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By examining legal documents, doctrine and experts’ opinions and the ICRC’s position on the matter, the present article demonstrates that child soldiers do not bear the necessary requisites to be legally capable of directly participating in hostilities, as these children lack the intent that must be considered a conditio sine qua non for such acts to be carried out. By demonstrating this, the article shows that all children associated with armed forces or groups must be considered as victims, exploited by the adults that welcome or force them into joining belligerent parties. This conclusion, while not preventing belligerents from seeking a military victory, calls on them to take into account the specific situation of these children as they should be computed as potential collateral damage in targeting operations and treated as victims in need of special care for their rehabilitation when captured. The final sections of the article analyze in detail such consequences for belligerents that capture child soldiers or target forces with children in their ranks.

A1 Effects of enhanced recovery pathways on renal function Charles R. Horres, Mohamed A. Adam, Zhifei Sun, Julie K. Thacker, Timothy J. Miller, Stuart A. Grant A2 Economic outcomes of enhanced recovery after surgery (ERAS) Jeffrey Huang A3 What does eating, drinking and mobilizing after enhanced recovery surgery really mean? Kirstie McPherson, Sanjiv Patel, Su Cheen Ng, Denise Veelo, Bart Geerts, Monty Mythen A4 Intra-operative fluid monitoring practices Su Cheen Ng, Mark Foulger, Tim Collins, Kirstie McPherson, Michael Mythen A5 Development of an integrated perioperative medicine care pathway Mark Edwards, Denny Levett, Tristan Chapman, Imogen Fecher – Jones, Julian Smith, John Knight, Michael Grocott A6 Cardiopulmonary exercise testing for collaborative decision making prior to major hepatobiliary surgery Mark Edwards, Thomas Sharp, Sandy Jack, Tom Armstrong, John Primrose, Michael Grocott, Denny Levett A7 Effect of an enhanced recovery program on length of stay for microvascular breast reconstruction patients Adam B. King, Kye Higdon, Melissa Bellomy, Sandy An, Paul St. Jacques, Jon Wanderer, Matthew McEvoy A8 Addressing readmissions associated with an enhanced recovery pathway for colorectal surgery Anne C. Fabrizio, Michael C. Grant, Deborah Hobson, Jonathan Efron, Susan Gearhart, Bashar Safar, Sandy Fang, Christopher Wu, Elizabeth Wick A9 The Manchester surgical outcomes project: prevalence of pre operative anaemia and peri operative red cell transfusion rates Leanne Darwin, John Moore A10 Preliminary results from a pilot study utilizing ears protocol in living donor nephrectomy Aparna Rege, Jayanth Reddy, William Irish, Ahmad Zaaroura, Elizabeth Flores Vera, Deepak Vikraman, Todd Brennan, Debra Sudan, Kadiyala Ravindra A11 Enhanced recovery after surgery: the role of the pathway coordinator Deborah Watson A12 Hospitalization costs for patients undergoing orthopedic surgery treated with intravenous acetaminophen (IV-APAP) + IV opioids or IV opioids alone for postoperative pain Manasee V. Shah, Brett A. Maiese, Michael T. Eaddy, Orsolya Lunacsek, An Pham, George J. Wan A13 Development of an app for quality improvement in enhanced recovery Kirstie McPherson, Thomas Keen, Monty Mythen A14 A clinical rotation in enhanced recovery pathways and evidence based perioperative medicine for medical students Alexander B Stone, Christopher L. Wu, Elizabeth C. Wick A15 Enhanced recovery after surgery (ERAS) implementation in abdominal based free flap breast reconstruction Rachel A. Anolik, Adam Glener, Thomas J. Hopkins, Scott T. Hollenbeck, Julie K. Marosky Thacker A16 How the implementation of an enhanced recovery after surgery (ERAS) protocol can improve outcomes for patients undergoing cystectomy Tracey Hong, Andrea Bisaillon, Peter Black, Alan So, Associate Professor, Kelly Mayson A17 Use of an app to improve patient engagement with enhanced recovery pathways Kirstie McPherson, Thomas Keen, Monty Mythen A18 Effect of an enhanced recovery after surgery pathway for living donor nephrectomy patients Adam B. King, Rachel Forbes, Brad Koss, Tracy McGrane, Warren S. Sandberg, Jonathan Wanderer, Matthew McEvoy A19 Introduction and implementation of an enhanced recovery program to a general surgery practice in a community hospital Patrick Shanahan, John Rohan, Desiree Chappell, Carrie Chesher A20 “Get fit” for surgery: benefits of a prehabilitation clinic for an enhanced recovery program for colorectal surgical patients Susan VanderBeek, Rebekah Kelly A21 Evaluation of gastrointestinal complications following radical cystectomy using enhanced recovery protocol Siamak Daneshmand, Soroush T. Bazargani, Hamed Ahmadi, Gus Miranda, Jie Cai, Anne K. Schuckman, Hooman Djaladat A22 Impact of a novel diabetic management protocol for carbohydrate loaded patients within an orthopedic ERAS protocol Volz L, Milby J A23 Institution of a patient blood management program to decrease blood transfusions in elective knee and hip arthroplasty Opeyemi Popoola, Tanisha Reid, Luciana Mullan, Mehrdad Rafizadeh, Richard Pitera

