bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incitement in international criminal law
Authors: Kristin Timmermann Wibke 
Published: May 2007

AbstractThe author critically analyses in this article the status of incitement in international criminal law. After a discussion of the relevant judgments by the Nuremberg Tribunal and related courts, including German de-Nazification courts, the travaux préparatoires of the Genocide Convention and the case-law of the International Criminal Tribunals, the international approach is criticized, particularly its practice of regarding only direct and public incitement to genocide as inchoate, whilst instigation generally is treated as not inchoate. The author recommends the adoption of an approach modelled on German and Swiss domestic law and argues that instigation per se should also be regarded as an inchoate crime.
A la guerre comme à la guerre: patterns of armed conflict, humanitarian law responses and new challenges
Authors: Reydams Luc 
Published: May 2007

AbstractContinuous transformation of armed conflict since the adoption in 1864 of the first international humanitarian law treaty compels international humanitarian law to adapt accordingly. These adaptations, through either customary law or new multilateral treaties, always have been towards greater protection, greater reach. As for treaty practice, international humanitarian law historically has been substantially revised every twenty-five to thirty years. This article links those revisions to specific conflicts which laid bare deficiencies in the existing law. What follows is thus a chronicle of conflicts with their most critical humanitarian issues. From this emerges a picture of the changing face of armed conflict since the middle of the nineteenth century. The article also considers recent challenges to international humanitarian law and speculates on possible responses.
Respect for international humanitarian law by armed non-state actors in Africa
Authors: Ewumbue-Monono Churchill 
Published: May 2007

AbstractThis report presents the instruments and strategies used by non-state actors to respect international humanitarian law during intra-state conflicts in Africa and highlights the recognition by these non-state actors of the role of humanitarian organizations. It examines the impact of such recognition on the development of international humanitarian law and the activities of humanitarian organizations, and shows the problems encountered by non-state actors with respect to their commitments. It concludes with some suggestions as to a way forward.
International treaties against terrorism and the use of terrorism during armed conflict and by armed forces
Authors: O'Donnell Daniel 
Published: May 2007

AbstractDuring the second half of the twentieth century the international community, facing the terrorist phenomenon, reacted with the adoption of a series of treaties concerning specific types of terrorist acts, and the obligations of states with regard to them. Alternatively terrorism-oriented legislation, which initially covered only acts affecting civilians, has gradually expanded to cover some acts of terrorism against military personnel and installations. This contribution attempts to assess the repercussions of this evolution on the status and the protection of armed forces engaged in the so-called “war on terrorism” by examining the existing dynamic between these regulations and international humanitarian law.
Precautions under the law governing the conduct of hostilities
Authors: Quéguiner Jean-François 
Published: May 2007

AbstractThis article presents a descriptive analysis of the precautions that are required of all belligerents in order to ensure the protection of civilian populations and objects against the effects of hostilities. The author argues that both the attacker and the defender must take precautions to avoid, or at least minimize, collateral casualties and damage. The rules imposing such precautionary measures represent clear standards of conduct. This is true even though they are worded in flexible terms to take into account the reality that mistakes or misjudgements are inevitable, and that the balance between military and humanitarian interests is not always easy to reach.
Incidence of Propofol Infusion Syndrome during Noninvasive Radiofrequency Ablation for Atrial Flutter or Fibrillation
Authors: Cravens Grant T. , Packer Douglas L. , Johnson Michael E. 
Published: May 2007

Background
Propofol infusion syndrome is first manifest by unexplained metabolic acidosis. Its incidence is unknown.

Methods
Charts of all patients undergoing nonsurgical, catheter radiofrequency ablation for atrial flutter or fibrillation from 1999 through 2001 at Mayo Clinic Rochester, who received propofol and had an arterial blood gas drawn during the procedure, were reviewed retrospectively for metabolic acidosis, prospectively defined as base excess -2 or less. Of 301 radiofrequency ablation cases, 55 had an arterial blood gas. Virtually all radiofrequency ablation patients received propofol, so they could not be used as nonpropofol controls. Instead, all carotid endarterectomy patients in 2000 who did not receive propofol and had an arterial blood gas drawn after anesthetic induction and before surgical incision were used as a comparator group.

