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1

Landman, Lennart. "Bjørn Møller, European Security: the Roles of Regional Organisations, Ashgate, 2012, 516 pages, ISBN 978-1-4094-4408-4, price 75 GBP / 130 USD." Security and Human Rights 24, no. 2 (2013): 219–21. http://dx.doi.org/10.1163/18750230-02402002.

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2

S. Sarhan, Mugahed, Mohd Irwan Syazli Saidin, and Zarina Othman. "The Religious-Political Ideology of Houthis’ Rebellion in Yemen: Theoretical Perspective of the Divine Right to Rule." Islamiyyat 44, no. 1 (June 1, 2022): 231–40. http://dx.doi.org/10.17576/islamiyyat-2022-4401-20.

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Анотація:
This article examines the religious-political ideology of the Houthi movement in Yemen. In particular, it explores the political objectives and historical roots of the Houthis’ rebellion that was initiated in 2004 and continued into 2009 through six rounds of wars, which were called Sa’dah wars. The Houthis implemented a military coup in 2014 against Mansour Hadi’s government and seized state institutions which led to Yemen’s current civil war. A catastrophic battle also erupted when the Saudi-led military coalition decided to intervene in the conflict in 2015, with the aim of restoring the legitimacy of the previous regime as well as defeating the Houthis insurgency. Despite numerous studies on the issues relating to civil war in Yemen, there is no adequate study on the perspective of Houthis’ religious-political ideology. This research is qualitative using in-depth interviews with seven experts and observers of the Yemeni war. This article analyses major reasons for the historical rebellion and the ongoing catastrophic war in Yemen, based on the Houthis’ religious-political ideology. The findings of this article inform that the current conflict in Yemen is rooted in historical circumstances which gave rise to a heavy responsibility or burden on the Houthis, whereby according to the theory of the divine right to rule, the Houthis and their ancestors, the Hashemites claim the monopoly of regional (present day Yemen) power. Thus, this theory has been considered as one of the key dynamics of the outbreak and the continuation of the current war in Yemen. It is very likely that the trend of increased Houthis’ rebellion will continue for the next few years in Yemen due to the movement’s firm aim of power struggle, based on their religious-political ideology of the ‘divine right to rule’.
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3

Malamud, Andrés. "Sebastián Mazzuca: Latecomer State Formation. Political Geography and Capacity Failure in Latin America. New Haven & London: Yale University Press, 2021, 448 pp." Araucaria, no. 49 (2022): 592–619. http://dx.doi.org/10.12795/araucaria.2022.i49.29.

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4

Fuhrmann, Matthew. "Being Nuclear: Africans and the Global Uranium Trade. By Gabrielle Hecht. Cambridge, MA: MIT Press, 2012. 440p. $29.95." Perspectives on Politics 11, no. 3 (September 2013): 995–96. http://dx.doi.org/10.1017/s1537592713001953.

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5

Milly, Deborah J. "Environmental Politics in Japan: Networks of Power and Protest. By Jeffrey Broadbent. Cambridge: Cambridge University Press, 1998. 440p. $64.95 cloth, $22.95 paper." American Political Science Review 94, no. 4 (December 2000): 960. http://dx.doi.org/10.2307/2586256.

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6

Turner, Lowell. "The Challenge of Restructuring: North American Labor Movements Respond. Edited by Jane Jenson and Rianne Mahon. Philadelphia: Temple University Press, 1993. 440p. $49.95." American Political Science Review 87, no. 4 (December 1993): 1042–43. http://dx.doi.org/10.2307/2938866.

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7

Yadav, Vineeta. "When Crime Pays: Money and Muscle in Indian Politics. By Milan Vaishnav. New Haven: Yale University Press, 2017. 440p. $40.00 cloth." Perspectives on Politics 16, no. 3 (August 21, 2018): 869–71. http://dx.doi.org/10.1017/s1537592718000622.

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8

Çıdam, Çiğdem. "The Cambridge Companion to Civil Disobedience. Edited by William E. Scheuerman. Cambridge: Cambridge University Press, 2021. 440p. $99.99 cloth, $29.29 paper." Perspectives on Politics 20, no. 4 (December 2022): 1435–37. http://dx.doi.org/10.1017/s1537592722002250.

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9

Thaxton, Ralph A. "Social Suffering and Political Confession: Suku in Modern China. SUN FEIYU . Singapore: World Scientific, 2013. xix + 197 pp. £58.00. ISBN 978-981-4407-29-8." China Quarterly 218 (June 2014): 578–80. http://dx.doi.org/10.1017/s0305741014000563.

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10

San Narciso Martin, David. "La niebla constitucional de la corona. Las ceremonias políticas de la monarquía en la construcción del Estado-nación español (1808-1868)." Historia y Política: Ideas, Procesos y Movimientos Sociales, no. 44 (November 19, 2020): 219–49. http://dx.doi.org/10.18042/hp.44.08.

