Vitality and age of conjunctival petechiae: The expression of P-selectin

Confocal laser scanning microscopy (CLSM) results in displaying multiple ruptures of capillaries and venules define conjunctival petechiae as a rhexis haemorrhage. In order to distinguish between petechiae which have arisen before death as opposed to post-mortem artefacts and the establishment of the age of the vessel's damage, we carried out an investigation on a collection of samples from medico-legal cases (positive petechiae: n = 65; post-mortem artefacts: n = 12; control: n = 19) to establish whether the expression of the endothelial adhesion molecule P-selectin as demonstrated by immunohistochemical methods is influenced by trauma before death and possibly by time. Except for cases with massive congestion in those cases where the victim had survived for around minutes, CLSM examination revealed a strong endothelial reaction at the site where the vessel had ruptured. It was impossible to detect a strong P-selectin expression signal in both those vessels which had not suffered any mechanical insult and those which had experienced post-mortem rupture. Therefore, the elevated expression of P-selectin can be used as a criterion to distinguish between those lesions which have occurred in life and those which are post-mortem artefacts.     

Belief in a Just World,Causal Attributions,and Adjustment to Sexual Violence

What influence do the personal belief in a just world (i.e., the perception that one usually gets what one deserves) and different kinds of causal attributions have on adjustment to sexual violence? Using a sample of N = 62 victims of sexual aggression (mean age = 21.7) it was shown that respondents were better able to adjust to their experience of sexual violence the higher their personal belief in a just world. Moreover, the more respondents attributed their victimization to situational circumstances (external attributions) and the less they attributed their victimization to their character and personality (characterological self-attributions), the less they felt distressed by past victimization. The degree to which participants attributed their victimization to their own concrete behavior (behavioral self-attribution) was not related to their adjustment. Further analyses showed that the influence of the personal belief in a just world was mediated by the three attribution styles. Additionally, the adaptiveness of external attributions was moderated by participants’ just world belief.     

Visualization of postmortem chondrocyte damage by vital staining and confocal laser scanning 3D microscopy

The present study was designed to investigate whether the combination of vital dyes [calcein acetomethyl ester and ethidium homodimer (LIVE/DEAD Viability/Cytoxicity Kit)] together with confocal laser scanning 3D microscopy was a suitable process to detect postmortem chondrocyte damage, and whether this process could be used to establish postmortem interval. Human knee cartilage from 13 autopsies (postmortem interval from 1 day to 2.5 months) was incubated with the two dyes. The chondrocytes revealed intense staining according to their vitality. For those cases that were stored mainly at 4 degrees C there was a vitality of approximately 88 to 96% within the first 4.5 days, which decreased to 58% after 6 days and to 9% after 1.5 months. After 2 days and 14 days at summer temperatures there were 70% and 8% vital chondrocytes respectively. Three of the 13 cases showed that altered body and storage conditions limited the efficacy of the method. Initial data suggested a time and temperature dependent increase in cell breakdown. Under stable cooling conditions the use of vital dyes and confocal laser scanning 3D microscopy to measure chondrocyte loss may be a valuable tool for estimating the postmortem interval.     

Cause of death in heroin users with low blood morphine concentration

The blood morphine concentrations in cases of heroin-associated fatalities can vary considerably. Currently, a free-morphine concentration of > or = 100 ng/ml in blood is generally considered as potentially fatal. Moreover, it is a common observation that fatal cases of heroin-intoxication with blood morphine concentrations lower than 100 ng/ml occur. This poses the question of how the fatal cases with low blood morphine concentrations can be explained. In the study described here, 62 cases of morphine only intoxications were examined. The fatal cases were divided into two groups according to the free morphine concentrations measured in the blood of the heart (group I: free morphine concentration < 100 ng/ml, n = 21 cases; group II: free morphine concentration > or = 100 ng/ml, n = 41 cases). The two groups were compared as to circumstances of death, as well as to autopsy findings and histopathologic alterations. Overall, infections of the respiratory tract occurred significantly more often in group I (lower morphine concentrations) than in group II. In a second step, the group I cases were analyzed individually to get detailed information on the cause of death. In 19 of the 21 cases the authors could find a plausible explanation for death in combination with low free morphine concentrations in the blood.     

