过敏性反应死亡法医病理学研究

目的探讨过敏性反应死亡的法医病理学特点,从而解决困扰法医学工作者对过敏性反应死后诊断的鉴定要点。方法对华西法医鉴定中心1995―2004年尸检检出的26例药物过敏性死亡案例进行回顾性分析。结果本组26例药物过敏所致死亡案例的死者年龄以31-40岁的例数最多,占了38%;26例因药物过敏所致死亡的案例中,12例为青霉素类药物过敏,为引起过敏最常见的药物;而药物使用途径引起过敏反应死亡的案例中以注射为主,共20例;以个体诊所及基层医院多发生过敏反应死亡的案例;18例在使用药物后出现典型的严重的过敏性反应的临床表现;15例为在用药后半小时内发生死亡;病理解剖可见咽喉粘膜水肿20例,其中咽喉腔阻塞大于75%2例,50￣75%5例,25～50%7例,小于25%6例,显微镜下检查嗜酸性粒细胞浸润咽喉粘膜者21例、肺组织18例;6例血清IgE检测值呈现出显著的升高。结论过敏性反应的死后诊断应结合死者的生前临床病史,死亡时间,生前临床表现,病理解剖发现及血清IgE检测值综合分析。     

过敏性反应死亡法医病理学研究

目的 探讨过敏性反应死亡的法医病理学特点，从而解决困扰法医学工作者对过敏性反应死后诊断的鉴定要点。方法 对华西法医鉴定中心1995--2004年尸检检出的26例药物过敏性死亡案例进行回顾性分析。结果 本组26例药物过敏所致死亡案例的死者年龄以31—40岁的例数最多．占了38％；26例因药物过敏所致死亡的案例中，12例为青霉素类药物过敏，为引起过敏最常见的药物；而药物使用途径引起过敏反应死亡的案例中以注射为主，共20例；以个体诊所及基层医院多发生过敏反应死亡的案例；18例在使用药物后出现典型的严重的过敏性反应的临床表现；15例为在用药后半小时内发生死亡；病理解剖可见咽喉粘膜水肿20例，其中咽喉腔阻塞大于75％2例，50．75％5例，25-50％7例，小于25％6例，显微镜下检查嗜酸性粒细胞浸润咽喉粘膜者21例、肺组织18例；6例血清IgE检测值呈现出显著的升高。结论 过敏性反应的死后诊断应结合死者的生前临床病史，死亡时间，生前临床表现，病理解剖发现及血清IgE检测值综合分析。     

20例海洛因滥用相关死亡案例的法医学分析

目的对20例海洛因滥用相关死亡案例进行回顾性分析,为相关案例的法医学鉴定提供参考依据。方法对20例海洛因相关死亡案例死者的一般情况、毒品使用方式、死亡原因、法医学检验情况进行统计分析,总结案例的死亡原因及法医病理学改变。结果本组案例死者多为青壮年,男性多于女性。组织病理学检验为非特异性改变。死亡原因包括海洛因使用(或泄露)后急性中毒死亡(13例,占65%)、滥用海洛因后继发性疾病(3例,占15%)、吸食海洛因致吸入性窒息(2例,占10%)及戒断综合征导致死亡(2例,占10%)四种。结论海洛因滥用相关死亡者的法医学鉴定,需在全面系统的尸体检验基础上,结合实验室对死者体内海洛因及代谢产物的定性、定量分析,综合案情资料、现场勘验情况进行分析。     

132例自发性脑出血死亡分析

<正> 作者收集了132例自发性脑出血死亡案件资料,并自发性脑出血的死因鉴定,从发病情况、临床表现、临床检验等结合法医病理进行综合分析,可望为脑出血死亡的法医学鉴定和临床确诊提供参考。1 临床资料本组132例中男性87例,女性45例。年龄分布22～86岁,平均年龄59.5岁,其中50～59岁43例,60～69岁65例,70～79岁24例。发病季节多见于1～3月(38例)和10～12月(44例)。发病诱     

新生儿呼吸系统疾病死亡的法医病理学分析

目的分析和探讨呼吸系统疾病引起新生儿死亡的病理学特点,为法医学死亡原因鉴定和相关医疗纠纷鉴定提供科学依据。方法回顾性总结分析1993～2008年16年间攀枝花市公安局尸检档案中85例新生儿死亡案例。结果呼吸系统疾病是引起新生儿死亡的首要因素（共56例,占65.88%）,其中新生儿吸入性肺炎20例（23.53%）、新生儿感染性肺炎14例（16.47%）、新生儿窒息12例（14.12%）、新生儿肺透明膜病6例（7.59%）、新生儿肺出血4例（4.71%）。结论新生儿尸检应重视呼吸系统的检查,根据新生儿发病特点和肺部病理变化明确临床诊断和死亡原因。     