Results
In propofol radiofrequency ablation patients with no apparent cause of metabolic acidosis besides propofol, 13 of 55 (24%) had base excess of -2 or less, versus 22 of 267 carotid patients (8.2%) (P<0.01). Maximal negative base excess was -4.2+/-1.7 in these propofol patients and was not correlated with propofol dose, age, or fluid dose, versus base excess of -3.2+/-1.5 in carotid patients (P>0.05). Propofol patients received prolonged anesthetics (7 h) and high-dose propofol (20 mg/kg).

Conclusions
This is the first incidence estimate of metabolic acidosis during prolonged propofol infusion and suggests that it is not rare. The study is limited by its retrospective nature and by the lack of baseline arterial blood gas data and will require confirmation by prospective study.
Volume Replacement Therapy during Major Orthopedic Surgery Using Voluven® (Hydroxyethyl Starch 130/0.4) or Hetastarch
Authors: Gandhi Sweeta D. , Weiskopf Richard B. , Jungheinrich Cornelius , Koorn Robert , Miller Diane , Shangraw Robert E. , Prough Donald S. , Baus Daniela , Bepperling Frank , Warltier David C. 
Published: May 2007

Background
The purpose of this study was to test the equivalence of efficacy and compare the safety of the 6% hydroxyethyl starches (HES) Voluven (HES 130/0.4; Fresenius Kabi, Bad Homburg, Germany) and hetastarch (HES 670/0.75 in saline) for intravascular volume replacement therapy during major orthopedic surgery.

Methods
In a prospective, controlled, randomized, double-blind, multicenter trial of patients undergoing major orthopedic surgery, 49 patients were treated with HES 130/0.4 and 51 patients were treated with hetastarch. Infusion of colloids was guided by central venous and arterial blood pressures. The primary efficacy endpoint was the volume of colloid solution infused; the primary safety endpoints were calculated total erythrocyte loss, the nadir factor VIII activity, and the nadir von Willebrand factor concentration within 2 h of completion of surgery.

Results
The total volume of colloid solution required for intraoperative volume replacement did not differ between HES 130/0.4 and hetastarch (1,613+/-778 [SD] ml for HES 130/0.4 and 1,584+/-958 ml for hetastarch). The nadir factor VIII activity within 2 h of the end of surgery was lower for hetastarch than for HES 130/0.4 (P=0.0499); for those who received greater than 1,000 ml colloid, the nadir factor VIII activity and von Willebrand factor concentration within 2 h of end of surgery were lower for hetastarch than for HES 130/0.4 (P=0.0487 and P=0.008, respectively).

Conclusion
Voluven (HES 130/0.4) and hetastarch are equally efficacious plasma volume substitutes; however, HES 130/0.4 has a lesser effect on coagulation.
N-Terminal Pro-brain Natriuretic Peptide Identifies Patients at High Risk for Adverse Cardiac Outcome after Vascular Surgery
Authors: Mahla Elisabeth , Baumann Anneliese , Rehak Peter , Watzinger Norbert , Vicenzi Martin N. , Maier Robert , Tiesenhausen Kurt , Metzler Helfried , Toller Wolfgang 
Published: May 2007

Background
Preoperative N-terminal pro-BNP (NT-proBNP) is independently associated with adverse cardiac outcome but does not anticipate the dynamic consequences of anesthesia and surgery. The authors hypothesized that a single postoperative NT-proBNP level provides additional prognostic information for in-hospital and late cardiac events.

Methods
Two hundred eighteen patients scheduled to undergo vascular surgery were enrolled and followed up for 24-30 months. Logistic regression and Cox proportional hazards model were performed to evaluate predictors of in-hospital and long-term cardiac outcome. The optimal discriminatory level of preoperative and postoperative NT-proBNP was determined by receiver operating characteristic analysis.

