Eosinophilic Coronary Periarteritis with Arterial Dissection: The Mast Cell Hypothesis

A subset of coronary arterial dissections is associated with eosinophilic coronary periarteritis (ECPA); however, the pathogenesis of the process remains unclear. Mast cells normally reside in coronary arterial adventitia and are known mediators of eosinophilic inflammatory conditions such as type I hypersensitivity reactions. We report two cases in which coronary arterial dissection with ECPA was detected at autopsy. Tryptase, CD68, CD4, CD8, and CD1a immunohistochemical staining was performed to better characterize inflammation. While eosinophils represented a prominent periadventitial inflammatory cell, there were slightly more lymphocytes: CD4/CD8 ratios were within expected reference ranges. There were moderate numbers of macrophages, and few neutrophils or dendritic cells. Numbers of mast cells in dissected versus nondissected sections were compared: adventitial mast cell densities were threefold higher in dissected portions and showed a trend toward increased degranulation. These findings suggest that mast cells may play a role in orchestrating inflammation in cases of ECPA.     

Interdependent and Domestic Foundations of Policy Change: The Diffusion of Pension Privatization Around the World

In the last two decades, striking correlations in the location and timing of structural pension reforms have raised important questions about the kind of information used by policy makers in their decisions to adopt such measures. This study tests the hypothesis that the adoption of pension privatization is shaped systematically by an interdependent logic, wherein the decision to privatize pensions in one country is systematically linked to corresponding decisions made by governments in relevant peer nations. Duration analysis with time-varying covariates of data from 59 countries between 1980 and 1999 reveals that the decision to adopt a private pension reform in one country increases systematically as the proportion of peer nations that have adopted corresponding measures rises. Importantly, the effect of this peer dynamic varies across groups of nations, with the most powerful impact of peer decisions being found among Eastern European and Central Asian nations. Peer dynamics likewise contribute powerfully to the adoption of private pension reforms in Latin America, but do not significantly shape the hazard of privatization among the Organization for Economic Cooperation and Development member nations. Even controlling for diffusion mechanisms, the analysis shows that pension reform decisions remain subject to domestic political and economic considerations, including demographic pressures, financial costs and incentives to reform, and constraints delimited by the political institutions in each nation.     

Postmortem genetic testing in sudden unexplained death: A public health laboratory experience

Sudden unexplained death in the young poses a diagnostically challenging situation for practicing autopsy pathologists, especially in the absence of anatomic and toxicological findings. Postmortem genetic testing may identify pathogenic variants in the deceased of such cases, including those associated with arrhythmogenic channelopathies and cardiomyopathies. The Wisconsin State Laboratory of Hygiene (WSLH) is a state-run public health laboratory which performs postmortem genetic testing at no cost to Wisconsin medical examiners and coroners. The current study examines sequencing data from 18 deceased patients (ages 2 months to 49 years, 5 females) submitted to WSLH, from 2016 to 2021. Panel-based analysis was performed on 10 cases, and whole exome sequencing was performed on the most recent 8 cases. Genetic variants were identified in 14 of 18 decedents (77.8%), including 7 with pathogenic or likely pathogenic variants (38.9%). Whole exome sequencing was more likely to yield a positive result, more variants per decedent, and a larger number of variants of uncertain significance. While panel-based testing may offer definitive pathogenic variants in some cases, less frequent variants may be excluded. Whole exome testing may identify rare variants missed by panels, but increased yield of variants of uncertain significance may be difficult to interpret. Postmortem genetic testing in young decedents of sudden unexplained death can provide invaluable information to autopsy pathologists to establish accurate cause and manner of death and to decedent's relatives to allow appropriate management. A public health laboratory model may be a financially advisable alternative to commercial laboratories for medical examiner's/coroner's offices.     

Studies presented to the international commission for the history of representative and parliamentary institutions 1980 — 1985

SUMMARY

In this article Joseba Agirreazkuenaga continues his account of the development of the Basque political institutions to the period following the settlement of the first Carlist war by the Convention of Bergera in 1839. This laid down a process for incorporating the Basque foral institutions into the framework of the new liberal constitution of the Spanish monarchy. It required negotiations between the Spanish Cortes and Basque representatives, which produced the institution of the Basque Conferencias to speak for the three Basque provinces. Once established these developed into the main institutional voice for the developing Basque national movemebt. By the 1860s the Conferencias had virtually acquired the function of a Basque provincial government.     