73例儿科医疗损害的法医病理学鉴定

目的通过对73例儿科医疗损害的法医病理学鉴定案例进行分析,探讨法医病理学在解决儿科医疗损害等问题上的重要性。方法收集南京医科大学司法鉴定所2002年1月—2016年8月受理的、死亡年龄在28 d~10岁的儿科医疗损害病理检验案例73例,对死亡原因及与涉案医疗机构的关系进行回顾性分析。结果 73例中,男女性比例1.70∶1,年龄在28 d~1岁的居多,为26例(35.62%),其次是1~3岁,为21例(28.77%)。通过尸体检验确定死亡原因的71例中,死亡原因以疾病为主,其中呼吸系统疾病占首位,为33例(46.48%),其次是心血管系统疾病,为12例(16.90%)。医疗损害涉及医疗机构共75所,三级医疗机构32所(42.67%),其次为二级以下(不包括二级)医疗机构23所(30.67%)。临床诊断与法医病理学诊断相符及基本相符的有38例(52.05%),未明确或者误诊的35例(47.95%)。结论法医学尸体解剖及病理学鉴定有助于确定死亡原因,不仅为儿科医疗损害提供了科学的依据,并且丰富和发展了临床医学知识,可在一定程度上提高诊疗水平。     

主动脉夹层破裂致死20例分析

目的分析主动脉夹层破裂致死的相关特征,以期为主动脉夹层破裂致死案例的法医学鉴定提供参考。方法收集主动脉夹层破裂致死的法医学鉴定案例20例,对死者年龄、性别、临床症状、死亡原因、病理特征、易患危险因素(高血压、冠心病等)、伤病关系等进行统计分析。结果 (1)20例中涉及医疗纠纷有10例,涉及外伤有7例;1例首发症状为典型的胸背部撕裂样疼痛,其余19例均为非典型疼痛;死亡距发病平均时间为11.46±13.84(1.00～51.00)h。(2)心脏重量平均为432.29±61.94(340～540)g,左心室厚度平均为1.39±0.29(1.10～2.50)cm,均大于正常厚度;内膜破口位于主动脉瓣环口上方平均为2.47±1.43(1.0～6.5)cm处,形态多为横行,外膜破口多位于主动脉根部。(3)13例既往有高血压病史,11例存在主动脉粥样硬化。结论非典型痛性主动脉夹层破裂导致死亡更容易引发医疗纠纷,法医鉴定中需详细调查患者生前有无高血压、主动脉粥样硬化、妊娠、先天结缔组织疾病等高危因素,有无腹痛、头晕等不典型症状,进而通过全面系统尸检和病理检验寻找主动脉夹层的客观诊断依据。外伤后主动脉夹层破裂致死的案例,鉴定时应进行伤病关系的评定。     

药物不良事件及其法医学鉴定

目的研究药物不良事件的法医学鉴定原则及注意事项,为此类案件的法医学鉴定提供参考并积累基础资料。方法通过对33例药物不良事件法医学鉴定案件的回顾性分析,总结药物不良事件相关案件的法医学鉴定原则及注意事项。结果药物不良事件的法医学鉴定案件有增长趋势,患者以女性多见(20例,60.6%)。33例药物不良事件中,以医疗过错鉴定案件多见(21例,63.6%),21例医疗过错鉴定案件中,只有1例(4.8%)与医院过量使用药物有关,其他均未发现医院存在医疗过错;非法行医案8例(24.2%),均与使用药物不当有关。法医鉴定类型以活体鉴定为主(27例,81.8%),死亡案件6例(18.2%)。结论药物不良事件的法医学鉴定案例在不断增加并具有自身特点和复杂性,应引起鉴定人的重视。     