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Анотація:
El liberalismo español concedió mucha importancia a la ritualidad política. Era necesario representar públicamente sus principios, sus valores constitutivos y su orden sociopolítico, condensándolo en un sistema simbólico complejo. En una época dominada por las formas de gobierno monárquicas, este proyecto ritual liberal se elaboró en diálogo con las ceremonias monárquicas, integradas en una longeva tradición cultural. Esto hizo que se produjera un continuo trasvase entre ambas formas rituales y sus significados políticos. Este artículo analiza los intentos por conciliar simbólica y ritualmente los dos principales sujetos soberanos del siglo XIX –la monarquía y la nación– mediante las ceremonias políticas que llevaba a la Corona a la sede de la representación nacional: la apertura/clausura de Cortes y la jura de la Constitución. El proceso no fue monolítico, sino que sufrió intensos cambios en función a los contextos y el reparto de papeles. Entre 1808 y 1837 se sucederán en España tres modelos ceremoniales asociados a tres sistemas políticos, enfatizando el complejo proceso de adaptación de la monarquía al liberalismo. Establecido el modelo definitivamente en 1837, comenzó entonces un intenso combate por sus usos y significados. Estos rituales llevaron a los gobiernos a instrumentalizar a la Corona, haciéndola descender al combate político alejado de aquella reclusión moderadora teorizada. Pero igualmente, se convirtieron en espacios de protesta y discusión pública. Tras estas ceremonias se evidencia la lucha por el control del espacio público y la legitimación política donde los silencios, las aclamaciones y los vítores se erigen en armas políticas.
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11

Ranis, Peter. "The Labor Wars in Córdoba, 1955–1976: Ideology, Work, and Labor Politics in an Argentine Industrial City. By James P. Brennan. Cambridge: Harvard University Press, 1994. 440p. $59.95." American Political Science Review 90, no. 2 (June 1996): 446–47. http://dx.doi.org/10.2307/2082941.

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12

Tillema, Herbert K. "From People's War to People's Rule: Insurgency, Intervention and the Lessons of Vietnam. By Timothy J. Lomperis. Chapel Hill: University of North Carolina Press. 440p. $55.00 cloth, $19.95 paper." American Political Science Review 91, no. 3 (September 1997): 783–84. http://dx.doi.org/10.2307/2952156.

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13

Rincón-Castro, Hernán, Jenny Berthel, and Miguel Gómez. "Balance fiscal estructural y cíclico del gobierno nacional central de Colombia, 1980-200." Ensayos sobre Política Económica, no. 36 (December 2003): 12–62. http://dx.doi.org/10.32468/espe.4401.

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14

Baqueiro, Armando, Alejandro Diaz-de Leon, and Alberto Torres. "¿Temor a la flotación o a la inflación? : la importancia del “traspaso” del tipo de cambio a los precios." Ensayos sobre Política Económica, no. 36 (December 2003): 64–94. http://dx.doi.org/10.32468/espe.4402.

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15

Arango-Arango, Carlos Alberto, and Angela Milena Rojas. "Demanda laboral y reforma comercial en el sector manufacturero colombiano : 1977-1999." Ensayos sobre Política Económica, no. 36 (December 2003): 96–154. http://dx.doi.org/10.32468/espe.4403.

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16

Kibata, Yoichi. "Rieko Karatani, Defining British Citizenship. Empire, Commonwealth and Modern Britain, London/Portland, OR: Frank Cass, 2003, pp. xviii + 228, ISBN 0-7146-5336-5 (hbk), ISBN 0-7146-4428-5 (pbk)." Japanese Journal of Political Science 5, no. 1 (May 2004): 220–22. http://dx.doi.org/10.1017/s146810990424138x.

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17

Bhattacharyya, Urmi. "Book review: Supriya Singh, Commercialization of Hinterland and Dynamics of Class, Caste and Gender in Rural India." Journal of Human Values 26, no. 2 (May 2020): 199–200. http://dx.doi.org/10.1177/0971685820913158.

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Анотація:
Supriya Singh, Commercialization of Hinterland and Dynamics of Class, Caste and Gender in Rural India. Newcastle upon Tyne: Cambridge Scholars Publishing, 2017, 148 pp., £58.99 (Hardbound). ISBN: 978-1-4438-8647-5.
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18

Sarfati, François. "Faut-il être compétent pour pouvoir développer ses compétences ? L’exemple de la sélection à l’entrée en Master 2." Formation emploi, no. 130 (June 10, 2015): 31–48. http://dx.doi.org/10.4000/formationemploi.4402.

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19

Khosa, Dee. "Gender and Police Leadership: An Analysis of Metropolitan Police Departments in South Africa." International Journal of Criminology and Sociology 10 (August 23, 2021): 1333–41. http://dx.doi.org/10.6000/1929-4409.2021.10.153.

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Анотація:
Despite a number of initiatives aimed at improving the representation and progressive of women in the law enforcement. Studies continue to document the persistence of gender inequality within law enforcement agencies all over the world and South Africa is not an exception. This article bring to light gender inequalities in the law enforcement sector where women in leadership ranks remains low. Historically, the police career was male-dominated and females were not allowed to work in the police. Therefore, equal gender representation in the workplace should by now be at an advanced developmental stage in South Africa since the abolition of discrimination rules. The Commission on Employment Equity of South Africa reported that women comprised 44.8% of the economically active population, yet males were still in charge of senior management positions in South African industries including the law enforcement environment. The data was collected from female officers from Metropolitan Police departments in Gauteng province. The findings suggest that culture, stereotypes, economic and socio-political dynamics, and physical fitness were perceived as barriers that hindered the representation of women into senior leadership positions.
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20

Khaparde, M. S., Ashok K. Srivastava, and R. Meganathan. "Successful School Management in India: Case Studies of Navodaya Vidyalayas." Educational Research for Policy and Practice 3, no. 3 (January 2004): 243–65. http://dx.doi.org/10.1007/s10671-005-4418-2.