The newly mandated eighty hour work week for anesthesia residents demands that they make efficient use of their time to accomplish their educational, clinical, and administrative objectives. We set out to help residents with these tasks by developing a point of care handheld computer (HC) system that gives them access to the hospital network and the Internet through a secure, wireless local area network (WLAN) from most perioperative locations.Different hardware and software platforms were investigated to meet the capability of the specification above. Five anesthesia residents were asked to evaluate the platform selected through a simple ten-question survey.The PocketPC operating system and Dell Axim HC with third party encryption and Web browsing software was the best performing platform. Residents unanimously agreed that the system improved their daily workflow efficiency and compliance with administrative requirements. No electromagnetic interference was noted between the HC or WLAN and medical equipment, cell phones or pagers. One resident saw the Web browsing capability as a potential distraction from patient care.This system appears to be a valuable tool for resident education, although more rigorous study of its effect on resident vigilance and the safety of patient data are needed.

BACKGROUND: Bevacizumab, a monoclonal antibody that targets vascular endothelial growth factor, has been shown in a small series of children with vision loss associated with optic pathway gliomas (OPG) to produce marked vision recovery. METHODS: A single-institution retrospective record review of pediatric patients who had poor visual acuity and received bevacizumab from 2014-2017 was performed at Children’s Hospital Colorado. Data collected included demographics, pathology information, visual acuity exams (Snellen), visual field exams, optical coherence tomography (OCT), and bevacizumab dosing and toxicity. RESULTS: Eighteen patients (10:8, male:female) received bevacizumab for poor visual acuity. The median age of patients at the start of bevacizumab treatment was 5.2 years (range, 1.3-21.5 years). Thirteen patients had OPGs, three patients had craniopharyngioma, and two had other brain tumors with vision loss due to hydrocephalus at diagnosis. Median time from tumor diagnosis to start of bevacizumab was 0.6 years (range, 0.1-12.9 years). Most (11/18) patients (8 OPG, 2 craniopharyngioma, 1 glioneuronal tumor) experienced improvement (i.e., LogMAR decrease >0.1) in visual acuity in at least one eye. Bevacizumab (median of 13 doses and range of 4-20 doses administered per patient) was tolerated well overall. Seven patients experienced transient toxicities (including proteinuria, hypertension, and headaches). OCT analysis is ongoing. CONCLUSIONS: Bevacizumab appears to improve visual acuity in some children with vision loss associated with injury to the optic apparatus from tumor or hydrocephalus. A clinical trial to investigate the use of bevacizumab for vision recovery in pediatric brain tumor patients is warranted.

Social learning theory posits that one crucial way individuals learn how to behave is by observing and modeling the behavior of salient others. We conducted a short-term longitudinal study using multisource data on 183 teenaged ice hockey players (M age=13.39 years) in 16 hockey teams to test the effects of 3 potentially salient leadership influences (team coaches, team players, and parents) on players' on-ice aggression. We tested a cross-level mediated model in which player aggression (penalty minutes) as measured by referees was the criterion variable. After controlling for prior levels of player aggression, team-level aggression mediated the relationship between team-level coach transformational leadership and player aggression. Parents' transformational leadership did not influence player aggression when assessed simultaneously with team-level coach transformational leadership. Consistent with social learning theory, the findings suggest that transformational leaders model prosocial behavior for followers.

We discuss the feasibility of seeing a Higgs boson which decays to four partons through a pair of (pseudo-)scalars at the LHC. We restrict our search to Higgs bosons produced in association with a W/Z boson at high transverse momentum. We argue that subjet analysis techniques are a good discriminant between such events and W/Z plus jets and top-antitop production. For light scalar masses (below 30 GeV), we find evidence that a flavor-independent search for such a non-standard Higgs boson is plausible with 100 fb^-1 of data, while a Higgs decaying to heavier scalars is only likely to be visible in models where scalar decays to b quarks dominate., Comment: 6 pages, 4 figures

We discuss the feasibility of seeing a Higgs boson which decays to four bottom quarks through a pair of (pseudo-)scalars at the LHCb experiment to argue that the use of b-physics triggers and off-line vertex reconstruction, as opposed to jet triggers with b tagging, may be more effective for this signal. Focusing on inclusive production for the Higgs, we find that for light scalar masses below 20 GeV, signal reconstruction efficiencies of order a few percent may be enough for LHCb to find evidence for a Higgs with a dominant 4b decay channel., Comment: 6 pages, 2 figures