创伤性骨关节炎法医学鉴定41例分析

目的探讨创伤性骨关节炎的法医学鉴定要点。方法总结苏州同济司法鉴定所2006~2010年受理的41例创伤性骨关节炎法医临床学鉴定案例,对被鉴定人的性别、年龄、致伤方式、损伤部位、损伤形态、影像学表现、治疗方式、创伤性骨关节炎确诊的时间间隔等资料进行回顾性统计、分析。结果法医学检验检见生理结构破坏合并功能障碍7例,功能障碍30例,生理结构与功能检查均未见明显异常9例,另2例临床于外伤后短时间内即诊断为创伤性骨关节炎的,法医学鉴定时未予认定。创伤性骨关节炎影像学表现的严重程度与疼痛、功能障碍等临床表现并没有显著的相关性。结论创伤性骨关节炎作为骨折后常见的并发症之一,好发于负重关节,发生的间隔时间不一,其临床表现严重程度较影像学表现对法医学鉴定意见的意义更大。     

38例单纯型脑干损伤法医学尸检的回顾性研究

目的报道38例原发性单纯型脑干损伤致死案例法医学尸检所见的脑干损伤、致伤方式和致伤物等特点,并探讨在法医学鉴定中的意义。方法从208例脑干损伤死亡法医学尸检案例中,挑选出38例符合单纯型脑干损伤的案例,分析单纯型脑干损伤发生的案情、损伤的部位和类型等特点。结果38例中男性占绝大多数,农民明显多于其它人员;大多发生于纠纷斗殴中;头部拳击伤18例(47.4%);头皮挫伤19例(50.0%);头皮挫裂创9例(23.7%);未见头皮损伤7例(18.4%);受伤当时昏迷并很快死亡者34例(89.5%);其损伤为局灶性挫伤出血,有32例(84.2%)肉眼未能辨认出,镜检见小灶性出血:其中,桥脑18例(47.4%)、延脑10例(26.3%)、中脑4例(10.5%)、桥脑和延脑均有出血6例(15.8%)。结论原发性单纯型脑干损伤不仅存在,而且能致人死亡;应引起同行的重视。     

Bhartṛhari and Maṇḍana on Avidyā

The concept of avidyā is one of the central categories in the Advaita of Śaṇkara and Maṇḍana. Shifting the focus from māyā, interpreted either as illusion or as the divine power, this concept brings ignorance to the forefront in describing duality and bondage. Although all Advaitins accept avidyā as a category, its scope and nature is interpreted in multiple ways. Key elements in Maṇḍana’s philosophy include the plurality of avidyā, individual selves as its substrate and the Brahman as its field (viṣaya), and the distinction in avidyā between non-apprehension and misapprehension. A closer investigation shows that Maṇḍana is directly influenced by Bhartṛhari’s linguistic non-dualism in developing the concept of avidyā. This study also compares other key constituents such as vivartta and pariṇāma that are relevant to the analysis of avidyā. As the concept of counter-image (pratibimba) emerges as a distinct stream of Advaita subsequent to Maṇḍana, this study also compares the application of pratibimba in the writings of Bhartṛhari and Maṇḍana.     

Unraveling the <Emphasis Type="Italic">Kāvyaprakāśa</Emphasis>: Jayadeva Pīyūṣavarṣa’s idiosyncratic sequence of topics in the <Emphasis Type="Italic">Candrāloka</Emphasis>

In his twelfth century alaṃkāraśāstra, the Candrāloka, Jayadeva Pīyūṣavarṣa reverses the sequence of topics found in Mammaṭa’s Kāvyapr-akāśa, an earlier and immensely popular work. With such a structural revisionism, Jayadeva asserts the autonomy of his own work and puts forth an ambitious critique of earlier approaches to literary analysis. Jayadeva investigates the technical and aesthetic components of poetry in the first part of the Candrāloka, prior to his formal semantic investigations in the latter half of the text, thus suggesting that aesthetic evaluations of poetry beneficially inform scientific investigations of language. Jayadeva’s organization of his chapters on the semantic operations, moreover, intimates that the study of suggestive and metaphoric functions of language clarifies our understanding of denotation, which is conventionally understood to be the primary and direct path of verbal designation.     