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21

Jansen, Marc. "Scott B. Smith, Captives of Revolution: The Socialist Revolutionaries and the Bolshevik Dictatorship, 1918-1923 (Pittsburgh: University of Pittsburgh Press, 2011), xix + 380 pp. $45.00 (hb), ISBN 978-0-8229-4403-4." Soviet and Post-Soviet Review 39, no. 1 (2012): 137–38. http://dx.doi.org/10.1163/187633212x624023.

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22

Roper, L. H. "Betty Wood, Slavery in Colonial America, 1619–1776. The African American History Series. Lanham, MD: Rowman and Littlefield2005. xi + 131 pp. ISBN: 0-7425-4418-4 (hbk.); 0-7425-4419-2 (pbk.)." Itinerario 30, no. 2 (July 2006): 210–12. http://dx.doi.org/10.1017/s0165115300014376.

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23

Belk, Russell. "Book Review: Daniel Miller, The Comfort of the Things. Cambridge: Polity, 2008. 302 pp. ISBN 978—0—7456—4403—5 (hbk)." Journal of Consumer Culture 9, no. 2 (June 15, 2009): 297–99. http://dx.doi.org/10.1177/1469540509104856.

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24

Matrosov, Valerii. "Nadirov, I. I. (2021) Dzhakhiliia i islam: ocherk demonologii [Jahiliyya and Islam: Essays on Demonology]. SPb.: Izd-vo RGPU im. A. I. Gertsena. — 440 s., ill." State Religion and Church in Russia and Worldwide 39, no. 4 (2021): 341–47. http://dx.doi.org/10.22394/2073-7203-2021-39-4-341-347.

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25

Legleye, Stéphane, Géraldine Charrance, Nicolas Razafindratsima, Nathalie Bajos, Aline Bohet, and Caroline Moreau. "The Use of a Nonprobability Internet Panel to Monitor Sexual and Reproductive Health in the General Population." Sociological Methods & Research 47, no. 2 (December 27, 2015): 314–48. http://dx.doi.org/10.1177/0049124115621333.

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Анотація:
Background: Reliability of nonprobability online volunteer panels for epidemiological purposes has rarely been studied. Objectives: To assess the quality of a questionnaire on sexual and reproductive health (SRH) administered in a nonprobability Web panel and in a random telephone survey ( n = 8,992; n = 8,437, age 16–49 years). Especially, we were interested in the possible difference in the association of sociodemographic variables and some outcome variables in the two surveys that are in the reliability of analytical epidemiological studies conducted in such panels. Methods: Interventions to increase response rate were used in both surveys (four e-mail reminders, high number of call attempts and callbacks to refusals). Both were calibrated on the census population. Sociodemographic composition, effects of reminders, and prevalence were compared to their telephone counterpart. In addition, the associations of sociodemographic and sexual behaviors were compared in the two samples in multivariate logistic regressions. Results: The online survey had a lower response rate (20.0 percent vs. 44.8 percent) and a more distorted sociodemographic structure although the reminders improved the representativeness as did the analogous interventions on the telephone survey. Prevalences of SRH variables were similar for the common behaviors but higher online for the stigmatized behaviors, depending on gender. Overall, 29 percent of the 63 interactions studied were significant for males and 11 percent for women, although opposite effects of sociodemographic variables were rare (5 percent of the 171 tested for each gender). Conclusion: Nonprobability online panels are to be used with caution to monitor SRH and conduct analytical epidemiological studies, especially among men.
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26

Fawaz, Amine. "Energy and Foliations on Riemann Surfaces." Annals of Global Analysis and Geometry 28, no. 1 (August 2005): 75–89. http://dx.doi.org/10.1007/s10455-005-4405-0.

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27

Perrone, Domenico. "The Rough Laplacian and Harmonicity of Hopf Vector Fields." Annals of Global Analysis and Geometry 28, no. 1 (August 2005): 91–106. http://dx.doi.org/10.1007/s10455-005-4406-z.

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28

Skinner, Daniel. "Ethically Challenged: Private Equity Storms U.S. Health Care. By Laura Katz Olson. Baltimore: Johns Hopkins University Press, 2022. 440p. $34.95 cloth. - Disorder: A History of Reform, Reaction, and Money in American Medicine. By Peter A. Swenson. New Haven: Yale University Press, 2022. 584p. $35.00 cloth." Perspectives on Politics 20, no. 4 (December 2022): 1458–59. http://dx.doi.org/10.1017/s153759272200278x.

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29

Pörhölä, Maili, Kristen Cvancara, Esta Kaal, Kristina Kunttu, Kaja Tampere, and Maria Beatriz Torres. "Bullying in university between peers and by personnel: cultural variation in prevalence, forms, and gender differences in four countries." Social Psychology of Education 23, no. 1 (October 15, 2019): 143–69. http://dx.doi.org/10.1007/s11218-019-09523-4.

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Abstract This study reports results from cross-cultural comparisons of (a) the frequency of university students’ experiences of bullying victimization and perpetration between students, (b) students’ experiences of bullying victimization by university personnel, and (c) the breakdown of victimization by the forms of bullying students have experienced. Gender breakdowns are offered. Survey data were collected from undergraduates in a total of 47 universities, using large sample sizes, similar measures and assessment methods in four countries: Argentina (N = 969), Estonia (N = 1053), Finland (N = 4403), and the United States (N = 2072). The results confirmed previous findings which suggest that a notable number of students experience bullying during university studies by fellow students and/or staff members, and a smaller number of students admit to bully their fellow students. The results add to previous knowledge by demonstrating remarkable cultural differences in the prevalence and forms of bullying and suggesting that bullying at the university level starts to transform similar to bullying in the workplace. The overall rates of bullying victimization and perpetration between students were the highest in Argentina, followed by the USA, Finland, and finally Estonia. However, victimization by university personnel was reported the most in Estonia, followed by Argentina, the USA, and Finland. Gender breakdowns in bullying experiences varied between countries. Verbal forms of bullying were common experiences. The most often reported form in all countries was unjustified criticism, belittling or humiliation related to academic performance. Students in the USA reported the highest frequencies in most forms of victimization. The results are discussed by reflecting on higher education features and comparing cultural characteristics of the countries. Practical implications are provided.
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30

