A rapid screening procedure for drugs and poisons in gastric contents by direct injection-HPLC analysis

A high performance liquid chromatographic method for toxicological drug screening of gastric content has been developed. The samples were diluted (1:3-1:30) in 0.01 N hydrochloric acid and injected into a reverse phase column for separation by gradient elution. Mobile phase consisted of solvent A (acetonitrile/water 90:10, 0.01 M sodium dodecylsulphate, 0.5% v/v glacial acetic acid) and solvent B (water/acetonitrile 90:10, 0.01 M sodium dodecylsulphate, 0.5% v/v glacial acetic acid); the gradient was programmed from 20 to 80% A in 30 min. The flow was kept constant at 1.5 ml/min. Two home-made internal standards, butyrylsalicylic acid and diacetyltubocurarine with retention times of 5.6 and 21.4 min, respectively, were used. Drugs are identified by matching their relative retention times and UV spectra (200-400 nm) with those contained in a home made library of more than 340 reference compounds (9 analgesics, 22 antidepressants, 30 antihistamines, 14 antihypertensives, 21 antirheumatics, 15 beta-blockers, 9 bronchodilators, 10 Ca antagonists, 14 diuretics, 26 neuroleptics, 25 tranquilizers, and other significant xenobiotic compounds). The fluorometric (FLD) emission spectrum (280-700 nm; excitation wavelength, 230 nm) was used as a further identification. At 50mg/l analyte concentrations, the injection of gastric content after dilution (1:3) produced S/N ratios in the range 8-140. The method is simple, rapid, rather inexpensive and proved to be a useful means of investigation if used in combination with GC-MS screening in blood. On the other hand, the system suffers from a relatively limited sensitivity for compounds with a low UV absorption and from interferences due to the presence in the matrix of some highly UV- and FL-responsive compounds (e.g. tryptophan).     

European Banking Union to the Rescue? How Supranational Institutions Influenced Crisis Management in Italy

ABSTRACT

This article examines the management of the recent banking crisis in Italy. In particular, we investigate the changing coalitional dynamics among Italian banks with a view to identifying the conditions under which banks are more likely to share the costs of crisis management. We argue that banks’ preferences are significantly shaped by the institutional context within which they operate. In particular, the establishment of Banking Union in the European Union (EU) significantly weakened the traditional coalitional dynamics among Italian banks by injecting uncertainty about the distributional effects of crisis management policy solutions.     

Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa,Southeast Turkey (2012–2022)

Electric shock injuries (EIs) have high rates of morbidity and mortality in both children and adults. The aim of this study was to examine autopsy cases resulting from EIs and to compare pediatric and adult groups with respect to sociodemographic data, clinical characteristics, location of the incident, electricity entry–exit wound characteristics, current direction, pathological effects of the electric shocks on the body, and cause of death. A total of 8075 autopsies conducted between 2012 and 2022 were retrospectively examined. Şanliurfa is a city in the southeast of Turkey with the highest birth rate in the country. Of 123 cases of death resulting from EIs in Şanliurfa, 58 (47.2%) were children (age < 18 years). In the majority of children (81%), a low-voltage injury resulted from a domestic appliance while the children were playing at home in a rural area. In the vast majority of adults, a high-voltage injury (HVI) resulted from a workplace accident due to working with HVI materials in an area outside the home. The manner of death was accidental in all the electric shock injuries. The electricity entry and exit wounds formed as a result of EIs had similar characteristics in both children and adults, with no significant difference identified. In the province of Şanliurfa, Turkey, which borders Syria and where the main occupation is agricultural activities, there is a need to increase electrical safety precautions within the home, educate parents, and increase electrical safety conditions and worker education in the workplace.     

An unusual case of a triple suicide pact at the time of the COVID-19 pandemic

In December 2020, the World Health Organization (WHO) declared SARS-CoV2 a global pandemic. Home confinement, low social contacts, and fear of virus transmission played a major role as risk factors for suicides during the following period. Suicide pacts, in particular, showed a different pattern. A rare case of a triple suicide pact among members of the same family nucleus is presented. The victims were an elderly, severely ill woman and her adult children (a son and daughter), linked by a morbid relationship. The last time the family was seen alive was 40 days before the discovery. All corpses presented decompositional changes. After a full autopsy, the cause of death was determined to be a lethal intake of morphine for the mother and acute blood loss due to self-stabbing at the neck for the siblings. The younger woman was under the effects of a large amount of heparin. Toxicological analysis was positive for opioids and alcohol in both siblings. Suicide pacts have rarely been described during the COVID-19 pandemic. In the few cases reported, the victims were more often relatives than people in a romantic relationship. The involvement of three people is unusual, as is the use of different suicide methods among the victims. In the presented case, the elderly mother's imminent death from terminal cancer, her concern over dying in a nondomestic environment, and the siblings' fear of being alone likely led to the conception of the suicide pact. Social isolation and economic difficulties also played a contributing role.     

