15 years of facts and figures on veterinary disciplinary measures in the Netherlands.

In most countries, a veterinary disciplinary system is in force to ensure the quality of the veterinary profession and to offer an objective platform for complaints. We present an analysis of 15 years of veterinary disciplinary verdicts (2001-2016) to compare facts and figures and identify which factors are of major influence on the outcome of the verdicts. Rulings were collected from both paper files and the digital database of the veterinary disciplinary council (VDC), categorized, and used to create a database that enabled a statistical analysis. The results showed that complaints pertaining to companion animals are filed predominantly by owners, whereas complaints about livestock are mostly filed by the governmental civil servant (CS). CS complaints mostly address compliance issues. For the complaints made by owners (client complaints, CCs), reporting, communication, and veterinary mistakes appeared to be of statistical significance. Further studies are needed to investigate the impact of the complaints on veterinarians in general and how we can improve the veterinary disciplinary system.

A novel approach to screening and managing the urinary tract infections suspected sample in the general human population.

Background: Automated urine technology providing standard urinalysis data can be used to support clinicians in screening and managing a UTI-suspected sample. Fully automated urinalysis systems have expanded in laboratory practice. Commonly used were devices based on digital imaging with automatic particle recognition, which expresses urinary sediment results on an ordinal scale. There were introduced fluorescent flow cytometry analyzers reporting all parameters quantitatively. There is a need to harmonize the result and support comparing bacteria and WBC qualitative versus semiquantitative results. Methods: A total of 1,131 urine samples were analyzed on both automated urinalysis systems. The chemical components of urinalysis (leukocyte esterase and nitrate reductase) and the sediment results (leukocytes and bacteria) were investigated as potential UTI indicators. Additionally, 106 specimens were analyzed on UF-5000 and compared with culture plating to establish cut-offs that can be suitable for standard urinalysis requirements and help to guide on how to interpret urinalysis results in the context of cultivation reflex. Results: The medians of bacteria counts varies from 16.2 (absence), 43.0 (trace), 443.5 (few), 5,389.2 (moderate), 19,356.6 (many) to 32,545.2 (massive) for particular digital microscopic bacteriuria thresholds. For pyuria thresholds, the medians of WBC counts varies from 0.8 (absence), 2.0 (0-1), 7.7 (2-3), 21.3 (4-6), 38.9 (7-10), 61.3 (11-15) to 242.2 (>30). Comparing the culture and FFC data (bacterial and/or WBC counts) was performed. Satisfactory sensitivity (100%), specificity (83.7%), negative predictive value (100%), and positive predictive value (75%) were obtained using indicators with the following cut-off values: leukocytes ≥40/µl or bacteria ≥300/µl. Conclusions: Accurate urinalysis gives information about the count of bacteria and leukocytes as useful indicators in UTIs, in general practice it can be a future tool to cross-link clinical and microbiology laboratories. However, the cut-off adjustments require individual optimization.

Shoulder dystocia: Updating some medico-legal issues.

Shoulder dystocia, or shoulder entrapment at birth, is an obstetrician's nightmare, which not infrequently leads to court litigation with complaints of serious foetal and/or maternal damage. Increasingly, retrospective management scrutiny is extending well beyond second stage birth mechanics and involving all case file entries, history taking, ultrasound scan measurements and haematology profile results, etc. The article highlights some medico-legal issues including the influence of the Montgomery ruling on patient disclosure and subsequent management.

[Disinfectants during the COVID-19 pandemic: a challenge]. / Desinfektionsmittel in der COVID-19-Pandemie: eine Herausforderung.

Disinfection measures have become more important as a result of the COVID-19 pandemic in Germany. The increased need for disinfectants at the beginning of the pandemic required temporary legal regulations in order to provide a sufficient quantity of products for the necessary disinfection in the medical sector on the one hand and for the additional demand in the population on the other. For this purpose, the Federal Institute for Drugs and Medical Devices (BfArM) and the Federal Institute for Occupational Safety and Health (BAuA) issued a general ruling, which is explained in more detail in this article. The focus was on measures for hygienic hand disinfection. However, other applications such as surface disinfection in relation to pandemic respiratory diseases are also addressed. The experience gained in ensuring the supply of disinfectants that are effective and safe to use should be used to prepare for further pandemics.

