Drug screening in clinical or forensic toxicology: are there differences?

Legal and medical practitioners need to remember that, with respect to drug analysis, there are two distinct disciplines in analytical toxicology concerned with human biological matrices, namely clinical and forensic toxicology. Both fields use similar analytical techniques designed to detect and quantify drugs, chemicals and poisons in fluids or tissues. In clinical toxicology, analytical results help to specify the appropriate treatment of a poisoned or intoxicated patient. In forensic toxicology, the results often play a vital role in determining the possible impairment or behavioural changes in an individual, or the contribution of drugs or poisons to death in a medico-legal investigation. This column provides an overview of the similarities and differences inherent in clinical and forensic toxicology.     

Leadership Matters: The Effects of Targeted Killings on Militant Group Tactics

Targeted killings have become a central component of counterterrorism strategy. In response to the unprecedented prevalence of this strategy around the world, numerous empirical studies have recently examined whether “decapitating” militant groups with targeted killings is strategically effective. This study builds on that research program by examining the impact of targeted killings on militant group tactical decision-making. Our empirical strategy exploits variation in the attack patterns of militant groups conditional on whether a government’s targeted killing attempt succeeded against them operationally. In both the Afghanistan-Pakistan and Israel-West Bank-Gaza Strip theaters, targeted killings significantly alter the nature of militant group violence. When their leaderships are degraded with a successful strike, militant groups become far less discriminate in their target selection by redirecting their violence from military to civilian targets. We then analyze several potential causal mechanisms to account for these results and find strongest evidence that targeted killings tend to promote indiscriminate organizational violence by empowering lower level members with weaker civilian restraint.     

Party performance explains disagreement between politicians and their parties

Are politicians more likely to disagree with their party after an electoral defeat or during a spell in opposition? If so, are they likely to advocate a more moderate or a more radical position than their party? In order to evaluate this, the article analyses the absolute distance between candidates for parliament and their parties on the left–right dimension. The sample used consists of 5614 politicians from 11 countries (Comparative Candidate Survey). Controlling for party system differences and individual characteristics, the results demonstrate that politicians take more moderate positions than their party after an electoral defeat. Also politicians of government parties are surprisingly more likely to disagree than politicians of opposition parties. These results overlap with predictions of party position shifts and inform the discussion on how intra-party dynamics bring about changes in party position. In addition, the article finds evidence of loss aversion, and differences in the responsiveness of elite and non-elite candidates.     

Assessment of the stability of 30 antipsychotic drugs in stored blood specimens

The accuracy of antemortem diagnosis of pulmonary embolism is within the range of just 10-30%, so representing one of the most frequent missed diagnosis in sudden, unexpected death. We describe 43 fatal cases of pulmonary embolism as confirmed by post-mortem examination. The aim of our study was to verify the systematic search for the most common genetic thrombophilias (Factor V Leiden (G1691A) and FII (G20210A) gene variants) and dating the thrombus. As a whole, 41 patients (95.3%) had at least one risk factor. Pre-existing symptoms are described just before fatal embolism in 18 (41.9%) out 43 patients. In 18 out of 43 (41.9%) it was not possible to find the thrombotic site. In 24 out of the remaining 25 cases the involvement of the deep veins of one leg was shown; in 1 case the thrombus was localised in the inferior caval vein. 10 (41.7%) were iliac vein thromboses, 7 (29.1%) femoral, 2 (8.3%) popliteal, 3 (12.6%) posterior-tibial, 1 (4.1%) anterior-tibial and 1 (4.1%) peroneal vein thromboses. In our cohort of patients, 4 (10%) out of 40 cases carried the 20210A prothrombin gene variant in heterozygosis. One (2.5%) out of 40 carried the Factor V Leiden (G1691A) gene variant in heterozygosis. Patients carrying these gene variants in homozygosis or carrying both were not present in our case-series. We strongly underline the relevance of a complete methodological approach, integrating clinical data by means of autopsy findings and histological study. On the contrary, investigating common inherited thrombophilia is not warranted.