Knowledge of child abuse and neglect in nursing students: Assessment and perspectives

Misdiagnosis of child abuse and neglect can delay early treatment. Some authors have pointed out that nurses can miss child abuse and neglect diagnoses due to a lack of knowledge. It is unclear whether the lack of knowledge is due to students' insufficient preparation in nursing school and/or a deficiency in continuing education. An 18-item questionnaire was administered to final-year nursing students to assess their degree of knowledge on child abuse and neglect and to evaluate if the lack of knowledge was due to insufficient teaching/training during nursing school. The students were also asked to evaluate themselves by assigning a score to their knowledge. A statistical comparison was performed to define whether sufficient/insufficient results were associated with the following variables: sex, pediatric or general nursing student, attending pediatric lectures, training in pediatric wards/ambulatories, and attending specific lectures on child abuse and neglect. The study population comprised 175 students (154 females, 20 males, 1 unknown). Exactly 66.3% of the participants had ≤9/18 correct answers. Of all students, 77.7% self-evaluated their level of knowledge as ≤5/10. The comparisons yielded statistically significant differences between the groups with sufficient objective knowledge and those unrelated to training in pediatric wards/ambulatories or pediatric nursing students. Overall, there was little objective knowledge on the subject, which may be related to insufficient teaching/training in nursing schools. Useful corrective strategies include further teaching on child abuse and neglect, preferably using a practical approach. Further, common teaching/training programs should be conducted by both pediatric and general nursing schools.     

A systematic approach to improve downstream single-cell analysis for the DEPArray™ technology

Most commercially available STR amplification kits have never been fully validated for low template DNA analysis, highlighting the need for testing different PCR kits and conditions for improving single-cell profiling. Here, current strategies rely mainly on adjusting PCR cycle number and analytical threshold settings, with a strong preference for using 30 amplification cycles and thresholds at 30–150 RFU for allele detection. This study aimed to (1) determine appropriate conditions for obtaining informative profiles utilizing a dilution series, and (2) test the outcome on single cells using the DEPArray™ technology. Four routinely applied forensic STR kits were compared by using three different amplification volumes and DNA dilutions down to 3.0 pg, while two well-performing kits were used for single/pooled leucocyte and sperm cell genotyping. Besides reduced costs, the results demonstrate that a 50%–75% PCR volume reduction was beneficial for peak height evaluation. However, this was counteracted by an increased artifact generation in diluted DNA volumes. Regarding profile completeness, the advantage of volume reduction was only prominent in samples processed with Fusion 6C. For single and pooled cells, ESIFast and NGMDetect provided a solid basis for consensus profiling regarding locus failure, although locus dropouts were generally observed as stochastic events. Amplification volume of 12.5 μL was confirmed as appropriate in terms of peak heights and stutter frequencies, with increased stutter peaks being the main artifact in single-cell profiles. Limitations associated with these analyses are discussed, providing a solid foundation for further studies on low template DNA.     

A Case of Lethal Idiopathic Plasmacytic Lymphadenopathy with Polyclonal Hypergammaglobulinemia: A Medical Challenge for the Forensic Pathologist

A rare case of lethal idiopathic plasmacytic lymphadenopathy (IPL) with polyclonal hyperimmunoglobulinemia with chronic renal failure is described. A 40‐year‐old woman who had suffered from upper airways disease was admitted to the Emergency Room with acute renal failure and hypergammaglobulinemia. She developed pericardial effusion, a pruritic rash, splenomegaly and fell into a coma after 6 days. Multiple myeloma, infection, collagenopathy, and coagulopathy were ruled out. Finally, a form of malignant hypergammapathy was suspected. At autopsy, lymph nodes were infiltrated by polyclonal plasma cells and lymphocytes, with erythrophagocytosis features; immunohistochemistry confirmed the plasma cells (CD138+), with a prevalence of kappa‐positive cells, B (CD20+) and T (CD3+) cells. Kidneys showed advanced glomerulosclerosis containing similar infiltrates. The cause of death was IPL with polyclonal hypergammaglobulinemia and advanced renal failure. Similar cases are unusual, and possible medical liability associated with failure to diagnose and treat idiopathic plasmacytic lymphadenopathy deserves discussion and further studies.     

Relationships,learning, and trust: lessons from the SNV–RECOFTC partnership

The term ‘partnership’ has become a watch-word for development organisations that aim to mobilise the resources and collaboration needed to achieve long-term goals such as poverty reduction and sustainable resource management. Achieving effective collaboration in practice, however, can be challenging. This article adds to recent discussions on what makes effective partnerships, offering lessons from an on-going partnership between RECOFTC (Regional Community Forestry Training Center for Asia and the Pacific) and SNV (Netherlands Development Organisation). Key findings include the observation that the role of individuals in maintaining partnerships often goes unrecognised and needs to be supported in appropriate ways; clearly defined and focused areas of collaboration are essential; a formal basis for the partnership needs to be backed with strong informal communication and collaboration processes; and, while partners bring distinctive knowledge and networks to a partnership, some degree of evenness in the scale and type of resources committed to the partnership is important.     

Offender as Forager? A Direct Test of the Boost Account of Victimization

Recent research has demonstrated that burglary clusters in space and time, resulting in temporal changes in crime hotspot patterns. Offender foraging behavior would yield the observed pattern. The offender as forager hypothesis is tested by analyzing patterns in two types of acquisitive crime, burglary and theft from motor vehicle (TFMV). Using a technique developed to detect disease contagion confirms that both crime types cluster in space and time as predicted, but that the space–time clustering of burglary is generally independent of that for TFMV. Police detections indicate that crimes of the same type occurring closest to each other in space and time are those most likely to be cleared to the same offender(s), as predicted. The implications of the findings for crime forecasting and crime linkage are discussed.