An Algorithm for the Factorization of Split Quaternion Polynomials.

We present an algorithm to compute all factorizations into linear factors of univariate polynomials over the split quaternions, provided such a factorization exists. Failure of the algorithm is equivalent to non-factorizability for which we present also geometric interpretations in terms of rulings on the quadric of non-invertible split quaternions. However, suitable real polynomial multiples of split quaternion polynomials can still be factorized and we describe how to find these real polynomials. Split quaternion polynomials describe rational motions in the hyperbolic plane. Factorization with linear factors corresponds to the decomposition of the rational motion into hyperbolic rotations. Since multiplication with a real polynomial does not change the motion, this decomposition is always possible. Some of our ideas can be transferred to the factorization theory of motion polynomials. These are polynomials over the dual quaternions with real norm polynomial and they describe rational motions in Euclidean kinematics. We transfer techniques developed for split quaternions to compute new factorizations of certain dual quaternion polynomials.

A Two-Stage Decision Making Approach for Safety Studies.

For safety studies, two types of hypothesis testing are often considered: detecting a safety signal and ruling out a safety concern. Under the detecting framework, statistical non-significance is often confused with the conclusion that there is no safety concern. Such a conclusion, in the presence of low study power or large variability, is problematic. To overcome the interpretation issue with non-significant results from a detecting hypothesis, we propose a Two-Stage Decision-Making (TSDM) approach for safety studies. It is basically a ruling-out design allowing an interim analysis that applies both detecting and ruling-out criteria at the interim and final stages with a pre-specified alpha spending function. The proposed TSDM approach incorporates both detecting a safety signal and ruling out safety concerns into a single study design to increase the probability of making a definite decision. It is based on the ruling-out framework that utilizes both directions of the confidence interval to make a decision for ruling out unacceptable risk or detecting safety signal at each analysis stage. We assess the proposed TSDM approach by investigating properties such as operational type I error rate, overall study power based on analytical approximations, overall probability of making a decision, and required sample sizes. We conduct Monte Carlo simulations to evaluate such properties regarding various outcome types of confidence intervals and summarize the statistical interpretations and the implications on study design.

The analogy between DNA kinship and DNA mixture evaluation, with applications for the interpretation of likelihood ratios produced by possibly imperfect models.

Two main applications of forensic DNA analysis are the investigation of possible relatedness and the investigation whether a person left DNA in a trace. Both of these are usually carried out by the calculation of likelihood ratios. In the kinship case, it is standard to let the likelihood ratio express the support in favour of the investigated relatedness versus no relatedness, and in the investigation of traces, one by default compares the hypothesis that the person of interest contributed DNA, versus that he is unrelated to any of the actual contributors. In both cases however, we can also view the probabilistic procedure as an inference of the profile of the person we look for: in other words, in both cases we carry out probabilistic genotyping. In this article we use this general analogy to develop various more specific analogies between kinship and mixture likelihood ratios. These analogies help to understand the concepts that play a role, and also to understand the importance of the statistical modeling needed for DNA mixtures. In this article, we apply our findings to consider what we can and cannot conclude from a likelihood ratio in favour of contribution to a mixed DNA profile, if that is computed by a model whose specifics are not entirely known to us, or where we do not know whether they provide a good description of the stochastic effects involved in the generation of DNA trace profiles. We show that, if unrelated individuals are adequately modeled, we can give bounds on how often LR's coming from certain types of black box models may arise, both for persons who are actual contributors and who are unrelated. In particular we show that no model, provided it satisfies basic requirements, can overestimate the evidence found for actual contributors both often and strongly.

How should we regulate products of new breeding techniques? Opinion of surveyed experts in plant biotechnology.

