Lessons from institution building in Kenya

Participant observation of institution building in a public sector organization in Kenya provides a basis for a critical discussion of key facets of the institution-building process. Problems identified include: flawed needs assessments; overambitious project designs; poor selection and briefing of consultants; and countervailing vested interests on the parts of external agents. Recommendations include narrowing the gap between development rhetoric and reality; more careful project formulation; greater emphasis on in-house training; more careful selection of project team leaders; and the provision of funding for post-project sustainability evaluations.     

The Role of Postmortem Cardiac Markers in the Diagnosis of Acute Myocardial Infarction*

Abstract: Sudden cardiac deaths because of acute myocardial infarction (MI) constitute a significant percentage of the caseload for death investigators, coroners, and forensic pathologists. Clinicians use cardiac markers, highly sensitive and specific for myocardial damage, to screen living patients for acute MI; however, to this point, the utility of these markers in the autopsy setting has not been fully established. The current study included 10 decedents, five who died of acute MI, and five subjects who died of noncardiac disease. Samples of pericardial fluid and blood from multiple sites were tested for creatine kinase, creatinine kinase MB, and troponin‐I. Three main conclusions were drawn: the levels of cardiac markers from all patients are significantly higher than the reference range for living patients, there are significant differences in cardiac marker levels between samples from different anatomic locations, and only three cardiac marker/anatomic site combinations were significantly different between the control and study groups.     

International relations in China and Europe: the case for interregional dialogue in a hegemonic discipline

Abstract

The international relations (IR) discipline is known as an ‘American Social Science’ dominated by scholars and theories from the US core. This paper compares IR in two noncore settings, China and Europe. It shows that there is a growing institutional and intellectual integration into global Anglophone, mostly American, IR in both Europe and China. Both Chinese and European IR communities have established top Anglophone journals like the European Journal of International Relations and the Chinese Journal of International Politics to spearhead their integration into mainstream Anglophone IR and carve out a space for regional thinking. Yet, the analysis of their publication and citation patterns shows that IR outside the American core communicates through a hub-and-spokes system where there is always a connection to the American core but rarely very strong linkages to other peripheral regions. The two journals studied thus function as outlets for ‘local’ and American scholars, rely on ‘local’ and American sources, and there is very little integration and exchange between Chinese and European IR. Chinese and European IR would benefit from such a dialogue, especially regarding ‘schools’ of IR at the margins of an ‘American social science’.     

Entomological and Cardiologic Evidence of Time Since Death in Short Postmortem Intervals

Estimating the time since death of the deceased is a main goal in forensic investigations, but this can be challenging due to contradictory results derived from different investigations at the scene of death. We present a case of a 78‐year‐old woman, found dead in a small forest with broad‐leaved trees, whose husband had a history of domestic violence. Routinely performed investigations, such as postmortem rectal temperature and lividity, yielded inconsistent time since death results between only a few and longer than 20 h. This difficulty was most likely caused by high ambient temperatures of up to 38.0°C, which negatively influenced the informative value of the applied nomogram method. Additionally, performed entomological investigation of fly maggots (Lucilia illustris) recovered from the corpse and the assessment of heart pacemaker data revealed consistent and incontrovertible results. The presented case highlights the benefits of information provided by entomological investigations and data evaluation of cardiac implantable electronic devices and the combined use of the two techniques.     

Dynamics of Polarizing Rhetoric in Congressional Tweets

Affective polarization is pervasive in modern US politics, and can be intensified by strategic messaging from members of Congress. But there are gaps in our knowledge of the dynamics of polarizing appeals from elected representatives on social media. We explore the usage of polarizing rhetoric by members of Congress on Twitter using the 4.9 million tweets sent by members of Congress from 2009 to 2020, coded for the presence of polarizing rhetoric via a novel and highly accurate application of supervised machine learning methods. Fitting with our expectations, we find that more ideologically extreme members, those from safer districts, and those who are not in the president’s party are more likely to send polarizing tweets, and that polarizing tweets garner more engagement, increasing campaign funding for more polarizing members.     

Ancillary studies in amniotic fluid embolism: a case report and review of the literature

The incidence of amniotic fluid embolism during pregnancy is approximately 1/50,000 and has a mortality rate in excess of 80%. The postmortem diagnosis of amniotic fluid embolism can be challenging for forensic investigators and pathologists. At autopsy, usually signs of disseminated intravascular coagulation suggest an amniotic fluid embolism. A definitive diagnosis of amniotic fluid embolism cannot be made until ancillary studies are performed on the decedent's tissues. We report a case of a 37-year-old G3P2 white female who was 36 weeks gestation when her membranes spontaneously ruptured. She suddenly became breathless, went into cardiogenic shock, and died. The autopsy revealed gross and microscopic findings of amniotic fluid embolism, which was confirmed with ancillary studies consisting of special stains, immunohistochemistry, and a serum tryptase level. The authors hope this case report, including gross and microscopic autopsy findings with procedural and ancillary studies, and review of the literature will help investigators and pathologists in the diagnosis of amniotic fluid embolism.