Enthoven, Victor. "James C. Boyajian, Portuguese Trade in Asia under the Habsburgs, 1580–1640. Baltimore and London (The Johns Hopkins University Press) 1993. XVII + 356 pp. ISBN 0-8018-4405-3 and George D. Winius ed., Portugal, the Pathfinder: Journeys from the Medieval towards the Modern World, 1300-ca. 1600. Madison (The Hispanic Seminary of Medieval Studies) 1995. Portuguese Series, No 2, XI + 428 pp. ISBN 1-56954-008-X." Itinerario 20, no. 3 (November 1996): 145–46. http://dx.doi.org/10.1017/s0165115300004022.

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31

Prasad, Sampada. "A Prospective Study of Maternal and Perinatal Outcomes in Eclampsia in a Tertiary Care Centre." Journal of Obstetrics and Gynecological Surgery 3, no. 2 (December 12, 2022): 23–26. http://dx.doi.org/10.52916/jogs224028.

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Анотація:
Background: The term eclampsia is derived from a Greek word, meaning like a flash of lightening. The onset of convulsions in a woman with pre-eclampsia that cannot be attributed to other causes is termed eclampsia. It is a major cause of maternal and fetal mortality and morbidity in our country. The management of eclampsia is still challenging to the obstetrician, requiring the greatest skill, judgement, and patience. Methods and Materials: Our study is an observational and prospective study of 58 cases admitted with eclampsia in Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. The study was extended from January 2020 to December 2021. The inclusion criteria were all the cases of eclampsia (antepartum and postpartum), primigravida and multigravida, duration of gestation>20 weeks. Patients with convulsion during pregnancy or in puerperal period attributed to epilepsy or other causes were excluded from the study. Results: In our study majority of cases (58.6 %) belong to the younger age group /= 37 weeks). 55.2% had antepartum eclampsia, 36.2% postpartum and 8.6% had intrapartum eclampsia. Most common complication observed was need of blood or blood products transfusion (35 %), Hemolysis, Elevated Liver Enzymes Low Platelets (HELLP) syndrome (21%), prolonged Intensive Care Unit (ICU) admission (19%) followed by abruption, Disseminated Intravascular Coagulation (DIC), Acute Kidney Injury (AKI), Posterior Reversible Encephalopathy Syndrome (PRES), hypertensive retinopathy, pulmonary edema. Majority of patients (57%) underwent cesarean section, most common indication being poor bishop’s score with deteriorating maternal condition (54.5%). Out of 58 cases, 84.4% were live births and 15.6% were still born. 63.2% of all live births were small for gestational age, 44.8% had Neonatal Intensive Care Unit (NICU), and 8% had early neonatal death. Conclusion: Early pregnancy registration, good antenatal care and counselling about warning symptoms, early identification of pre-eclampsia and its complications, and timely intervention can reduce the incidence of eclampsia. Early identification of high-risk cases at primary healthcare facilities including severe pre-eclampsia, impending eclampsia and eclampsia and immediate referral to tertiary care centre equipped with multidisciplinary team, ICU and NICU facilities, might reduce fetal morbidities like prematurity, neonatal intensive care unit admission etc. and maternal morbidities like prolonged hospitalisation, AKI, DIC , pulmonary edema, multi organ dysfunction syndrome etc. and mortality.
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32

Smyth, Stuart J., Alan McHughen, Jon Entine, Drew Kershen, Carl Ramage, and Wayne Parrott. "Removing politics from innovations that improve food security." Transgenic Research, May 30, 2021. http://dx.doi.org/10.1007/s11248-021-00261-y.

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AbstractGenetically modified (GM) organisms and crops have been a feature of food production for over 30 years. Despite extensive science-based risk assessment, the public and many politicians remain concerned with the genetic manipulation of crops, particularly food crops. Many governments have addressed public concern through biosafety legislation and regulatory frameworks that identify and regulate risks to ensure human health and environmental safety. These domestic regulatory frameworks align to international scientific risk assessment methodologies on a case-by-case basis. Regulatory agencies in 70 countries around the world have conducted in excess of 4400 risk assessments, all reaching the same conclusion: GM crops and foods that have been assessed provide no greater risk to human health or the environment than non-GM crops and foods. Yet, while the science regarding the safety of GM crops and food appears conclusive and societal benefits have been globally demonstrated, the use of innovative products have only contributed minimal improvements to global food security. Regrettably, politically-motivated regulatory barriers are currently being implemented with the next genomic innovation, genome editing, the implications of which are also discussed in this article. A decade of reduced global food insecurity was witnessed from 2005 to 2015, but regrettably, the figure has subsequently risen. Why is this the case? Reasons have been attributed to climate variability, biotic and abiotic stresses, lack of access to innovative technologies and political interference in decision making processes. This commentary highlights how political interference in the regulatory approval process of GM crops is adversely affecting the adoption of innovative, yield enhancing crop varieties, thereby limiting food security opportunities in food insecure economies.
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33

Tsivatyi, Viacheslav. "INSTITUTIONAL HISTORY, MODERN MODEL AND DEVELOPMENT STRATEGIES OF THE CONSULAR SERVICE OF UKRAINE Book review: Consular Service of Ukraine: Formation and Development / Ed. H.M. Perepelytsia. – К.: Логос, 2018. – 440с. ISBN 978-617-7446-73-5". Foreign Affairs, 2020, 44–49. http://dx.doi.org/10.46493/2663-2675-2020-11-12-4.

