Evaluation of pediatric skull fracture imaging techniques

Radiologic imaging is crucial in the diagnosis of skull fracture, but there is some doubt as to whether different imaging modalities can accurately identify fractures present on a human skull. While studies have been performed to evaluate the efficacy of radiologic imaging at other anatomical locations, there have been no systematic studies comparing various CT techniques, including high resolution imaging with and without 3D reconstructions to conventional radiologic imaging in children, we investigated which imaging modalities: high-resolution CT scan with 3D projections, clinical-resolution CT scans or X-rays, best showed fracture occurrence in a pediatric human cadaver skull by having an expert pediatric radiologist examine radiologic images from fractured skulls. The skulls used were taken from pediatric cadavers ranging in age from 5 months to 16 years. We evaluated the sensitivity and specificity for the imaging modalities using dissection findings as the gold standard. We found that high-resolution CT scans with 3D projections and conventional CT provided the most accurate fracture diagnosis (single-fracture sensitivity of 71%) followed by X-rays (single-fracture sensitivity of 63%). Linear fractures outsider the region of the sutures were more identifiable than diastatic fractures, though the incidence of false positives was greater for linear fractures. In the two cases where multiple fractures were present on the same anatomical skull location, the radiologist was less likely to identify the presence of additional fractures than a single fracture. Overall, the high-resolution and clinical-resolution CT scans had the similar accuracy for detecting skull fractures while the use of the X-ray was both less accurate and had a lower specificity.     

The Role of Semi-Direct Democracy in Shaping Swiss Federalism: The Behavior of Cantons Regarding Revision of the Constitution, 1866-1981

Swiss federalism operates as a semi-direct democracy involvingreiterated constitutional choice by the people and the territorialunits. In this respect, the Swiss federal process is uniquein comparison to other federal systems. An analysis of constitutionalreferenda and constitutional initiatives conducted from 1866to 1981 was undertaken in order to characterize the politicalbehavior of Swiss cantons concerning the referenda that havealtered the original Constitution of 1848. The behavior of thecantons may be explained by their sociopolitical features. Threegroups of cantons are distinguished by their pattern of behaviortoward proposed revisions of the federal Constitution. In addition,a comparison was made of the similarity and divergence of thecantons with the pattern of behavior of the entire federationin order to measure the degree of cohesion of the Swiss partnership.Strikingly, some of the cantons with a minority subculture weremore frequently in the winning coalition than were some cantonsthat share more of the characteristics of the majority culture.The Swiss federal process is found to strengthen nation-buildingby means of the continual adaptation, along with some innovation,of the original constitutional design on the part of the peopleas a whole and the cantons.     

Books,Bureaus, and the Historiography of Cameralism

This paper traces a deep rift in the historiography of cameralism, demonstrating how historians have systematically separated cameralist writings from the context of the Holy Roman Empire’s fiscal chambers. Scholarship on the subject has been largely defined by an artificial separation between “cameralists of the book” and “cameralists of the bureau.” I argue that it is time to interrogate this distinction, which is itself a legacy of the nineteenth century.     

The characteristics of injuries to the thoracic spine in children with a forward flexion

Excessive flexure of the thoracic spine in childhood may result in latent lesions of the middle thoracic vertebra and intervertebral disks visible by X-ray and on sagittal cuts. The prior deformation may be judged by their morphological signs. Ability of infantile vertebral bodies to recover their form after load removal reduces reliability of mathematical processing of X-ray data. Use of X-ray method for examination of thoracic spine in expert practical work makes it possible to detect lesions and mechanism of their formation.     

The Role of Emotion and Cognition in Juror Perceptions of Victim Impact Statements

Recent legislation has contributed to an increasing number of victims participating in the trial process by way of providing victim impact statements (VISs). The present study evaluated jurors’ perceptions of VISs in a jury-eligible sample. Participants were 402 jury-eligible community members in the southwestern United States. Using a vignette-based method, VIS presence and content (i.e., Victim Harm versus Victim Emotion information) were examined for their influence on sentencing decisions and blame attribution. Individual differences of need for affect (NFA) and need for cognition (NFC) were featured as moderators of these relations. Notable results included significantly lengthier sentencing recommendations and decreased levels of victim blame in the presence of a VIS, regardless of content. In addition, juror NFC was significantly positively associated with perpetrator blame, while NFA moderated the relation between VIS content and sentencing length. The presence of a VIS impacted blame and sentencing, although jury panel member individual differences moderated such effects. Implications for victim rights policy, trial consultation, and social–emotional theory are discussed.     

Interpretation of neuropathological lesions: Its limitations in medico-legal experts’ reports

Aggressive or paradoxical behaviour may reflect an organic dementia. The most frequent is Alzheimer's disease, which results from an abnormal structural conformation of tubulin-associated protein (tau) and beta-amyloid protein that, respectively, aggregate in certain neurons as intracellular neurofibrillary tangles (NFTs) and in the extracellular environment as senile plaques.These lesions progress in the brain tissue according to the stages described by Braak and Braak. Staging of neurofibrillary pathology has proven anatomical and clinical correlation, which can be used in a medico-legal procedure. We report two cases demonstrating discrepancies between anatomical and clinical features, which should encourage medical expert to prudence when interpreting neuropathological reports.