Carbon Monoxide Poisoning and Death in a Large Enclosed Ventilated Area

A 55‐year‐old man with a medical history of tobacco use suddenly collapsed while power washing an empty indoor pool in a hotel. The decedent was transported to the local hospital where he was pronounced. A postmortem examination revealed atherosclerotic heart disease and bilateral pulmonary edema and congestion. A postmortem blood carbon monoxide (CO) level was 27% saturation, and a CO performed on hospital admission blood was 49% saturation. CO poisoning is a common cause of toxicological morbidity and mortality in the United States. The circumstances most often occur in an enclosed environment and may be intentional or unintentional. CO poisoning has been reported in open, well‐ventilated spaces, but rarely results in death. A warning label was present on the engine clearly stating the dangers of CO emission. However, there was a false sense of security due to the large size of the pool room and the presence of industrial blowers that were being used for ventilation.     

Adenoid Cystic Carcinoma of the Trachea Resulting in Fatal Asphyxia

Primary malignant tumors of the trachea are uncommon. The authors report a case of a 72‐year‐old female who died from asphyxia due to an undiagnosed obstructing adenoid cystic carcinoma of the trachea. The decedent became unresponsive while eating cereal and was pronounced upon arrival at the local hospital. The autopsy revealed a near occlusive tumor mass just superior to the bifurcation of the distal trachea. There was no evidence of aspiration. The death was the result of asphyxia due to obstruction of the trachea by an adenoid cystic carcinoma. This case demonstrates that an obstructive tumor mass may remain undiagnosed until an obstructive episode results in a sudden death.     

Self‐Embedding Behavior in Adults: A Report of Two Cases and a Systematic Review

Self‐embedding behavior (SEB) is the repeated insertion of sharp objects, such as needles or pins, into the soft tissues of abdomen, limbs, and other body parts. In this study, two cases of SEB were reported and the scientific worldwide literature reviewed. Thirty‐two cases of SEB were identified through systematic searches in the main bibliographic databases. Mean age was 35 years (SD = 8.97). Just over two‐thirds of the patients were female. Although the number of embedded objects could be as high as 200, major clinical and surgical complications were uncommon and mortality was null. Patients with SEB presented three major diagnoses: psychotic (25%), personality (21.9%), and factitious (28.1%) disorders. The practice of SEB largely went undetected as the patients themselves did not bring it to the attention of family members or physicians and usually denied they have engaged in SEB. A high level of suspicion is required to avoid a missed diagnosis.     

Rethinking the presumption of innocence

This article is concerned with what constitutes interference with the presumption of innocence and what justifications there might be for such interference. It provides a defence of a theory of the presumption of innocence that suggests that the right is interfered with if the offence warrants conviction of defendants who are not the intended target of the offence. This thesis is defended against two alternative theories. It then considers what might justify interference with the presumption of innocence. It explores the idea that interference is justified if it is necessary in a democratic society and considers the presumption in relation to the aims of the criminal trial. It is concluded that no good grounds have been provided for interference with the right, and that the right should be regarded as inviolable.

Upper‐Bounding the Incidence Rate of Associations Between Camouflage Uniforms and Surveillance Images*

Abstract: Camouflage garments can be associated with surveillance images of a crime scene even in the absence of unique wear marks or very high‐quality images. However, the probability of an accidental association, or incidence rate, is significant. The present work describes and validates a method for estimating the incidence rate based on a statistical model of the garment manufacturing process. The model was developed primarily for use with the current U.S. Army Combat Uniform (ACU), but can be applied to any camouflage garment. Eight garment manufacturers were studied, and all sources of variation in the manufacturing process were characterized. The marking and spreading procedures were found to be dominant and consistent sources of variation. However, some sources of variation, in particular those because of human operators, were not consistent enough to accurately characterize. Sources of variation that could not be well‐characterized were ignored in the statistical model, yielding a worst‐case estimate that is an upper‐bound to the true incidence rate. The model was evaluated for a variety of cases. Depending on the quality of the surveillance image, the manufacturing parameters, and the local population, incidence rates range from about 3% to negligibly small. The model was validated by returning to one manufacturer, and sampling a large number of completed garments and estimating empirical match probabilities. The empirical probabilities validated the estimates of the worst‐case incidence rate and also demonstrated that typical incidence rates are significantly lower.     

Responding to Terrorism? Human Rights Organization Shaming and Terrorist Attacks

Why do Human Rights Organizations (HROs) target or “shame” countries for human rights abuses? The literature using country-level factors to explain why one country is likely to be targeted over another is growing but many questions still remain. Terrorist activity in a country should have a positive effect on the amount of shaming directed at a country. HROs are in the publicity business and have organizational interests to shame states already receiving attention. Findings show that there is a connection between certain types of transnational terrorist incidents occur in a country and the amount of HRO shaming of governments, even after accounting for the human rights practices within the state.     

Measuring Meritocracy in the Public Sector in Europe: a New National and Sub-National Indicator

Since the late nineteenth century, the presence of an independent and meritocratic bureaucracy has been posited as an advantage for effective bureaucratic behaviour and a means of limiting patrimonial networks and corruption, among other benefits. There is little consensus on how the features of an independent and meritocratic bureaucracy should be measured across countries, however, and broad empirical studies are therefore rare. What is more, the few such studies that exist have advanced measures which are constructed exclusively on expert surveys. Although these have indeed contributed to the knowledge in the field, the data on which they are built come with problems. This paper proposes a set of novel measures that complement existing measures and thus fill important gaps in this burgeoning literature. The measures we present are not based on expert assessments but on perceptions of public sector employees’ and citizens’. We create two measures—that can be combined into one—from a recent survey (2013) of over 85,000 citizens in 24 European countries. One is purely based on the assessments from public sector employees’ and the other is based on perceptions of citizens working outside the public sector. The paper also discusses the survey and explores the external validity of the measures provided here, showing correlations with alternative measures based on expert opinions, as well as variables from the literature that we would expect to correlate highly with a meritocratic bureaucracy.