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Анотація:
Scientific Intelligence "Consular Service of Ukraine: Formation and Development" is an original, modern and relevant scientific study, which analyzes the international political, international legal, institutional and historical features of the development and implementation of mechanisms to protect the rights of citizens in the consular sphere in a polycentric world XXI century, its effectiveness and priority in the future is clearly defined: "This book is not only about the glorious historical heritage of the Ukrainian consular service, but also about its current representatives - Ukrainian consuls who create this history and pave the future of the Ukrainian state and Ukrainian nation."
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34

"Brian Glyn Williams. Afghanistan Declassified: A Guide to America’s Longest War. Philadelphia: University of Philadelphia Press, 2012. 239 pages, preface, index, and acknowledgments. Cloth US$34.95 ISBN 978-0-8122-4403." Review of Middle East Studies 46, no. 2 (2012): 267–69. http://dx.doi.org/10.1017/s215134810000361x.

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35

Zhen Kao, Bi. "Determinants of Re Bleeding and Mortality in Cirrhotic Patients after Variceal Bleeding." SOJ Complementary and Emergency Medicine 2, no. 2 (2022). http://dx.doi.org/10.53902/sojcem.2022.02.000515.

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Background: Variceal bleeding (VB) is the most serious complication of liver cirrhosis and carries a high mortality rate. Methods: The retrospective analysis on 263 cirrhotic patients with variceal bleeding in Taipei Medical University Shuang Ho hospital from 2012 to 2018. Aim: determine determinants of re-bleeding and mortality. Results: Patients’ characters were median age (56 years), male (73.4%), HCC (28.1%), ascites (53.2%), portal vein thrombosis (PVT, 6.4%), mean MELD score (17.5); mean Child-Tourette-Pugh score (CTP=8.2) and active bleeding at endoscopy (44.8%). Variceal re-bleeding occurred 4.1% at day-five, 11.0% at week-six and 28.1% at year-one. CTP score>7, MELD score>16, bilirubin>30mg/dL, hepatic encephalopathy and HCC predicted early and late re-bleeding. Old age, renal injury, active bleeding, albumin<2.8 g/dL, ascites, bacterial infection and PVT determined early re-bleeding. The mortality after first VB was 3.8%, 14.1% and 25.8% at day-5, week-6 and year-1 respectively. Old age, CTP>7, MELD>16, renal injury, ascites, hepatic encephalopathy, bacterial infection and HCC were determined early and late mortality. Early variceal re-bleeding was associated with early mortality. Use of non-selective beta-blocker or variceal ligation reduced mortality at year-1 (Odds Ratio; OR 0.03 and OR 0.3) and combination therapy reduced early re-bleeding (OR 7.5). Conclusion: Re-bleeding and mortality rate after VB were substantially high in hepatic decompensation, renal injury, presence of HCC, PVT and infection. Early identification of variceal bleeding patients who are at substantially high risk would probably benefit from early trans-jugular intrahepatic portosystemic shunt or liver transplantation.
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36

Wang, Jennifer Miao. "Early Response to COVID-19." Voices in Bioethics 8 (August 2, 2022). http://dx.doi.org/10.52214/vib.v8i.9445.