Silicosis: Diagnosis and Medicolegal Implications

Despite well‐publicized sources of occupational hazard, silicosis continues to threaten industrial workers in the United States. We performed a retrospective search of the University of Wisconsin electronic pathology database to retrieve autopsy cases of silicosis and collaborated with the Wisconsin Department of Health Services to obtain statewide epidemiologic data regarding silicosis morbidity/mortality since 2003. Three silicosis autopsy cases were retrieved: all were men with ≥ 30 years of occupational crystalline silica exposure and similar histologic features of collagenous pulmonary nodules with admixed refractile particles. Overall, our state exceeds the national rate of silicosis‐related hospitalizations and mortality, that is, 10.1 hospitalizations per million WI residents versus 1.2 nationally and 1.2 deaths per million WI residents versus 0.4 nationally. Surveillance is crucial to identify emerging occupational hazards and protect workers. A diagnosis of silicosis must be carefully considered at autopsy since it carries substantial implications for worker's compensation, compensatory losses, and employer liability.     

The state as entrepreneur: from CDC to CDIC

Abstract: Focusing upon the case of the Canada Development Corporation, this paper provides a critique of the joint stock company as an instrument of public policy. The corporation's performance is evaluated against three criteria which emerge from a review of the circumstances leading to the creation of the CDC, namely: contributing to diversified industrial development in Canada; establishing the joint stock company as an accepted medium of private/public cooperation in economic activity; and providing income returns to the government. The CDC'S failure as a governing instrument is attributed to the fact that, in resolving its anomolous status as neither clearly state enterprise nor clearly private enterprise, the corporation was forced to distance itself from its major shareholder (i.e., the state) in order to retain the support of the investment community. The analysis in the second part of the paper proceeds through three stages: a review of the circumstances in the creation of the Canada Development Investment Corporation (cdic); identification of its probable rble; and a comparison with two alternative models of the state holding company. While the CDIC is a more tractable governing instrument than was the CDC, the early pattern of the CDIC'S commercial activities suggests a dismal financial future. Sommaire: Cet article, qui étudie le cas de la Corporation de développement du Canada, présente une critique de la société en commandite en tant qu'instrument dapplication de la politique gouvernementale. Le rendement de la Corporation est évalué a partir des trois critères suivants, qui découlent de l'examen des circonstances ayant conduit à la création de la CDC: contribuer à la diversification du développement industriel au Canada; faire de la sociétA en commandite un moyen reconu de favoriser la coopération entre les entreprises publiques et privées dans l'activitééconomique; et fournir des revenus au gouvernement. L'échec de la CDC en tant qu'instrument de gouvernement est attribué au fait que, compte tenu de son statut ambigu dentreprise mi-publique mi-privée, la Corporation a été contrainte à prendre ses distances vis-à-vis de son principal actionnaire (à savoir l'Etat), afin de conserver l'appui des investisseurs. L'analyse presentee dans la seconde partie de l'article se déroule en trois étapes: étude des circonstances ayant amené la création de la CDIC, ou Corporation de développement et d'investissement du Canada; identification de son rôle probable; et comparaison avec deux autres modèles possibles de société H portefeuille contrôlée par I'Etat. Bien que la CDIC soit un instrument de gouvernement plus souple que ne l'etait la CDC, les premières conclusions que I'on peut tirer au sujet de ses activités commerciales tont envisager I'avenir financier avec un profond pessimisme. (The) form of public organization significantly affects the policies they adopt and the kind of management they conduct. Any structure for making decisions encourages certain types of choice and discourages others (emphasis added). Annmarie Hauck Walsh, 1978.     

SOCIAL JUSTICE AND FAMILY COURT REFORM

Creating a unified family court, or any type of family court reform, may have only a minimal impact if it simply changes the structure of how judges do business rather than addresses the structure of the child welfare system itself. The authors argue that family court reform must place social justice at its center. First, they discuss profound flaws in the child welfare system that make poor and minority families especially vulnerable to coercive state intervention. Second, they describe two approaches to child welfare cases–family systems theory and therapeutic justice–that can help to guide reform efforts directed at addressing these structural flaws. Finally, they suggest ways in which family law scholarship can assist in creating a social justice agenda for family court reform.