Injuries of the Head from Backface Deformation of Ballistic Protective Helmets Under Ballistic Impact

Modern ballistic helmets defeat penetrating bullets by energy transfer from the projectile to the helmet, producing helmet deformation. This deformation may cause severe injuries without completely perforating the helmet, termed “behind armor blunt trauma” (BABT). As helmets become lighter, the likelihood of larger helmet backface deformation under ballistic impact increases. To characterize the potential for BABT, seven postmortem human head/neck specimens wearing a ballistic protective helmet were exposed to nonperforating impact, using a 9 mm, full metal jacket, 124 grain bullet with velocities of 400–460 m/s. An increasing trend of injury severity was observed, ranging from simple linear fractures to combinations of linear and depressed fractures. Overall, the ability to identify skull fractures resulting from BABT can be used in forensic investigations. Our results demonstrate a high risk of skull fracture due to BABT and necessitate the prevention of BABT as a design factor in future generations of protective gear.     

Giant Diaphragmatic Lipoma: Two Autopsy Case Reports and Review of the Literature

Lipomas are common benign tumors most frequently found within the subcutaneous areas of the body. Deep-seated lipomas are rare and tend to be larger than cutaneous ones. Lipomas are rarely seen in the thoracic cavity, and they are usually located in the mediastinum, bronchiole, and lungs. Diaphragmatic lipomas have been occasionally reported in the literature, the first being described by Clark et al. in 1886. The authors report two rare cases of giant diaphragmatic lipoma incidentally found during forensic autopsies. In the first case, a Caucasian 85-year-old woman burned to death with another passenger, after her methane-fueled car collided with another car on a highway near Terni, Umbria, Italy. In the second case, a Caucasian 45-year-old man collapsed while walking through the countryside of Perugia. In either case, a large mass in the thorax was observed. The definitive pathologic diagnosis was giant intrathoracic diaphragmatic lipoma without evidence of malignancy. The authors also review the relevant literature and discuss differential diagnoses. These case reports contribute to the establishment of the actual incidence of diaphragmatic lipomas.     

Decisional Capacity to Consent to Clinical Research Involving Placebo in Psychiatric Patients

Evidence from a few studies indicates the existence of several issues related to psychiatric patients' decisional capacity to give informed consent to clinical research. Clinicians often face difficulties in acquiring valid informed consent in clinical practice and even more so in drug trials. Participants often fail to fully understand or retain information regarding the actual implications of research protocols. The Brief Assessment for Consent to Clinical Research (BACO) was developed to investigate capacity to consent to clinical trials and further compare patients with schizophrenia and healthy comparisons' decisional capacity. A method to avoid possible confounding effects of choosing a treatment regarding a current disease was applied. The study groups were administered the BACO and the MacArthur Competence Assessment Tool for Clinical Research. Psychiatric patients performed poorer in comprehending, appreciating, and reasoning abilities, than their healthy counterparts. Impaired cognitive functioning and psychiatric symptoms severity were associated with reduced capacity to consent.     

The interaction of international institutions from a social network perspective

The literature increasingly acknowledges that international institutions do not exist in isolation, but regularly interact with each other. This interplay might induce influence, affecting institutions’ development and performance. The following research adds to this debate by systematically analyzing the quantitative evidence on how institutional interaction drives institutional design from a network perspective. Using dyadic cross-sectional data on international environmental agreements in 1952–2000, the authors find support for their theoretical argument that regimes’ similarity in design as captured by their degree of legalization strongly depends on institutions’ interaction. However, while “soft law” disseminates between regimes that are well connected through direct or indirect links, this does not apply to “hard law.” The authors explain this divergence with states’ concerns about binding-law commitments and sovereignty costs associated with the latter. This research may have important implications for studies of international institutions and of network analysis in general.