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Photo by Mika Baumeister on Unsplash INTRODUCTION When the COVID-19 pandemic swept the globe, governments and healthcare systems scrambled to control it. While most of the global public health community agreed that actions against the COVID-19 pandemic needed to be prompt and efficient, there were disagreements on what those actions should be. Some governments opted to adopt a containment strategy while others implemented mitigation measures; each had reasons to support their course of action, whether rooted in governmental structures, scientific findings, beliefs, or ethical and moral values. However, the dramatically different response strategies may have led to disparate results. This divide is furthered when ethical and moral values and cultural norms are added to this equation. In this paper, I will examine China and Korea, two countries that implemented a preventative containment strategy, and the United States of America and the United Kingdom, which adopted mitigation strategies. I will examine the differences in their outcomes and whether there is a “correct” response to pandemics like COVID-19. l. Response in China and Korea After its initial discovery in December 2019, COVID-19 rapidly spread beyond China to surrounding countries, including South Korea, Japan, and Singapore. China implemented swift measures drawing on its experience with the SARS outbreak. Measures included lockdowns, contact tracing, testing all individuals exposed to the virus, and consequently enforcing isolation and quarantine provisions.[1] During the early stages, the public health systems and the national government moved to a “health care to all” system to avoid nationwide spread. The government and all sectors of society were mobilized to track, contain, and adapt to the overall state of the epidemic.[2] COVID-19 continued and spread in China during Lunar New Year celebrations when population movement within the country was at its peak. Thus, Wuhan entered lockdown to control the number of infected people leaving the city to contain the virus;[3] even in areas where there were few to no cases, the general population of China voluntarily abided by measures like those implemented in Wuhan. The measures included wearing masks, social distancing, and following stay-at-home orders. Furthermore, healthcare workers from all over the country volunteered to travel to Hubei, where Wuhan is, and assembled several Fangcang shelter hospitals.[4] Fangcang hospitals were designed based on emergency medical care cabins that were used after two devastating earthquakes in China and served as temporary quarantine housing and hospital facilities.[5] They are mobile, have fast deployment, and can adapt quickly to different environments. At the start of the pandemic, Wuhan converted gymnasiums, convention centers, sports arenas and training centers, factories, and other venues into Fangcang hospitals. Although temporary, these quarantine hospital facilities were equipped with full medical equipment and personnel, allowing for complete medical functions for “treatment, disease monitoring, diagnosis and other clinical tasks.”[6] Teams of psychologists were also assigned to each hospital to provide counseling for patients.[7] Beyond separating those who were infected from the rest of the population and thus having more control over the community spread of the virus, Fangcang hospitals played a vital role in reducing patient density in traditional hospitals and medical centers by expanding treatment capacities.[8] South Korea reported its first COVID-19 case in January 2020, and, within days, the government activated the Central Disaster and Safety Countermeasures Headquarters.[9] Similar to China, South Korea used existing epidemic protocols and implemented the 3Ts strategy, prioritizing testing, tracing, and treatment.[10] High-capacity screening facilities and working with the private sector to ensure an adequate supply of tests made South Korea’s efforts successful.[11] The South Korean government strictly regulated self-isolation and quarantine. Contact tracing efforts used various data sources, “including credit card transactions and closed-circuit television footage.”[12] The government also placed stringent restrictions on travel, beginning with designated entry lines and questionnaires, but expanding to include temperature checks, testing for all travelers at the border, and a mandatory fourteen-day monitored quarantine for anyone entering the country.[13] The majority of the population responded immediately with compliance, with national weekly movement decreasing by 38 percent between February 24, 2020, and March 1, 2020, compared to the corresponding week the previous month. Schools swiftly closed across the nation, and the entire country transitioned to remote learning until the gradual reopening in May and June 2020.[14] There was some discontentment within the population, especially with the South Korean government’s practice of publicly announcing the names of individuals who tested positive.[15] Critics of this practice say it is an infringement of patient privacy and can even be viewed as an invitation to public bullying.[16] However, even with some dissatisfaction with government regulations, a survey of 1,200 South Koreans in September 2020 asking people to agree if they were satisfied with the government’s response showed that the overwhelming majority either agreed or strongly agreed (44.08 percent and 19.75 percent, respectively), and less than 20 percent of the respondents either disagreed or strongly disagreed (11.50 percent and 5.08 percent, respectively).[17] Regulations surrounding isolation and quarantine were strict and applied to those with confirmed cases of COVID-19, anyone who traveled internationally, or individuals suspected to be infected. Individuals were required to use the Self-Quarantine Safety Protection app that tracked location for fourteen days to ensure that quarantine protocols were followed.[18] Case officers monitored the app, and violators not only faced a substantial fine but were also required to wear electronic wristbands that would alert the officers if the individual left the location of their mobile device.[19] ll. The Western Response: The UK and US COVID-19 was reported in many Western nations around January 2020. However, unlike South Korea, many countries did not immediately respond to the outbreak with surveillance and containment strategies but had a wait-and-see approach. As the pandemic worsened, they gradually adopted mitigation strategies to combat the disease as it progressed. While the US adopted a combination of containment and mitigation strategies, a concrete response from state and federal governments did not occur until March 2020.[20] Even then, many states did little to address the pandemic. Although equipped with a robust healthcare system, a shortage of ventilators and hospital beds became evident in some localities early on. The US healthcare system failed to acknowledge the pandemic and prepare a coordinated response in time to stop the momentum of the disease.