Post-mortem stability and redistribution of carbohydrate-deficient transferrin (CDT)

Post-mortem diagnosis of chronic alcohol abuse is a challenge for forensic experts due to the lack of pathognomonic morphological findings and often also inadequate background information. Objective methods demonstrating chronic excessive alcohol consumption would therefore be a useful tool for forensic pathologists. In clinical practice, several markers of chronic alcohol abuse have recently been introduced, among which carbohydrate-deficient transferrin (CDT) is the most accepted, but the use of these markers in autopsy has not yet been established. We examined post-mortem stability and possible post-mortem redistribution of CDT and compared two analytical methods, capillary zone electrophoresis and high-performance liquid chromatography. According to our results, CDT remains stable for an appreciable time after death. The results further indicate that CDT is not subject to major post-mortem redistribution.     

Vitreous humor carbohydrate-deficient transferrin concentrations in the postmortem diagnosis of alcoholism

Deaths from the effects of alcohol intoxication are encountered routinely in forensic practice. In an important number of cases difficulty may arise in interpreting the significance of results obtained in the autopsy. In clinical practice biochemical markers, particularly serum gamma-glutamyl-transpeptidase (GGT), alanine aminotransferase (ALT), aspartate transaminase (AST), carbohydrate-deficient transferrin (CDT), and erythrocyte mean corpuscular volume are used to diagnose heavy alcohol consumption. CDT is used as a reliable and specific marker. In postmortem diagnosis, because of the difficulty in interpreting blood alcohol levels and relatively non-specific pathological features, biochemical compounds have been studied for use as possible markers. The aim of this study was to evaluate the usefulness of the postmortem determination of CDT in vitreous humor as a confirmation of antemortem alcoholism. CDT levels were studied in 66 male cadavers with a mean age of 55.9 years (S.D. 17.0, range 22-87 years) with a mean postmortem interval of 17.9 h (S.D. 11.4, range 4-72 h). Cases were assigned to two diagnostic groups according to the antemortem diagnosis of alcoholism. Statistically significant differences were found for CDT and ALT concentrations between the two diagnostic groups. The highest vitreous humor levels of CDT and ALT were obtained in the group of cases with a previous diagnosis of alcoholism. Our results suggest that vitreous humor CDT levels are useful in cases where the postmortem diagnosis of alcoholism is hindered by the non-specificity of data.     

Forensic analysis of carbohydrate-deficient transferrin (CDT) by HPLC--statistics and extreme CDT values

Background

Carbohydrate-deficient transferrin (CDT) is the most specific serum marker of chronic alcohol abuse so far. There is little knowledge about extreme CDT values of >20% and the more >30% CDT.

Methods

Serum CDT/transferrin ratios from 19,236 serum samples sent to our laboratory for routine CDT analysis were determined by HPLC. About 75% of these serum samples were from traffic or employment medicine investigations. A CDT value frequency histogram was computed and extreme CDT values were clinically validated.

Results

Fourteen thousand four hundred and sixty-one CDT results were normal (≤1.7%) and 4775 increased (1.8–36.9% CDT). Most frequent normal and increased results were 0.9% CDT (n = 1964) and 1.8% CDT (n = 356). CA. 70% of the pathological results were between 1.8% and 5.0% CDT, ca. 88% between 1.8% and 10.0% CDT, and 98% between 1.8% and 20.0%. CDT values >20.0% appeared in 79 cases and results >30.0% in two cases (33.8% and 36.9%). In each case of CDT values >20%, chronic alcohol abuse was the underlying cause as confirmed by anamnestic exploration.

Conclusions

CDT/transferrin ratios are usually <20%. Higher values can appear in rare cases. CDT results >30% can be due to alcohol abuse but should be considered as remarkable single observations. Visualization of the transferrin isoform patterns by HPLC allows the detection of pathological transferrin isoform patterns and of genetic transferrin variants. This is essential for a reliable interpretation of (extreme) CDT values. CDT analysis by immunoassays without physico-chemical confirmatory analysis is no longer acceptable.     

