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ObjectiveIn stroke survivors, atrial fibrillation (AF) is typically evaluated solely by short-term ECG monitoring in the stroke unit. Prolonged continuous ECG monitoring or insertable cardiac monitors require substantial resources. Chest and thumb ECG could provide an alternative means of AF detection, which in turn could allow prompt anticoagulation to prevent recurrent stroke. The objective of this study was to assess the yield of newly diagnosed AF during 28 days of chest and thumb ECG monitoring two times per day in cryptogenic stroke.MethodsThis study, Transient ECG Assessment in Stroke Evaluation, included patients who had a stroke from Region Gävleborg, Sweden, between 2017 and 2019. Patients with a recent ischaemic stroke without documented AF (or other reasons for anticoagulation) before or during ECG evaluation in the stroke unit were evaluated using the Coala Heart Monitor connected to a smartphone application for remote monitoring.ResultsThe prespecified number of 100 patients (mean age 67.6±10.8 years; 60% men) was analysed. In nine patients (9%, number needed to screen 11) AF but no other significant atrial arrhythmias (>30 s) was diagnosed. The mean CHA2DS2-VASc score was similar among patients with AF and no AF (4.9±1.1 vs 4.3±1.3; p=0.224) and patients with AF were older (74.3±9.0 vs 66.9±10.8; p=0.049). Patients performed on average 90.1%±15.0% of scheduled transmissions.ConclusionIn evaluation of cryptogenic stroke, 9% of patients had AF detected using chest and thumb ECG two times per day during 1 month. In many stroke survivors, this is a feasible approach and they will be potentially protected from recurrent stroke by anticoagulation treatment.Trial registration numberNCT03301662.

Desde la entrada en vigor de la Convención de las Naciones Unidas sobre el Derecho del Mary el Acuerdo relativo a la aplicación de su Parte XI, el 16 de noviembre de 1994, la Autoridad Internacional de los Fondos Marinos se ha ocupado principalmente de la aprobación de los reglamentos para la prospección y exploración de los minerales de la Zona internacional de los fondos marinos - “Código de minería” - y de la concesión de licencias de exploración. Se aproxima el momento en el que den comienzo las primeras actividades de explotación y la incertidumbre en cuanto a su posible impacto ambiental está centrando las negociaciones del nuevo reglamento sobre la explotación de minerales. En este estudio se abordan los principales desafíos que el diseño de la política ambiental de la Autoridad plantea con el fin de garantizar la protección eficaz del medio marino y la explotación sostenible de los recursos de la Zona, considerados patrimonio común de la humanidad.&nbsp

In the new millenium, the scope and limits of the use of force in international relations are still the subject of strong debate. Some legal scholars and state representatives favour an expanded interpretation of the right of self-defence which includes so-called pre-emptive and anticipatory self-defence. The International Court of Justice recently dealt with a dispute involving the use of force, allegedly in self-defence, in the Case Concerning Oil Platforms (Iran v. United States). This article explores the contribution of the judgment to international law on the use of force in self-defence. It discusses two issues: the relationship between self-defence and the protection of essential security interests of states, and the Court’s analysis of the conditions for self-defence. We conclude that the ICJ has largely confirmed its existing jurisprudence in the field and avoided making any explicit, significant new contribution to the notion of self-defence. Nonetheless, we suggest that the Court’s insistence on a narrow interpretation of certain conditions and silence on some controversial arguments advanced by the parties is prudent and more eloquent than words. Sin financiación No data (2005) UEM