Results
During a median follow-up of 826 days, 44 patients (20%) experienced 51 cardiac events. Perioperatively, median NT-proBNP increased from 215 to 557 pg/ml (interquartile range, 83/457 to 221/1178 pg/ml; P<0.001). The optimum discriminate threshold for preoperative and postoperative NT-proBNP was 280 pg/ml (95% confidence interval, 123-400) and 860 pg/ml (95% confidence interval, 556-1,054), respectively. Adjusted for age, previous myocardial infarction, preoperative fibrinogen, creatinine, high-sensitivity C-reactive protein, type, duration, and surgical complications, only postoperative NT-proBNP remained significantly associated with in-hospital (adjusted hazard ratio, 19.8; 95% confidence interval, 3.4-115) and long-term cardiac outcome (adjusted hazard ratio, 4.88; 95% confidence interval, 2.43-9.81).

Conclusion
A single postoperative NT-proBNP determination provides important additional prognostic information to preoperative levels and may support therapeutic decisions to prevent subsequent structural myocardial damage.
A Series of Anesthesia-related Maternal Deaths in Michigan, 1985–2003
Authors: Mhyre Jill M. , Riesner Monica N. , Polley Linda S. , Naughton Norah N. 
Published: May 2007

Background
Maternal Mortality Surveillance has been conducted by the State of Michigan since 1950, and anesthesia-related maternal deaths were most recently reviewed for the years 1972-1984.

Methods
Records for pregnancy-associated deaths between 1985 and 2003 were reviewed to identify 25 cases associated with a perioperative arrest or major anesthetic complication. Four obstetric anesthesiologists independently classified these cases, and disagreements were resolved by discussion. Precise definitions of anesthesia-related and anesthesia-contributing maternal death were constructed. Anesthesia-related deaths were reviewed to identify the chain of medical errors or care management problems that contributed to each patient death.

Results
Of 855 pregnancy-associated deaths, 8 were anesthesia-related and 7 were anesthesia-contributing. There were no deaths during induction of general anesthesia. Five resulted from hypoventilation or airway obstruction during emergence, extubation, or recovery. Lapses in either postoperative monitoring or anesthesiology supervision seemed to contribute to 5 of the 8 anesthesia-related deaths. Other characteristics common to these cases included obesity (n=6) and African-American race (n=6).

Conclusions
The 8 anesthesia-related and seven anesthesia-contributing maternal deaths in Michigan between 1985 and 2003 illustrate three key points. First, all anesthesia-related deaths from airway obstruction or hypoventilation took place during emergence and recovery, not during the induction of general anesthesia. Second, system errors played a role in the majority of cases. Of concern, lapses in postoperative monitoring and inadequate supervision by an anesthesiologist seemed to contribute to more than half of the deaths. Finally, this report confirms previous work that obesity and African-American race are important risk factors for anesthesia-related maternal mortality.
Respiratory Variations in Pulse Oximetry Plethysmographic Waveform Amplitude to Predict Fluid Responsiveness in the Operating Room
Authors: Cannesson Maxime , Attof Yassin , Rosamel Pascal , Desebbe Olivier , Joseph Pierre , Metton Olivier , Bastien Olivier , Lehot Jean-Jacques 
Published: May 2007

Background
Respiratory variations in pulse oximetry plethysmographic waveform amplitude (DeltaPOP) are related to respiratory variations in pulse pressure (DeltaPP) and are sensitive to changes in preload. The authors hypothesized that DeltaPOP can predict fluid responsiveness in mechanically ventilated patients during general anesthesia.

Methods
Twenty-five patients referred for cardiac surgery were studied after induction of general anesthesia. Hemodynamic data (cardiac index, central venous pressure, pulmonary capillary wedge pressure, DeltaPP, and DeltaPOP) were recorded before and after volume expansion (500 ml hetastarch, 6%). Fluid responsiveness was defined as an increase in cardiac index of 15% or greater.

Results
Volume expansion induced changes in cardiac index (2.0+/-0.4 to 2.3+/-0.5 mmHg; P<0.05), DeltaPP (11+/-7 to 6+/-5%; P<0.05), and DeltaPOP (12+/-9 to 7+/-5%; P<0.05). DeltaPOP and DeltaPP were higher in responders than in nonresponders (17+/-8 vs. 6+/-4 and 14+/-7 vs. 6+/-4%, respectively; P<0.05 for both). A DeltaPOP greater than 13% before volume expansion allowed discrimination between responders and nonresponders with 80% sensitivity and 90% specificity. There was a significant relation between DeltaPOP before volume expansion and percent change in cardiac index after volume expansion (r=0.62; P<0.05).