Analysis of carbohydrate-deficient transferrin (CDT) in vitreous humour as a forensic tool for detection of alcohol misuse

Analysis of carbohydrate-deficient transferrin concentration in vitreous humour (VH-CDT) has recently been demonstrated to be useful for diagnosis of pre-mortal alcohol misuse, but more knowledge considering possible methodological problems is warranted. In a forensic sample we examined the stability of VH-CDT during laboratory handling as well as the possible affection of time-dependent changes of total transferrin concentrations in vitreous humour (VH-Transferrin) in the dead body on VH-CDT as indicator of alcohol misuse. By use of a commercial assay designed for serum analysis (CDTect) it was possible to measure VH-CDT with high precision, and detectable amounts were found in 20 of 21 alcoholics and in two of seven controls. The compound was demonstrated to be stable in vitreous humour during laboratory handling, since the results of the first analysis were well reproducible after 4 months storage of the specimens (rs=0.86, P=0.0002). Transferrin concentrations in vitreous humour (VH-Transferrin) correlated to the estimated time since the individual last time had been alive before the forensic examination (rs=0.57, P<0.005). However, in this small sample the discriminating property of VH-CDT as indicator of alcohol misuse was not decisively affected, whether or not the variables "VH-Transferrin" and "estimated time since the individual last time had been alive" were considered in a multivariate logistic regression analysis (minor change in the beta-coefficient from 0.57 to 0.52, P=0.086). We conclude that CDT is stable in vitreous humour during proper laboratory handling and that detection of VH-CDT is primarily a marker of alcohol misuse before death. However, the results of this study do not exclude that time-dependent changes of VH-Transferrin, possibly affecting VH-CDT, may occur in the dead body. VH-CDT analysis should thus, at present, be restricted to cases with rather short post-mortal time interval.     

Forensic analysis of carbohydrate-deficient transferrin (CDT): implementation of a screening and confirmatory analysis concept is hampered by the lack of CDT isoform standards

The aim of the study was to test combinations of commercially available carbohydrate-deficient transferrin (CDT) assays for their usefulness as screening and confirmatory CDT analysis systems. A set of 292 serum samples from routine CDT analysis was analyzed by two assays based on anion-exchanger microcolumn CDT and non-CDT fractionation followed by a turbidimetric immunoassay (ChronAlcoI.D. and %CDT TIA) and a high-performance liquid chromatography with on-line sample preparation (ClinRep CDT on-line). The CDT analysis results were divided into four groups based on the test-specific borderlines of the compared methods: NN with negative CDT results by both tests, PN with positive screening but negative confirmation results, NP with negative screening and positive confirmation results, and PP with positive results by both tests. Regardless of the test combination and whether applying the lower or upper limits of the borderlines, approximately one-third of contradictory (positive screening and negative confirmation or vice versa corresponding to groups PN and NP) were obtained. This was not due to analytical outliers (only 6 of 292 serum samples). Indeed, parametric and non-parametric ANOVA analysis pointed to different calibrations and/or recoveries of the three CDT assays. Our data give again evidence for the urgent need of an international CDT isoform standard material. At this time, we cannot recommend a combination of the three tests for screening and confirmatory analysis in forensic CDT testing.     

影响法医病理检验的因素

法医尸检过程中难辨或易混尸体现象、操作中人为现象均影响病理解剖结论的正确性和客观性,总结尸体搬运、生前抢救、尸体腐败及解剖、切片制作观察过程中造成的常见人为现象及难辨尸体现象,并提出相应干预措施以期得出合理的鉴定结论.     

影响法医病理检验的因素

法医尸检过程中难辨或易混尸体现象、操作中人为现象均影响病理解剖结论的正确性和客观性，总结尸体搬运、生前抢救、尸体腐败及解剖、切片制作观察过程中造成的常见人为现象及难辨尸体现象，并提出相应干预措施以期得出合理的鉴定结论。     

Identification of some factors influencing soil transfer on shoes

In criminal activities, soil can be transferred from a crime scene to items linked with a perpetrator; for example, shoes, cars or tools. Several parameters will influence the quantity of soil transferred in a given scenario. The knowledge of the most influential factors can help the expert to assess the evidence using a logical approach at the activity level or to predict the amount of soil that can be expected in a given scenario. The influence of five chosen parameters, namely the shoe profile, shoe size, walker's weight, soil type and soil humidity were assessed using Design of Experiment (DOE) in order to understand their influence on soil quantity transferred on shoes.The Faced Central Composite Design (FCCD) using a quadratic model was found to be highly significant, thus they could be adequately used to model and to interpret the amount of soil recovered from one shoe.These designs demonstrate that the characteristics of the donor (soil type and soil humidity), as well as a combination of these two factors have a very significant impact on the soil transfer. The characteristics of the receptor (shoe profile, shoe size and walker's weight) also have an impact on the transfer but to a lesser extent.Globally, this research provides valuable information for the forensic scientist both in investigative mode: evaluation of the soil quantity possibly transferred on shoes, and in the evaluative steps: is the quantity of soil found on the suspect shoes in accordance to the proposition/scenario given by the prosecution and the defence?     