Immigration,intermarriage and the changing face of Europe in the post war period

In this article we compare the propensity to intermarry of various migrant groups and their children who settled in Germany, France, England, Belgium and the Netherlands in the post-war period, using a wide range of available statistical data. We try to explain different intermarriage patterns within the framework of Alba and Nee's assimilation theory and pay special attention to the role of religion, colour and colonial background. We therefore compare colonial with non colonial migrants and within these categories between groups with ‘European’ (Christian) and non-European (Islam, Hinduism) religions. First of all, religion appears to be an important variable. Migrants whose faith has no tradition in Western Europe intermarry at a much lower rate than those whose religious backgrounds correspond with those that are common in the country of settlement. The rate of ethnic endogamous marriages in Western Europe are highest in Hindu and Muslim communities, often regardless if they came as guest workers or colonial migrants. Whereas differences in religion diminish the propensity to intermarry, colour or ‘racial’ differences on the other hand seem to be less important. This is largely explained by the pre-migration socialisation. Furthermore, the paper argues that the attention to institutions, as rightly advocated by Richard Alba and Victor Nee, needs a more refined and layered elaboration. Institutions, often as barriers to intermarriage, do not only emanate from the receiving society, but also—be it less formalized—within migrant communities. Especially religions and family systems, but also organized nationalist feelings, can have a profound influence on how migrants think about endogamy. Finally, strong pressures to assimilate, often through institutionalized forms of discrimination and stigmatization, not only produce isolation and frustrate assimilation (with resulting low intermarriage rates), but can also stimulate assimilation by 'passing' mechanisms. These factors, together with a more comparative perspective, are not completely ignored in the new assimilation theory, but—as this study of Western European intermarriage patterns stresses—deserve to be included more systematically in historical and social scientist analyses.     

The Supreme Array Scripture: A New Interpretation of the Title “Gaṇḍavyūha-sūtra”

This article argues for a new interpretation of the Sanskrit compound gaṇḍa-vyūha as it is used in the common title of the Mahāyāna text the Gaṇḍavyūha-Sūtra.The author begins by providing a brief history of the sūtra’s appellations in Chinese and Tibetan sources. Next, the meanings of gaṇḍa (the problematic member of the compound) are explored. The author proposes that contemporary scholars have overlooked a meaning of gaṇḍa occurring in some compounds, wherein gaṇḍa can mean simply “great,” “big” or “massive.” This general sense is particularly common in the compound gaṇda-śaila (a “massive rock” or “boulder”) and is found in such texts as the Bhāgavata Purāṇa, the Harivaṃśa and the Harṣacarita. Following the discussion of Gaṇḍa, the author examines the term vyūha (“array”) as it is used in the Gaṇḍavyūha-sūtra. The article concludes with the suggestion that a more appropriate translation of the Gaṇḍavyūha-sūtra would be “The Supreme array Scripture.”     

Evaluation of six presumptive tests for blood, their specificity, sensitivity, and effect on high molecular-weight DNA

Luminol, leuchomalachite green, phenolphthalein, Hemastix, Hemident, and Bluestar are all used as presumptive tests for blood. In this study, the tests were subjected to dilute blood (from 1:10,000 to 1:10,000,000), many common household substance, and chemicals. Samples were tested for DNA to determine whether the presumptive tests damaged or destroyed DNA. The DNA loci tested were D2S1338 and D19S433. Leuchomalachite green had a sensitivity of 1:10,000, while the remaining tests were able to detect blood to a dilution of 1:100,000. Substances tested include saliva, semen, potato, tomato, tomato sauce, tomato sauce with meat, red onion, red kidney bean, horseradish, 0.1 M ascorbic acid, 5% bleach, 10% cupric sulfate, 10% ferric sulfate, and 10% nickel chloride. Of all the substances tested, not one of the household items reacted with every test; however, the chemicals did. DNA was recovered and amplified from luminol, phenolphthalein, Hemastix, and Bluestar, but not from leuchomalachite green or Hemident.     

Illumination,Imagination, Creativity: Rājaśekhara,Kuntaka, and Jagannātha on <Emphasis Type="Italic">Pratibhā</Emphasis>

Sanskrit poeticians make the visionary faculty of pratibhā a necessary part of the professional poet’s make-up. The term has a pre-history in Bhartṛhari’s linguistic metaphysics, where it is used to explain the unitary perception of meaning. This essay examines the relation between pratibhā and possible theories of the imagination, with a focus on three unusual theoreticians—Rājaśekhara, Kuntaka, and Jagannātha Paṇḍita. Rājaśekhara offers an analysis of pratibhā that is heavily interactive, requiring the discerning presence of the bhāvaka listener or critic; he also positions pratibhā in relation to Bildung (vyutpatti) and practice. For Kuntaka, pratibhā, never an ex nihilo creation by a poet, serves as the basis for the peculiar forms of intensified insight and experience that constitute poetry; these may also involve the creative scrambling and re-articulation of the object in terms of its systemic composition. At times, Kuntaka’s pratibhā comes close to a strong notion of imaginative process. But the full-fledged thematization of the imagination, and of pratibhā as its support and mechanism, is best seen in the seventeenth-century debates preserved for us by Jagannātha. A link is suggested between the discourse of poetic imagination in Jagannātha and similar themes that turn up in Indo-Persian poets such as Bedil.     