The adoption of genome editing depends among others, on a clear and navigable regulatory framework that renders consistent decisions. Some countries like the United States decided to deregulate specific transgene-free genome edited products that could be created through traditional breeding and are not considered to be plant pests, while others are still challenged to fit emerging technologies in their regulatory system. Here we poll international experts in plant biotechnology on what approach should nations agree upon to accommodate current and future new breeding technologies and derived products. A key finding is product-based models or dual-product/process systems are viewed as potential appropriate frameworks to regulate outcomes of genome editing. As regulation of novel products of biotechnology is expected to impact research and trade, we test the impact of experts' worldviews on these issues. Results show that region influences worldviews of trade but not of agricultural innovation. In contrast, there was no effect of experts' worldviews on how products of novel biotechnologies should be regulated.

Quadratic Split Quaternion Polynomials: Factorization and Geometry.

We investigate factorizability of a quadratic split quaternion polynomial. In addition to inequality conditions for existence of such factorization, we provide lucid geometric interpretations in the projective space over the split quaternions.

No more only one mom? European Court of Human Rights and Italian jurisprudences' ongoing evolution.

The author has delved into the most significant Italian and European court rulings related to heterologous fertilization and surrogate motherhood between 2012 and 2019, with a close focus on same-sex couples seeking to have their donor-conceived children born abroad legally registered in their country of origin. Undeniably, surrogacy has brought about a crisis in the traditional family model, made up of a mother and a father. The paper draws upon European Court of Human Rights established jurisprudence that upholds the children's best interests. Italian Court rulings are expounded upon as well, which have been instrumental in establishing the principles by which parental figures do not necessarily coincide with those who have generated the children (through biological bonds or delivery), but rather with those who wish to be recognized as parents. The cases herein examined involve homosexual couples who decided to travel abroad in order to gain access to surrogacy, from which children were born. In the case regarding two fathers, the child had no genetic tie with either one intended parent. The Italian Supreme Court's joint sessions have ruled that such children cannot be legally registered in Italy, since their foreign-issued birth certificates indicate no genetic connection between the children and their intended parents. The Author believes that the Supreme Court decision is valuable, but further legislative interventions will be necessary on account of scientific advancements; the issue of surrogacy is utterly complex and multi-faceted.

[Bernhard von Gudden's psychiatric assessment and the deposition of King Ludwig II of Bavaria in 1886 : Comments on the article by R. Steinberg in Der Nervenarzt 01/2019]. / Das psychiatrische Gutachten Bernhard von Guddens und die Entmachtung König Ludwigs II. von Bayern 1886 : Ein Kommentar zum Beitrag von R. Steinberg in Der Nervenarzt 01/2019.

King Ludwig II of Bavaria drowned himself in Lake Starnberg on 13 June 1886 after subduing and drowning Bernhard von Gudden, a Munich-based psychiatrist who had tried to hold him back. Commissioned by Prince Luitpold, Ludwig's successor to the throne, von Gudden had provided a psychiatric assessment on the king. Finding him to be suffering from a progressive mental illness and paranoia (madness), he declared Ludwig incapable of ruling. On the basis of this report Ludwig was unlawfully declared incapacitated, deposed, arrested and locked up in the Berg Castle under von Gudden's medical supervision. We conducted a 5-year psychiatric historical study of King Ludwig II, the most thorough of its kind ever undertaken. The main results were: the private, official and political letters the king wrote until his very last day were reasonable, well-argued and impeccable in style. Until his final days Ludwig had invariably fulfilled his administrative tasks in a prompt and proper way. His handling of political affairs was also wise and reasonable. Due to social phobia afflicting him since his youth he neglected his representative duties as a monarch. Von Gudden's report is marred by severe flaws. In his article published in Der Nervenarzt (01/2019) R. Steinberg adopts von Gudden's psychiatric diagnosis and misjudgement. Steinberg writes that the king's illness developed "in a clear crescendo". In fact, it was the behavioral anomalies associated with the king's homosexual relationships that grew increasingly prevalent at the court, whereas Ludwig's mental efficiency improved over time. Given the historical misjudgment and numerous other errors that Steinberg adopts from von Gudden, I considered it necessary to compare and contrast his conclusions with results from our own research.