Econometric analysis of factors influencing crime on the campus

A statistical model is presented and described to test the hypothesis that crime on university campuses bears a systematic and statistically identifiable relationship to a number of independent variables. Of the independent variables tested, the proportion of students living in dormitories and proximity to urban areas with high unemployment seem to influence the amount of crime on campus.     

Opinions about child corporal punishment and influencing factors

The use of corporal punishment has been linked to negative developmental outcomes for children. Despite this finding, Section 43 of the Canadian Criminal Code permits the use of corporal punishment by parents for children 2 to 12 years of age. Therefore, this study's first objective is to investigate opinions toward Section 43 and spanking more generally. The second objective is to investigate predictors of opinions toward Section 43 and spanking more generally. The sample consists of 818 nonparents (70.7% female, 29.0% male) who completed an online study. Results indicate that 38.6% were favorable toward upholding Section 43. However, this decreases to 25.8% when a condition is included, stating that parents would not be prosecuted for mild slaps or spankings. For attitudes toward spanking more generally, results reveal that 16.7% of the participants held favorable attitudes. Hierarchical regression analyses reveal that planning to use corporal punishment upon becoming a parent predicted having a more favorable attitude toward Section 43 as well as toward spanking more generally (after controlling for sociodemographics). In contrast, having experienced violence during one's childhood predicts having less favorable attitudes toward Section 43 and spanking more generally. Significant interactions are found between childhood experiences of corporal punishment and perceptions of parental warmth/support and impulsiveness during discipline in predicting attitudes toward spanking. Those who report experiencing more corporal punishment during childhood but also more parental warmth/support hold more favorable attitudes toward spanking and those who report experiencing more corporal punishment during childhood and also more parental impulsiveness hold less favorable attitudes toward spanking. Findings indicate that examining opinions toward Section 43 and spanking separately is important because these concepts are not synonymous. In addition, both more immediate factors and those related to one's developmental history play a role in predicting opinions toward Section 43 and spanking more generally.     

尸体断层影像学文献计量分析

尸体断层影像学(post-mortem cross-sectional imaging,PMCSI),也称虚拟解剖(virtopsy)或解剖画像(Ai),是法医学的革命性技术。较国际而言,我国PMCSI领域发展相对缓慢。进行系统的PMCSI文献计量分析研究,对于厘清国际PMCSI发展整体概貌和制定我国PMCSI发展战略方面,有着重要的现实意义。本文通过对2013-2019年PMCSI领域下27个专业术语不同组合进行在线文献搜索,并对文献的年份、作者、研究领域、发表杂志、作者单位、发表国家等系列指标进行了定性定量分析。分析结果表明世界PMCSI发展迅速:PMCSI已成为国际法医学的研究热点;瑞士、日本和英国PMCSI研究位居世界领先地位;尸体计算机断层扫描、尸体计算机断层扫描血管造影和尸体磁共振成像三个领域研究最为深入;PMCSI研究已得到相关学界的认同;法医日常检案中普及PMCSI是世界发展趋势。     

Analyzing factors influencing readmission to a battered women's shelter

Factors that distinguished first admission and readmission to an emergency woman's shelter were examined using discriminant function analysis. Records from 563 women who were residents were analyzed. Results suggest that source of income, number and developmental stage of children, and prior history of physical assault are precursors of readmissions. This study was discussed in terms of improving follow-up services to former residents of emergency shelters.     

