p < 0.0001) and in the lower limbs (p < 0.05).

Conclusions:

ICU hospitalization is associated with greater lean mass loss in the upper limbs of burned children. Mobilization programs should include early mobilization of upper limbs to restore upper extremity function.
Statistical Analysis of Influences on the Psychosocial Status of Children With Hemangiomas and Their Families
Authors: Park Ji Ung , Kang Soohee , Choi Tae Hyun
Published: September 2017

The psychologic stress on the child and family, which arise from hemangiomas, the most common neoplasm of childhood, cannot be overestimated. This study determined the preoperative and postoperative psychosocial status and variation among Oriental children with hemangiomas and their families by questionnaire. Thirty patients who underwent surgery for hemangiomas were assessed for preoperative and postoperative psychosocial status by questionnaire. The distribution of the total mean score and variation between the preoperative and postoperative status was estimated. Based on these results, the significance was statistically analyzed according to variable determinants. This study showed that hemangiomas have harmful effects on psychosocial status of patients and families. After corrective surgery, an improvement in psychosocial status was noted with respect to the self-esteem category or categories related to social activity, and in the following variables, women, face, and dissatisfaction with appearance. When the authors care for patients with hemangiomas and their families, the psychosocial health must be presumed to be at particular risk. Earlier surgical interventions with esthetic concerns have permitted the patient and family the opportunity to reduce the psychologic impact that the hemangioma may otherwise have.
Bulla Down Endoscopic Sphenoidotomy
Authors: Al-Qudah Mohannad
Published: September 2017

Surgical approach to the sphenoid sinus is still one of the most challenging steps in sinus surgery. The author describes a novel, simple, and safe technique to access sphenoid sinus to manage isolated sphenoid pathologies or approach skull base by removing the bulla ethmoidalis and temporarily lateralizing the middle turbinate during endoscopic sinus surgery. The current approach provides an effective method to access the sphenoid sinus without increasing morbidity and avoids unnecessary possible complications associated with turbinates’ resection.
Co-Chaperone-Mediated Suppression of LPS-Induced Cardiac Toxicity Through NFκB Signaling
Authors: Ohno Marumi , Moore Rick , Myers Page , Negishi Masahiko
Published: September 2017

Co-chaperone cytoplasmic constitutive active/androstane receptor retention protein (CCRP), a member of heat shock protein (HSP) 40, was first characterized to retain a nuclear-destined protein in the cytoplasm. Here we have used CCRP KO mice and demonstrated that CCRP suppresses lipopolysaccharide (LPS)-induced cardiac toxicity in mice. LPS treatment decreased heart rates in CCRP KO mice, but not in wild-type (WT) mice. In addition, LPS-treated KO mice showed reduced fraction shortening, an indicator of ventricular contractile function, to a greater degree than WT mice did. Rat cardiomyocyte-derived H9c2 cells, in which CCRP is not expressed, were used to examine a cell signal through which CCRP suppressed LPS-induced cardiac toxicity. Overexpression of CCRP prevented p65, a nuclear factor κB (NFκB) subunit, from accumulating in the nucleus after LPS treatment. As observed with H9c2 cells, nuclear accumulation of p65 was found to be higher in the hearts of KO mice than WT mice after LPS treatment. Furthermore, induction of TNFα by LPS was markedly suppressed by CCRP in H9c2 cells as well as in LPS-treated mouse serum. In supporting the notion that CCRP repressed the LPS-induced NFκB signaling, pretreatment with pyrrolidinedithiocarbamate, an NFκB signaling inhibitor, or anti-TNF-α antibody before LPS treatment restored heart rates decreased in KO mice after LPS treatment in a dose-dependent manner. Our present study characterized a novel physiological role of CCRP in protecting cardiac functions through the inhibition of NFκB signaling.