Impacts of the EU GMO regulatory framework for plant genome editing.

New plant breeding technologies, such as genome editing, are enabling new crop varieties to be developed far quicker and with greater precision and scope than achievable using conventional methods. These advances could help farmers address the challenges of climate change, sustainability, and global food security. However, despite their potential, the uptake of these new technologies has been slowed down due to the uncertainty associated with the regulation of genome edited crops. For many European consumers, their view of new breeding technologies is influenced by many factors. Those who have never faced a major food crisis may not sufficiently appreciate the challenges posed by a projected rise of 2 billion in the human population by 2050. In addition, consumers with a regular and plentiful supply of food may not have to consider how their food is produced, or appreciate the challenges EU farmers are already facing to meet future demand. Misleading online articles, questioning the safety and ethics of these "new" biotech foods, can also lead consumers to be reluctant to accept them. Consequently, Europe's mixed view on biotech crops may also be hindering their adoption in countries who have even more to gain from the technology. In this review, we discuss the current data on global and EU GM crop adoption and the potential impact a new wave of crop development may have for agriculture. We reflect on how the EU has viewed GM crops, and we consider the future of both genetic modification (GM) and genome editing (GE) in the EU. We explore lessons learnt from the adoption of GM crops and examine the potential impact the recent decision not to exempt genome edited crops from the EU GMO Directive, will have on EU farmers, scientists, consumers, trading countries, and the rest of the world.

Luiz Simões Lopes entre administração e política: a trajetória de um dirigente / Luiz Simões Lopes, entre administración y política: la trayectoria de un dirigente / The history of Luiz Simões Lopes: a leader between administration and politics

Resumo A partir da utilização do método biográfico, este estudo teve por objetivo analisar a origem social, a trajetória, as estratégias de ascensão, os recursos sociais herdados ou adquiridos e os respectivos princípios de legitimação de Luiz Simões Lopes, um dos homens de confiança de Getúlio Vargas incumbido de dirigir o Departamento Administrativo do Serviço Público (Dasp) durante o período do Estado Novo. Seguindo a hipótese que afirma acerca da condição periférica da sociedade brasileira e, consequentemente, da inexistência de estruturas sociais em que o título profissional seja o principal critério de hierarquização de uma sociedade humana, propôs-se aqui explicitar e analisar os condicionantes sociais que levaram Luiz Simões Lopes à condição e ao reconhecimento enquanto elite dirigente responsável pela importação de modelos e princípios da administração científica norte-americana. Assim concluiu-se que, em função das bases de dominação pessoal já existentes, os novos recursos racional-formais importados foram redefinidos nas lutas políticas pelo controle do Estado brasileiro.

Resumen A partir del método biográfico, este estudio tiene como objetivo analizar el origen social, la trayectoria, las estrategias de ascenso, los recursos sociales heredados o adquiridos y los respectivos principios de legitimación de Luiz Simões Lopes, uno de los hombres de confianza de Getúlio Vargas en la dirección del Departamento Administrativo del Servicio Público (DASP) durante el Estado Nuevo. Por la hipótesis sobre la condición periférica de la sociedad brasileña y, consecuentemente, la inexistencia de estructuras sociales en que el título profesional sea el principal criterio de jerarquización de una sociedad humana, este estudio se propone explicitar y analizar los condicionantes que llevaron a Luiz Simões Lopes a la condición de elite dirigente responsable de la importación de modelos y principios de la administración científica estadounidense. Se concluyó que, en función de las bases de dominación personal ya existentes, los nuevos recursos racionales-formales importados se redefinieron en las luchas políticas por el control del Estado brasileño.