[21] The goal became “flattening the curve” (keeping the number of cases that needed hospital care low enough to avoid overwhelming the hospital system) as it was clear containment would be impossible. Once tests were developed, poor coordination of testing efforts and insufficient resources to test at the necessary scale to provide comprehensive national surveillance of the disease further hindered efforts to contain infected individuals and decelerate its spread.[22] Eventually, regulations and mitigation measures were implemented, including mask mandates, school closures, caps or bans on in-person gatherings, and the closure of non-essential businesses.[23] However, enforcement of these measures proved difficult, and people instigated protests against many of the recommended policies and requirements. The UK and the US both encountered a shortage of personal protective equipment for healthcare workers.[24] However, a more prominent problem arose from the UK’s initial response to the pandemic. The UK first said COVID-19 was like influenza and therefore did not call for emergency measures to deter its spread.[25] Furthermore, in the first few weeks of the pandemic, the UK government believed herd immunity was the best course of action, stating that most people would have mild symptoms,[26] and the population would become mostly immune to the virus once enough people were infected.[27] In theory, herd immunity was a potentially effective strategy. The public health authorities thought that if the threshold for herd immunity was reached, enough people would have developed protective antibodies against any future infection.[28] However, the risks of COVID-19 were high and the cases “would lead to high rates of hospitalization and need for critical care, straining health service capacity past the breaking point.”[29] Furthermore, while getting COVID-19 would offer some natural immunity against reinfection, reinfection remained a possibility, especially during the early stages of the pandemic when vaccines were unavailable.[30] Later, when vaccines were available, a study showed that an unvaccinated person who contracted the virus was more than twice as likely to become reinfected than a fully vaccinated person.[31] The UK government also expressed concern for “behavioral fatigue.”[32] It claimed that if restrictions were enforced pre-emptively and prematurely, people might become progressively “uncooperative and less vigilant.”[33] Regarding the concern for “behavioral fatigue,” numerous behavioral scientists stated that they were unconvinced that this reason was enough to hold off implementing restrictions. There was a lack of evidence of this phenomenon, and a group of 681 UK behavioral scientists said in an open letter that “[s]uch evidence is necessary if we are to base a high-risk public health strategy on it.”[34] Fortunately, this strategy only remained under consideration for a short period. After rapid increases in confirmed cases and deaths due to COVID-19, the UK government implemented more strict measures, like city lockdown, school closures, and the closure of non-essential businesses.[35] These restrictions took legal effect on March 26th, 2020 – around two weeks after the first proposal of the “herd immunity” strategy.[36] lll. Comparing the Two Approaches The Eastern and Western countries experienced significant outbreaks of COVID-19. However, looking at the mortality rate and new confirmed cases, the differences between the two categories of response to COVID-19 are significant. As of December 31, 2020, the mortality rate per 100,000 population for China and South Korea were 0.3 and 1.8, respectively, and new confirmed cases per day per 100,000 population were 87 and 1,029, respectively. However, the mortality rates per 100,000 in the US and the UK were 107 and 108, respectively, and they had up to 234,133 and 56,029 new confirmed cases every day, respectively.[37] As of July 2022, total deaths in China were 22, 994[38] (population 1.45 billion)[39] and in South Korea 24,794[40] (population 51.36 million)[41] compared to 1,015,093[42] in the US (population 335.03 million)[43] and 182,727[44] in the UK (population 68.62 million).[45] Further differences can be seen in the varying sectors of society, such as healthcare systems and authority models, political structures, and cultural customs among these countries, which in turn affect the response and control strategies.[46] In the US and the UK, rights-based political structures affected the response, making tracking and surveillance more problematic early on. But Western countries did have strict lockdowns and quarantines. China and South Korea maintained a proactive approach by “identifying and managing cases, tracking and isolating close contacts, and strictly restricting or controlling population movement when feasible and appropriate.”[47] In contrast, the UK implemented nationwide lockdowns early on, and the US restrictions varied among states. Both the UK and the US focused on treating the severe cases and those with underlying conditions rather than proactively preventing new cases from developing in the early pandemic.[48] They did shift gears to mass testing schemes and attempts to slow transmission. By the time they implemented cohesive strategies, COVID-19 was widespread. Due to their slow initial responses, they needed to manage an onslaught of cases while trying to prevent transmission. lV. Ethical Implications The “West vs. Rest” culture divide emerges when comparing the COVID-19 response strategies of East Asian countries to those of Western countries. The differences in their strategies further highlight the differences in the prevailing moral values influencing public policy. The preventative stance adopted by many East Asian countries shows a stronger collective identity among citizens. But it also may show more substantial governmental power and less appetite for protest. In contrast, the mostly non-interfering nature of Western governments’ actions shows a reliance on the “autonomous and unanimous responsibility of individuals.”[49] The moral values in the US also may reflect the prioritized position of personal rights and the suspicion of intrusive government policies. Culturally, the populations of South Korea and China are generally more tolerant of personal data-sharing and monitoring, suggesting there is less concern for autonomy or privacy. However, many people in the US and UK would consider the use of location tracking apps and electronic bracelets to be violations of individual autonomy and privacy.[50] Sectors of the Western world also argue that mandating masking or social distancing imposes on individual autonomy and free will. Mask-wearing was an existing practice in East Asian countries, even without mandates or pandemics. Individuals wear masks for common colds and influenza and do not consider a mask requirement an infringement of their autonomy. Furthermore, whether it is due to the authoritarian nature of the government or not, there is a general tendency toward public compliance and accepting government policies in many East Asian countries,[51] and the lack of public dissent played an important part in making combating COVID-19 easier for countries like China and South Korea. The lack of initiative from Western nations arguably violates the bioethical principles of beneficence and nonmaleficence.