Preventing Homelessness for System‐Involved Youth

Too many youth and young adults find themselves on the streets, couch‐surfing with friends, in emergency shelters or worse, after exiting the child welfare and juvenile justice systems. In some circumstances, youth have had court hearings until their exit from the legal system, but those hearings have not focused on long‐range plans of youth and emergencies youth may encounter. In other circumstances, there has been little or no planning prior to discharge, especially for young people who leave the juvenile justice system. Courts can and should prevent, alleviate or end youth homelessness for youth who appear before them through strategies that are enumerated in the recently‐passed NCJFCJ resolution. This article expounds on three of these strategies – coordinating transition and re‐entry plans, insisting on effective legal representation of youth, and utilizing sound judicial leadership. It also describes the concurrent efforts of the Coalition for Juvenile Justice and the American Bar Association's Homeless Youth Legal Network to remove legal barriers and improve outcomes for youth and young adults experiencing homelessness.     

Best practices for structuring a family court parenting plan evaluation under the 2022 AFCC Guidelines

Evaluation appointment orders provide enforceable scaffolding for conduct of family court parenting plan evaluations, and use of the evaluator's reports, feedback, file, and testimony. Unlike a contract, a stipulated or adjudicated appointment order is directly enforceable by the family court. It unambiguously positions the evaluator as the family court's appointee – answerable directly to the court and, in some jurisdictions, protected by quasi-judicial immunity from damages claims. A well-crafted appointment order governs the roles and expectations of the court, the evaluator, the parties, the lawyers, and the collateral witnesses. An appointment order mandates the legal duties, rights, powers, and responsibilities of the professionals, the parties, and the collateral witnesses. At minimum, an appointment order articulates the legal basis for the appointment, the purpose and scope of the evaluation, compensation of evaluator, and the duty of the parties to participate in the process. A written evaluation protocol or procedures statement discloses in advance the methods of investigation and assessment that the evaluator intends to use. Together, the appointment order and written protocol help the evaluator, lawyers, parents, and judge manage the complexity of the evaluation process.     

Monks Who Have Sex: Pārājika Penance in Indian Buddhist Monasticisms

In the study of Buddhism it is commonly accepted that a monk or nun who commits a pārājika offence is permanently and irrevocably expelled from the Buddhist monastic order. This view is based primarily on readings of the Pāli Vinaya. With the exception of the Pāli Vinaya, however, all other extant Buddhist monastic law codes (Dharmaguptaka, Mahāsāṅghika, Mahīśāsaka, Sarvāstivāda and Mūlasarvāstivāda) contain detailed provisions for monks and nuns who commit pārājikas but nevertheless wish to remain within the saṅgha. These monastics are not expelled. Rather, they are granted a special status known as the śikṣādattaka. In this paper I explore the rules. concerning pārājika penance and the śikṣādattaka with specific regard to monastic celibacy. Given that five out of six extant law codes recognise this remarkable accommodation to the rule of celibacy, I argue that we must look to Vinayas other than the Pāli Vinaya if we are to arrive at a nuanced and representative view of Indian Buddhist monasticism.

Grant me chastity and continence, but not yet. Augustine of Hippo (354–430 C.E.)

     

What similes in Sāṃkhya do: a comparison of the similes in the Sāṃkhya texts in the Mahābhārata, the Sāṃkhyakārikā and the Sāṃkhyasūtra

In Sāṃkhya similes are an important means to communicate basic philosophical teachings. In the texts similes are frequently used, especially in the Sāṃkhya passages in the Mahābhārata, in the Sāṃkhyakārikā and in the Sāṃkhyasūtra. This paper compares the similes in these three texts and analyses changes in the philosophy as revealed in the similes. A comparison of the similes of Sāṃkhya texts produced over more than one thousand years reveals changes in the emphasis in this philosophical system. The purpose of the similes in the Sāṃkhya passages of the Mahābhārata is to produce an intuitive understanding of the separateness of puruṣa and prakṛti. The similes are designed to lead the listener to understand this basic dualism. In the Sāṃkhyakārikā the most difficult issues are the relationship between prakṛti and puruṣa and the idea of prakṛti working for the salvation of puruṣa. One whole chapter of the Sāṃkhyasūtra is devoted to similes.