Abstract This study is based on a biographical methodology and aims to analyze the social origin, history, ascension strategies, and inherited or acquired social resources of Luiz Simões Lopes. The research observes the respective principles of legitimation of Luiz Simões Lopes, a man trusted by Getúlio Vargas in the direction of the Administrative Department of Public Service (Dasp) during the Brazilian period called Estado Novo (New State). Given the hypothesis of a peripheral condition of Brazilian society and, consequently, the absence of social structures in which the professional title is the main criterion of social hierarchy, this article explains the conditions that led Simões Lopes to be part of a ruling elite that imported models and principles from the North American scientific administration. The conclusion is that, due to the existing roots of personal domination in Brazil, the new rational-formal resources were established in the political struggles for Brazilian state control.

Montgomery and its impact on current medical practice - good or bad?

Patient autonomy requires full disclosure prior to a valid consent. The 2015 UK Supreme Court ruling in Montgomery has displaced Bolam on this issue and is inducing a disquieting sense of angst in some medico-legally conscious clinicians. For the time being, the Bolam test still applies for treatment and/or diagnosis claims. The very grossness of the defendant in Montgomery's withholding of information to the patient (remarkably not thought negligent by the lower courts) prompted the judges of the Supreme Court to dispense with the long-standing Bolam test. (The Editor considers the case should have been won using Bolam in any event.) The foreseeable shoulder dystocia that caused catastrophic injury to the claimant's baby would (and should) have been avoided by a planned caesarean section. The claimant's damage award of £5.25 million as a result of the defendant's obstetrician's failure to provide full disclosure seems to have induced clinicians to over-watch their step, at times to a ridiculous extent. On the one hand, many clinicians' anxiety may result in a defensive/protective approach: 'These are the facts, now you choose', thus leaving a sense of hurtful abandonment in patients. Much harm may be done within Medicine if the facts underlying the decision in Montgomery are not properly considered and evaluated.

Medico-legal considerations and operative vaginal delivery.

Women undergo operative vaginal delivery (OVD) as an alternative to caesarean section when complications arise in the second stage of labour. The perinatal mortality associated with OVD is very low, and most of the perinatal morbidity is minor. However, when serious adverse events occur, such as traumatic birth injury, shoulder dystocia, cerebral palsy and perinatal death, there are medico-legal implications. There is also the potential for litigation in relation to maternal pelvic floor injury, which is increased with OVD. Obstetricians performing and supervising OVDs need to be aware of the potential pitfalls and minimise the risk of adverse outcomes. Given that most obstetricians will be involved in adverse birth-related events, it is important that they are aware of the legal processes that may ensue. It is also important when reviewing adverse OVD-related outcomes that association is differentiated from causation. These issues are addressed in the current chapter with attention drawn to the Montgomery ruling, which redefines the legal standards expected in relation to informed consent.

Ruling engines and diffraction gratings before Rowland: the work of Lewis Rutherfurd and William Rogers.

Diffraction gratings are famously associated with Henry Rowland of Johns Hopkins University but there were precursors. Although gratings were first made and used in Europe, reliable machines for ruling gratings were developed in the USA, and two men, Lewis Rutherfurd and William Rogers, tackled the problem before Rowland. Rutherfurd, a wealthy independent astronomer, designed and built the first screw-operated engine for ruling diffraction gratings, the fore-runner of almost all subsequent ruling engines. With it he and his assistant D. C. Chapman ruled many gratings which he generously distributed to practising scientists, thereby materially advancing the science of spectroscopy. Rogers was a Harvard astronomer who developed an interest in the ruling of fine lines on glass that led him to construct a ruling engine with which he investigated the causes of the errors in the rulings he had examined. He continued to seek improvements with a second engine designed for ruling diffraction gratings. He ceased developing this engine when Rowland's excellent gratings began to be available, concentrating instead on related problems to which he could apply the knowledge and skills he had gained, but his investigations assisted Rowland and other later ruling engine builders. This paper brings together what is known about the ruling engines of Rutherfurd and Rogers, their development, the gratings they produced, their quality and the work that was done with them, and assesses and compares their achievements and the impacts of the work of these two men.

A Study of Automatic and Real-Time Table Tennis Fault Serve Detection System.