[52] For example, the promotion of the “herd immunity” strategy from the UK government and consequently the government’s inaction, risked the well-being of its citizens. The government failed to avoid the harm that COVID-19 brought. Similarly, by delaying its response until nearly two months after the initial case was reported, the US also violated the principle of non-maleficence. The success seen in South Korea and China during the early pandemic better exemplifies beneficence and nonmaleficence. The strategy of contact tracing and strict containment saved lives. The consequences of the restrictions varied across the countries as well. Not everyone can afford to self-isolate or quarantine and being required to do so can significantly impact many individuals’ well-being. Furthermore, not everyone’s occupation allows them to work from home and business closures disadvantaged portions of the population disparately. For those who are essential workers, school closures may also burden parents who do not have access to affordable childcare. The stringent restrictions regarding quarantine and self-isolation in East Asian countries also harmed people disparately, raising problems surrounding the principle of justice. However, the speed at which China had COVID-19 contained allowed people there to return to their normal lives quickly. Compared to some Western countries’ waves of lockdown and reinforcement of restrictions, the “zero-COVID” strategy in countries like China showed success, at least during the early stages of the pandemic. The contact tracing and containment was likely financially beneficial. While the pandemic resulted in substantial economic growth downgrades and global recessions, regions like East Asia were estimated to grow by around 0.5 percent. In comparison, the economy in regions like Europe contracted by around 4.7 percent.[53] CONCLUSION China arguably had an advantage in combating COVID-19 since the outbreak was relatively concentrated in one region. This allowed early detection of symptoms and quick containment of the virus. Other countries, like the US, had new cases on both coasts early in the pandemic; thus, containment was more challenging than it was in China. However, the delayed and reluctant response from countries like the US and the UK did not benefit the well-being of their populations and proved to put more stress on their healthcare systems. While mass tracking of people is politically contentious, the promptness of actions many East Asian countries employed at the beginning of COVID-19 seemed to be the more effective course of action that best protected the well-being of their citizens. - [1] Chen, Haiqian, et al. “Response to the COVID-19 Pandemic: Comparison of Strategies in Six Countries.” Frontiers in Public Health, vol. 9, September 30, 2021, pp. 1-11. doi: 10.3389/fpubh.2021.708496. [2] Chen, et al. [3] Chen, et al. [4] Chen, et al. [5] Wang, Ke-Wei, et al. “Fangcang shelter hospitals are a One Health approach for responding to the COVID-19 outbreak in Wuhan, China.” One Health, vol. 10, August 29th, 2020, pp. 1-6. doi: 10.1016/j.onehlt.2020.100167. https://www.sciencedirect.com/science/article/pii/S2352771420302688. [6] Wang. [7] Wang. [8] Wang. [9] Kim, June-Ho, et al. “Emerging COVID-19 Success Story: South Korea Learned the Lesson of MERS.” Our World Data, University of Oxford, March 5, 2021. https://ourworldindata.org/covid-exemplar-south-korea. [10] Chen, Haiqian, et al. [11] Kim, et al. [12] Kim. [13] Kim. [14] Scott, Dylan and Jun Michael Park. “South Korea’s Covid-19 success story started with failure.” Vox, April 19, 2021. https://www.vox.com/22380161/south-korea-covid-19-coronavirus-pandemic-contact-tracing-testing.. [15] Scott and Park. [16] Rich, Timothy S., et al. “What Do South Koreans Think of Their Government’s COVID-19 Response?” The Diplomat, October 7, 2020. https://thediplomat.com/2020/10/what-do-south-koreans-think-of-their-governments-covid-19-response/. [17] Rich, et al. [18] Kim, et al. [19] Kim, et al. [20] Chen, et al. [21] Chen, et al. [22] Chen, et al. [23] Chen, et al. [24] Chen, et al. [25]Chen, et al. [26] Chen, et al. [27] O’Grady, Cathleen. “The U.K. backed off on herd immunity. To beat COVID-19, we’ll ultimately need it.” National Geographics, March 20, 2020. https://www.nationalgeographic.com/science/article/uk-backed-off-on-herd-immunity-to-beat-coronavirus-we-need-it. [28] “Herd immunity and COVID-19: What you need to know.” Mayo Clinic, April 20, 2022. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunity-and-coronavirus/art-20486808?p=1. [29] O’Grady. [30] O’Grady. [31] Mayo Clinic, April 20, 2022. [32] Yong, Ed. “The UK’s Coronavirus ‘Herd Immunity’ Debacle.” The Atlantic, March 16, 2020. https://www.theatlantic.com/health/archive/2020/03/coronavirus-pandemic-herd-immunity-uk-boris-johnson/608065/. [33] Yong. [34] Harvey, Nigel. “Behavioral Fatigue: Real Phenomenon, Naïve Construct or Policy Contrivance?” Frontiers in Psychology, vol. 11, November 6, 2020. doi: 10.3389/fpsyg.2020.589892, quoting a March 16, 2020 open letter to the UK government. [35] Chen, et al. [36]“Timeline of UK coronavirus lockdowns, March 2020 to March 2021.” Institute for Government Analysis. https://www.instituteforgovernment.org.uk/sites/default/files/timeline-lockdown-web.pdf. [37] Chen, et al. [38] “China: WHO Coronavirus Disease (COVID-19) Dashboard.” World Health Organization, 2022, https://covid19.who.int/region/wpro/country/cn. [39] “China Population.” Worldometer, 2022, https://www.worldometers.info/world-population/china-population/. [40] “The Republic of South Korea: WHO Coronavirus Disease (COVID-19) Dashboard.” World Health Organization, 2022, https://covid19.who.int/region/wpro/country/kr. [41] “South Korea Population,” Worldometer, 2022, https://www.worldometers.info/world-population/south-korea-population/. [42] “The United States of America: WHO Coronavirus Disease (COVID-19) Dashboard.” World Health Organization, 2022, https://covid19.who.int/region/amro/country/us. [43] “United States Population,” Worldometer, 2022, https://www.worldometers.info/world-population/us-population/. [44] “The United Kingdom: WHO Coronavirus Disease (COVID-19) Dashboard.” World Health Organization, 2022, https://covid19.who.int/region/euro/country/gb. [45] “U.K. Population,” Worldometer, 2022, https://www.worldometers.info/world-population/uk-population/. [46] Chen, et al. [47] Chen, et al., p 6. [48] Chen, et al. [49] Festing, Marion, Tobias Schumacher and Yong-Yueh Lee. “How Cultural Norms and Values Shape National Responses to the COVID-19 Pandemic.” The London School of Economics and Political Science, April 15, 2021. https://blogs.lse.ac.uk/businessreview/2021/04/15/how-cultural-norms-and-values-shaped-national-responses-to-the-covid-19-pandemic/. [50] Festing, et al. [51] Festing, et al. [52] Beauchamp, Tom L. and James F. Childress. Principles of Biomedical Ethics. (New York: Oxford University Press, 2009). [53] “The Global Economic Outlook During the COVID-19 Pandemic: A Changed World.” The World Bank, June 8, 2020. https://www.worldbank.org/en/news/feature/2020/06/08/the-global-economic-outlook-during-the-covid-19-pandemic-a-changed-world.
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