Spinal epidural haematoma after blunt trauma to the neck and hyperflection of the cervical spine

Spinal epidural haematomas (sEDH) can be regarded as rare events, in principle a spontaneous and a traumatic aetiology can be distinguished. Spontaneous spinal epidural haematomas can arise, e.g. from vascular malformations, coagulopathies, etc. On the other hand, traumatic sEDH are related to, e.g. spinal trauma or intraoperative vascular injuries. With regard to clinical significance, spinal epidural haematomas accompanied by transient mild neurological symptoms up to lethal outcomes have been observed. We report on a 53-year-old male alcoholic who was found in the kitchen of his asylum in a grotesquely fixed body position, with his head and cervical spine in a maximum anteflected position. A general practitioner had ruled for a non-natural manner of death due to "broken neck" and alcohol intoxication, therefore, the prosecution authorities called for a medicolegal autopsy. At autopsy, paravertebral soft tissue haemorrhage in between the shoulder blades was disclosed. Furthermore, a spinal epidural haematoma, extending from the foramen magnum down to the middle portion of the thoracic spine was found. No fractures of vertebrae nor lesions of spine ligaments or bleedings of intervertebral discs were found. Blood alcohol concentration was determined 1.92 g/l and urine alcohol concentration was 1.76 g/l. Further morphological findings were cerebral oedema and cardiac hypertrophy; the urinary bladder was found filled to bursting. Neuropathological investigations confirmed the presence of the spinal epidural haematoma and assigned lethal significance to this finding. There were no histological signs of axonal injury. Reconstruction revealed that when sitting on a chair in a drunk condition, the individual's upper part of the body had fallen backwards in the corner and subsequently got stuck with maximum anteflection of the head and cervical spine, causing rupture of vessels and spinal epidural haematoma. Acute respiratory failure caused by impairment of the phrenic nerve following spinal epidural haematoma with potential synergism of alcohol intoxication was ascertained as the cause of death.     

Frequency of positive diazepam-screening in post-mortem examinations (author's transl)]

The post-mortem blood specimens of 389 forensic autopsies were analyzed for diazepam. The age of the cases investigated was above 10 years and the survival time was less than 12 hours. Eighteen samples corresponding to 4.6% were found to be diazepam-positive. These 18 samples were distributed equally between men and women. The proportion of diazepam-positive samples was increased in the groups of suicide and poisoning (alcohol and opiates). The association between diazepam intake and poisoning was statistically highly significant. No correlation was found between diazepam intake and age. Alcohol was found to occur significantly more often in the group of the diazepam positive cases as compared to the diazepam negative group.     

ABH and Lewis antigens of tracheal glands. II. Lewis negative individuals

Immunocytochemical studies were performed on tracheal wall samples embedded in paraffin; the samples were taken at 23 autopsies. In all cases, the red cells had been typed in postmortem serological studies as being Le(a-b-). Blood-group antigens were demonstrated by the indirect immunoperoxidase technique, using monoclonal Anti-A, Anti-B, Anti-Lea and Anti-Leb; H was detected by UEA 1. The secretor characteristics could clearly be diagnosed from the ABH staining pattern of the mucous glands. In 11 cases, the lewis antigen labeling patterns were identical to the group of Lewis-positive individuals. It seems probable, from the statistical point of view, that these 11 individuals were, in fact, Lewis-positive and that the negative serology resulted from deterioration of the cadaver blood samples. The immunocytochemistry was quite different in the remaining 12 cases: (a) secretors (n = 9) were completely negative for Lea, Leb was equally negative in one case, but in the remainder it was detectable within mucous epithelia in minimal amounts and in an atypical granular distribution; (b) nonsecretors (n = 3) reversely exhibited complete negativity for Leb but a minimal staining for Lea. These findings are in harmony with the well established Lewis serology typing of secretions in Lewis negative individuals. Thus, a minimal Lewis antigen biosynthesis and secretion seem to occur in the absence of the Le gene: A alpha-4-L-fucosyltransferase of low activity might be the product of the allele le.     

Lucilia silvarum Meigen, 1826 (Diptera: Calliphoridae)-A new species of interest for forensic entomology in Europe

In Europe, the blowfly genus Lucilia is represented in Forensic Entomology mainly by the species L. ampullacea, L. caesar, L. illustris and L. sericata. In the US, Lucilia silvarum is rarely recorded as a carrion breeding species but usually as a more or less exclusive parasite of frogs and toads. We present three forensic cases from different European countries reporting, for the first time, L. silvarum on human bodies that were found close to lakes, wetlands, or riversides. To use this species for post-mortem interval estimations, thermal development data is needed. The first step is accurate identification by morphological and molecular means. Therefore, we analysed a 611bp part of the mitochondrial COI region for 23 specimens of L. silvarum from 9 different geographical regions, all of which give the same haplotype. Differences within the haplotype varied by up to 0.2%. Comparison between the haplotype found and those published on GenBank showed up to 1.2% variance. Moreover, we present an updated key for the morphological identification of the third larval instars of European Lucilia spp. of forensic importance, adding not only L. silvarum, but also L. cuprina which was recorded in Europe for the first time about 20 years ago.     

Statesman to Statesman

Dear Readers,Forum is a column that provides a space for varying perspectives on contemporary Chinese society.We invite you to submit personal viewpoints on past and current topics(in either English or Chinese).yanwei@bjreview.com Please provide your name and address along with your comments     

American evangelicals and domestic versus international climate policy

Because a significant portion of the American electorate identify themselves as evangelical Christians, the evangelical position on climate policy is important to determining the role the United States could play in global climate cooperation. Do evangelicals oppose all climate policies, or are they particularly opposed to certain types of policies? We argue that American evangelicals oppose climate policy due to their distrust of international cooperation and institutions, which has been a prominent feature of evangelical politics since the beginning of the Cold War. Using data from the 2011 Faith and Global Policy Challenges survey and the 2010 Chicago Council Global View survey, we find support for the theory. Evangelicals are equally likely to support domestic climate policy as other Americans, but they are significantly less likely to support international treaties on climate cooperation. The findings suggest that proponents of climate policy could win more evangelicals to their side by focusing on domestic action, instead of multilateral negotiations or international institutions.     

Analysis of Factors of Overpricing in Public Procurement: A Study for Low-performing EU Countries

ABSTRACT

The paper deals with the issue of overpricing of public procurement in low-performing EU countries. It examines a uniquely large sample of public procurement in 11 Central and Eastern European countries. Hierarchical regression is used to analyze the factors that influence public contract. Our results indicate that institutional factors have a greater impact on overpricing than individual decisions by the contracting authority. Our analysis for low-performing EU countries provides interesting results and also draws attention to behavior that is not typical of the better established and more advanced EU countries. Our results are particularly important for public policy in each country, as they show the direction of regulatory action in the field of public procurement. The results introduce a debate on the appropriateness of “one size fits all” regulations within the EU.     

Breaking the glass ceiling,but facing a glass cliff? The role of organizational decline in women's representation in leadership positions in Dutch civil service organizations

Despite efforts to increase gender diversity and equality worldwide, women are still underrepresented in leadership positions in public bureaucracies. This article speaks to the debate on how organizational context, more specifically organizational decline, may influence gender representation in such leadership positions. Based on role congruity theory and glass cliff theory this article empirically examines whether and how excessive workforce reductions are associated with changes in the representation of women in leadership positions in Dutch civil service organizations. Panel analyses on administrative data show that women's representation in leadership positions varies over time, but is not significantly affected by excessive workforce reductions. Overall, the analyses do not provide evidence for a glass cliff for women in Dutch civil service organizations. Implications for theory and future research are discussed.