Conclusions
DeltaPOP can predict fluid responsiveness noninvasively in mechanically ventilated patients during general anesthesia. This index has potential clinical applications.
Long-term Effects of Botulinum Toxin on Neuromuscular Function
Authors: Frick Christiane G. , Richtsfeld Martina , Sahani Nita D. , Kaneki Masao , Blobner Manfred , Martyn J A. Jeevendra 
Published: May 2007

Background
Recent reports indicate increased incidence of Clostridium botulinum infections, particularly among drug abusers and tissue allograft recipients. Botulinum toxin also has potential application in biochemical warfare. The neurotoxin-induced paralysis often requires mechanical ventilation with and without muscle relaxants. The authors investigated the long-term effects of botulinum toxin on muscle function, expression of nicotinic acetylcholine receptors (nAChRs), and their interaction with muscle relaxant, atracurium.

Methods
Rats (n=30) were injected with varying doses (0.625, 2.5, and 10 U) of botulinum toxin into the tibialis muscle. Control animals (n=9) received an equivalent volume of saline. At 128 days after injection, neuromuscular function, pharmacodynamics of atracurium, and nAChRs were evaluated.

Results
Nerve-evoked tensions, including tetanic tension and muscle mass, were decreased on the toxin-injected side in a dose-dependent manner relative to saline-injected controls as well as the contralateral side. Specific muscle tension and specific tetanic muscle tension (tensions/muscle mass) were not reduced. The ED10 of atracurium was reduced, the ED50 was unchanged, and the ED90 was increased in the highest (10-U) dose of toxin group. The atracurium plasma concentration to maintain a steady state 50% paralysis was significantly reduced in the 10-U toxin group. The nAChR concentrations in the tibialis muscle were significantly increased in a dose-dependent manner in all experimental groups.

Conclusion
Botulinum toxin causes dose-dependent long-term neuromuscular changes. The loss of tension generating capacity is almost exclusively related to muscle atrophy, because the specific tension did not change. The decreased ED10, unaltered ED50, and increased ED90 to atracurium suggest its interactions with different isoforms of receptors having varying sensitivity to atracurium. The absence of fade, despite the persistent botulinum toxin-induced denervation (increased nAChRs), suggests that the up-regulated nAChRs may have compensated for the prejunctional effects of botulinum toxin.
Cholinergic Modulation of Sevoflurane Potency in Cortical and Spinal Networks In Vitro
Authors: Grasshoff Christian , Drexler Berthold , Hentschke Harald , Thiermann Horst , Antkowiak Bernd 
Published: May 2007

Background
Victims of organophosphate intoxication with cholinergic crisis may have need for sedation and anesthesia, but little is known about how anesthetics work in these patients. Recent studies suggest that cholinergic stimulation impairs gamma-aminobutyric acid type A (GABAA) receptor function. Because GABAA receptors are major targets of general anesthetics, the authors investigated interactions between acetylcholine and sevoflurane in spinal and cortical networks.

Methods
Cultured spinal and cortical tissue slices were obtained from embryonic and newborn mice. Drug effects were assessed by extracellular voltage recordings of spontaneous action potential activity.

Results
Sevoflurane caused a concentration-dependent decrease in spontaneous action potential firing in spinal (EC50=0.17+/-0.02 mM) and cortical (EC50=0.29+/-0.01 mM) slices. Acetylcholine elevated neuronal excitation in both preparations and diminished the potency of sevoflurane in reducing action potential firing in cortical but not in spinal slices. This brain region-specific decrease in sevoflurane potency was mimicked by the specific GABAA receptor antagonist bicuculline, suggesting that (1) GABAA receptors are major molecular targets for sevoflurane in the cortex but not in the spinal cord and (2) acetylcholine impairs the efficacy of GABAA receptor-mediated inhibition. The latter hypothesis was supported by the finding that acetylcholine reduced the potency of etomidate in depressing cortical and spinal neurons.