Calling a table tennis fault serve has never been easy for umpires, since they can only rely on their intuition. This study presents an algorithm that is able to automatically find the positions of the ball and racket in the images captured by high-speed camera. The trajectory of ball toss is analyzed and the result can be used as the objective basis for the umpire to decide if the serve is legal. This algorithm mainly consists of YCbCr color space processing, morphological processing method, circle Hough transform application, separation of moving and static components in an image sequence using the stable principal component pursuit method. The experiment results show that YCbCr color space provides better performance than HSV color space in recognizing the ball color close to skin tone. It is also demonstrated that the positions of the ball and racket can be successfully located by using the methods of color segmentation and stable principal component pursuit. Lastly, it is hoped that this study will provide more useful information regarding how to identify illegal ball toss in tennis ball game using image processing techniques to other researchers.

The UK National DNA Database: Implementation of the Protection of Freedoms Act 2012.

In 2008, the European Court of Human Rights, in S and Marper v the United Kingdom, ruled that a retention regime that permits the indefinite retention of DNA records of both convicted and non-convicted ("innocent") individuals is disproportionate. The court noted that there was inadequate evidence to justify the retention of DNA records of the innocent. Since the Marper ruling, the laws governing the taking, use, and retention of forensic DNA in England and Wales have changed with the enactment of the Protection of Freedoms Act 2012 (PoFA). This Act, put briefly, permits the indefinite retention of DNA profiles of most convicted individuals and temporal retention for some first-time convicted minors and innocent individuals on the National DNA Database (NDNAD). The PoFA regime was implemented in October 2013. This paper examines ten post-implementation reports of the NDNAD Strategy Board (3), the NDNAD Ethics Group (3) and the Office of the Biometrics Commissioner (OBC) (4). Overall, the reports highlight a considerable improvement in the performance of the database, with a current match rate of 63.3%. Further, the new regime has strengthened the genetic privacy protection of UK citizens. The OBC reports detail implementation challenges ranging from technical, legal and procedural issues to sufficient understanding of the requirements of PoFA by police forces. Risks highlighted in these reports include the deletion of some "retainable" profiles, which could potentially lead to future crimes going undetected. A further risk is the illegal retention of some profiles from innocent individuals, which may lead to privacy issues and legal challenges. In conclusion, the PoFA regime appears to be working well, however, critical research is still needed to evaluate its overall efficacy compared to other retention regimes.

Does Modern Research Concerning Chinese Medicine Acupoints Relate to Original Prescriptions? If Not, Why Not?

Objective: Huang Fu Mi's Zhen Jiu Jia Yi Jing (ZJJYJ) is regarded as the earliest text (282 ce) on differential diagnosis and clinical acumoxa therapy in Chinese Medicine. Are contemporary manual acupuncture practices consistent with those reported in the ZJJYJ? The aim of this research was to investigate if modern manual acupuncture uses reported in research are consistent with classical practices reported in the ZJJYJ. Materials and Methods: A database search of human research studies from 1995 to 2016 was performed for all 270 acupoints for all 8 leg/body channels. The clinical foci of these modern publications were compared with acupoint clinical indications documented in the Song Dynasty Chinese edition (1077) of the ZJJYJ and the sole English translation (translated and compiled by Yang and Chace in 1994) of The Systematic Classic of Acupuncture and Moxibustion. Results: Of 2149 articles in English, 63 met the search criteria. These articles predominately reported acupoints on the lower leg, back, chest, and head. Correlations between the acupoints used in modern research and those used in the ZJJYJ were minimal. Clinical indications from the ZJJYJ typically involved symptoms relating to pain, swelling, fever, seizures, hallucinatory states, dysentery, malaria, and tuberculosis, which are now treated pharmacologically. However, one-third of modern studies were functional magnetic resonance imaging (fMRI) investigations of neurophysiologic effects of manual acupuncture on the human brain. Conclusions: While, superficially, the ZJJYJ might seem irrelevant in modern manual acupuncture practices, well-documented physical effects (e.g., pain relief) of manual acupuncture do provide measurable outcomes for use in fMRI research. Therefore, the classical text does provide a guide for future research on influential acupoints on the leg and body channels.