Utility of the Frontonasal Suture for Estimating Age at Death in Human Skeletal Remains*

Abstract: This project evaluated the utility of the frontonasal suture for estimating age at death. Utilizing human remains of known age at death with varying degrees of fusion, curated at the American Museum of Natural History in New York City and the Smithsonian Institution’s National Museum of Natural History in Washington, DC, data were collected from the ectocranial surface of 522 crania; 68 of these were sagittally sectioned, allowing collection of internal data and observation of suture closure through the bone. Degree of ectocranial suture closure does not significantly predict age, even when sex and ancestry are accounted for. Suture closure progression data were converted into a Hershkovitz ratio (sum of the measurement of open portion divided by the total suture length), and regression models demonstrate that the effect of age accounts for only 13% of variation in suture closure.     

Procedural Issues in the Anti-Dumping Regulations of China: A Critical Review under the WTO Rules

Since the World Trade Organization (WTO) was established, Chinahas made large-scale efforts to shape its trade remedy systemthrough legal and organizational changes. Through these changes,China could clarify the meanings of WTO anti-dumping provisionsincluding the provision relating to the definition of domesticindustry. Moreover, procedural disciplines on reviews were fortifiedin Chinese anti-dumping system. While the overall improvementsto the trade remedy system of China are evident, definitionsof several key legal terms, including the concept of "relatedproducers", the negligible import standard, and adjustment factorsfor a fair comparison between normal values and export pricesare still absent, and some legal problems relating to priceundertakings and the countermeasure system remain to be solved.China should continue to proceed with the task of clarificationand improvement of its trade rules.     

Effect of wrist restraint on maximal exercise capacity in healthy volunteers

Each year, reports occur of deaths in individuals, while struggling against physical restraint. The mechanism of these deaths remains unclear. This study aimed to determine the effect of wrist restraint on cardiorespiratory function during maximal exercise. Twelve healthy volunteers underwent 3 incremental maximal exercise tests on a cycle ergometer. In a randomized order, they exercised while unrestrained, with the wrists tied in front of the body or wrists tied behind the back. The primary outcome measures were the number of minutes exercised in each position and heart rate and whole blood lactate level for each stage and on reaching maximum exercise capacity. The mean exercise duration was 19 minutes 6 seconds unrestrained (95% confidence interval [CI] 16 minutes 52 seconds to 20 minutes 57 seconds), 18 minutes 51 seconds (95% CI 17 minutes 51 seconds to 20 minutes 50 seconds) with arms restrained in front and 16 minutes 51 seconds (95% CI 14 minutes 6 seconds to 19 minutes 20 seconds) with the arms restrained behind the body (P = 0.16). There was no significant difference in heart rate or lactate measurements. It is probable that other factors make a more important contribution than wrist restraint behind the body to cardiorespiratory compromise in a struggling and fatigued individual.     

A comparison of respiratory symptoms and inflammation in sudden infant death syndrome and in accidental or inflicted infant death

Upper respiratory infection and pulmonary inflammation are common in sudden infant death syndrome, but their role in the cause of death remains controversial. Controlled studies comparing clinical upper respiratory infection and inflammation in sudden infant death syndrome with sudden infant deaths caused by accidents and inflicted injuries (controls) are unavailable. Our aim was to compare respiratory inflammation and upper respiratory infection within 48 hours of death and postmortem culture results in these two groups. A retrospective analysis of upper respiratory infection and pathologic variables in the trachea and lung of 155 infants dying of sudden infant death syndrome and 33 control infants was undertaken. Upper respiratory infection was present in 39% of sudden infant death syndrome cases and 40% of control cases. Upper respiratory infection was more likely to have occurred in association with more severe lymphocytic interstitial pneumonitis when sudden infant death syndrome cases and control cases were combined ( P=.04). Proximal and distal tracheal lymphocytic infiltration was more severe in control cases than in sudden infant death syndrome cases ( P=.01 and.01, respectively). Lymphocytic infiltrations of the bronchi, bronchioles, and pulmonary interstitium were similar between groups. Bronchial associated lymphoid tissue was more prominent in control cases ( P=.04). Cultures were positive in 80% of sudden infant death syndrome cases, 78% of which were polymicrobial. Among control cases, 89% were positive, with 94% being polymicrobial. This study confirms that microscopic inflammatory infiltrates in sudden infant death syndrome are not lethal.     

Fatal cyclobenzaprine overdose with postmortem values

There are only two published cases of overdose with postmortem blood cyclobenzaprine concentrations, both with confounding factors. We report two additional cases of fatal cyclobenzaprine overdose with postmortem values. Case 1: a 56-year-old female was found in full cardiopulmonary arrest after a verbal suicide threat to a friend. Postmortem blood concentrations were cyclobenzaprine 0.96 mg/L and diazepam 0.3 mg/L. Case 2: a 37-year-old male was found in full arrest by a family member after an intentional ingestion of cyclobenzaprine. Postmortem blood concentrations were cyclobenzaprine 0.8 mg/L and ethanol 0.174 gm/dL. The concentrations of diazepam and ethanol reported in these two patients were not found in quantities usually associated with a fatal outcome, suggesting that the cyclobenzaprine was the primary cause of the fatality. Additionally, the blood was drawn from a femoral site, so that postmortem redistribution is not a likely factor. Blood concentration of > or = 0.8 mg/L cyclobenzaprine may be associated with a fatal outcome.