小型餐饮业卫生监管影响因素与对策

由于小型餐饮业经营者投入不足,加之从业人员卫生意识淡薄,小型餐饮业存在着食品安全隐患。由于小型餐饮业点多面广,而基层卫生监督力量薄弱,导致了小型餐饮业的食品安全卫生监督存在诸多死角和真空。本文在分析小型餐饮业食品安全隐患的基础上,结合目前我国餐饮业卫生监督现状,探讨小型餐饮业卫生监督管理的影响因素及对策,以期为小型餐饮业的卫生监管提供参考。     

The time-dependant post-mortem redistribution of antipsychotic drugs

The post mortem redistribution of ten commonly prescribed antipsychotic drugs (APs) was investigated. Femoral blood was collected from 273 cases at admission to mortuary (AD) and at post-mortem (PM). The PM samples were collected at various times up to nine days after admission and the sample pairs analysed using LC-MS/MS. The drugs included in this study were 9OH-risperidone (paliperidone), amisulpride, chlorpromazine, clozapine, haloperidol, olanzapine, promethazine, quetiapine, risperidone, and zuclopenthixol. Haloperidol, quetiapine and risperidone showed minimal changes between AD and PM specimens, whereas the majority of drugs showed significant changes between the sample pairs collected at different time points post mortem (p<0.01) in addition to an average concentration change greater than the uncertainty of measurement of the applied method. Average increases in blood concentrations after admission to the mortuary ranged up to 112% (chlorpromazine and olanzapine) but also decreases up to -43% (9OH-risperidone) were seen. There were large standard deviations between sample pairs and substantial day-to-day unpredictable changes that highlight the difficulty in the interpretation of drug concentrations post-mortem. Based on the presented data, we recommend that specimens for toxicological analysis should to be taken as soon as possible after admission of a deceased person to the mortuary in order to minimise the effects of the PM interval on the drug concentration in blood.     

Trial investigation of post-mortem non-invasive transnasal endoscopy

We performed a trial investigation of transnasal endoscopy for post-mortem examinations to assess its efficacy in superficial post-mortem examinations. Transnasal endoscopy proved capable of permitting detailed visual inspections of the respiratory and the upper gastrointestinal tract, equal to direct viewing, on an LCD digital display. In 18 (40.9%) of 44 cases, findings obtained by post-mortem transnasal endoscopy (PMTNE) provided valuable clues regarding cause of death. The cases examined included seven deaths by fire, four by hypothermia, four by asphyxia (three involving death by mechanical asphyxia, the other by choking), two by drowning and one case of lung cancer. In two cases, PMTNE also led to informative findings not directly related to the cause of death. Under Japan's current systems, we are required to diagnose the cause of death for over 80% of all the unnatural death cases based solely on superficial post-mortem examinations, in the absence of an autopsy. Introducing PMTNE to superficial post-mortem examinations will undoubtedly provide much more information on the cause of death than relying solely on superficial post-mortem examinations.     

我国乡镇政府信用能力的影响因素与培育研究

本文运用政府信用理论对乡镇政府信用能力的影响因素进行了分析,结果表明,影响乡镇政府信用能力的主要因素为:乡镇政府职能、上下级政府的关系、农村社会的信用诉求、法律制度、乡镇公务员素质.结合乡镇政府信用能力的概念及其影响因素,研究构建了培育乡镇政府信用能力的框架,提出了我国培育乡镇政府信用能力的对策.     

Windows系统中文件时间属性的变化及影响因素

目的分析Windows系统中不同因素对文件时间属性的影响,总结文件时间属性的变化规律。方法在FAT32和NTFS两种文件系统中,对文件和文件夹进行各种操作,记录其时间属性的变化情况,总结其规律并分析各种因素的影响。结果文件时间属性的更新与系统环境、操作方法、文件类型等因素有关,而且文件时间属性更新有特定的周期。结论Windows系统中文件时间属性的变化既有特定的规律,又受其它因素影响,在检验中应加以注意。     

An unusual case of post-mortem redistribution of ethanol

We report an unusual case of post-mortem redistribution of ethanol in a woman diver who died by drowning in seawater. The ethanol concentrations were right heart blood 0.60 g/l, left heart blood 2.08 g/l, femoral venous blood 0.63 g/l, gastric contents 5.87 g/l, bile 0.83 g/l. The mechanisms of post-mortem redistribution of ethanol described in the literature, that is, early redistribution from the stomach or the lung parenchyma in the case of inhalation of gastric contents, are inadequate to account for the degree of variation observed between the measurements. We believe that this difference in concentration is explained by the presence of seawater in the pulmonary alveoli at the time of death.