Conclusions
The authors raise the question whether cholinergic overstimulation decreases the efficacy of GABAA receptor function in patients with organophosphate intoxication, thereby compromising anesthetic effects that are mediated predominantly via these receptors such as sedation and hypnosis.
Amnesic Concentrations of the Nonimmobilizer 1,2-Dichlorohexafluorocyclobutane (F6, 2N) and Isoflurane Alter Hippocampal θ Oscillations In Vivo
Authors: Perouansky Misha , Hentschke Harald , Perkins Mark , Pearce Robert A. 
Published: May 2007

Background
Drug-induced temporary amnesia is one of the principal goals of general anesthesia. The nonimmobilizer 1,2-dichlorohexafluorocyclobutane (F6, also termed 2N) impairs hippocampus-dependent learning at relative, i.e., lipophilicity-corrected, concentrations similar to isoflurane. Hippocampal theta oscillations facilitate mnemonic processes in vivo and synaptic plasticity (a cellular model of memory) in vitro and are thought to represent a circuit level phenomenon that supports memory encoding. Therefore, the authors investigated the effects of F6 and isoflurane on theta oscillations (4-12 Hz).

Methods
Thirteen adult rats were implanted with multichannel depth electrodes to measure the microelectroencephalogram and were exposed to a range of concentrations of isoflurane and F6 spanning the concentrations that produce amnesia. Five of these animals also underwent control experiments without drug injection. The authors recorded the behavioral state and hippocampal field potentials. They confirmed the electrode location postmortem by histology.

Results
The tested concentrations for isoflurane and F6 ranged from 0.035% to 0.77% and from 0.5% to 3.6%, respectively. Isoflurane increased the fraction of time that the animals remained immobile, consistent with sedation, whereas F6 had the opposite effect. Electroencephalographic power in the theta band was less when the animals were immobile than when they explored their environment. F6 suppressed the power of oscillations in the theta band. Isoflurane slowed theta oscillations without reducing total power in the theta band.

Conclusions
Drug-induced changes in theta oscillations may be a common basis for amnesia produced by F6 and isoflurane. The different patterns suggest that these drugs alter network activity by acting on different molecular and/or cellular targets.
Mutation of α1GT-type Calcium Channels in Mice Does Not Change Anesthetic Requirements for Loss of the Righting Reflex and Minimum Alveolar Concentration but Delays the Onset of Anesthetic Induction
Authors: Petrenko Andrey B. , Tsujita Mika , Kohno Tatsuro , Sakimura Kenji , Baba Hiroshi 
Published: May 2007

Background
T-type calcium channels regulate neuronal membrane excitability and participate in a number of physiologic and pathologic processes in the central nervous system, including sleep and epileptic activity. Volatile anesthetics inhibit native and recombinant T-type calcium channels at concentrations comparable to those required to produce anesthesia. To determine whether T-type calcium channels are involved in the mechanisms of anesthetic action, the authors examined the effects of general anesthetics in mutant mice lacking alpha1G T-type calcium channels.

Methods
The hypnotic effects of volatile and intravenous anesthetics administered to mutant and C57BL/6 control mice were evaluated using the behavioral endpoint of loss of righting reflex. To investigate the immobilizing effects of volatile anesthetics in mice, the minimum alveolar concentration (MAC) values were determined using the tail-clamp method.

Results
The 50% effective concentration for loss of righting reflex and MAC values for volatile anesthetics were not altered after alpha1G channel knockout. However, mutant mice required significantly more time to develop anesthesia/hypnosis after exposure to isoflurane, halothane, and sevoflurane and after intraperitoneal administration of pentobarbital.

Conclusions
The 50% effective concentration for loss of righting reflex and MAC values for the volatile anesthetics were not altered after alpha1G calcium channel knockout, indicating that normal functioning of alpha1G calcium channels is not required for the maintenance of anesthetic hypnosis and immobility. However, the timely induction of anesthesia/hypnosis by volatile anesthetic agents and some intravenous anesthetic agents may require the normal functioning of these channel subunits.