Increased risk of fatal intoxication and polypharmacy among psychiatric patients at death

Patients suffering from psychiatric disorders have an excess mortality and a shorter life span expectancy compared to the general population. Furthermore, they are treated with multiple drugs and are known to have an increased risk of drug abuse. In this study, we aimed at investigating the pharmaceutical drug and drug of abuse profiles of the deceased included in the Danish prospective autopsy‐based forensic study on psychiatric patients, SURVIVE. Using the postmortem systematic toxicological analysis results, we identified 129 different consumed compounds in our population (n = 443). Polypharmacy (≥5 compounds) was detected in 39.5% of the deceased. Deceased with a psychiatric diagnosis or who died from a fatal intoxication had significantly more compounds at the time of their death compared to having either no psychiatric diagnosis or another cause of death, respectively. Evidence of drug abuse was present, as 29.8% of our total population had consumed either methadone or illicit drugs of abuse, excluding tetrahydrocannabinol. Of those deceased with a psychiatric diagnosis, 33.6% had either consumed methadone or illicit drugs of abuse, a greater number than those without a psychiatric diagnosis. Fatal intoxication was the most frequent cause of death (40.6%) with methadone as the major intoxicant. Here, we found that those without a psychiatric diagnosis had fewer fatal pharmaceutical drug intoxications compared to the psychiatric diagnosis groups. Our findings add further context to understanding the excess mortality of psychiatric patents, since there is an increased occurrence of fatal intoxication, polypharmacy, and drug abuse in this population.     

Determined to Die! Ability to Act Following Multiple Self‐inflicted Gunshot Wounds to the Head. The Cook County Office of Medical Examiner Experience (2005–2012) and Review of Literature

Cases of multiple (considered 2+) self‐inflicted gunshot wounds are a rarity and require careful examination of the scene of occurrence; thorough consideration of the decedent's psychiatric, medical, and social histories; and accurate postmortem documentation of the gunshot wounds. We present a series of four cases of multiple self‐inflicted gunshot wounds to the head from the Cook County Medical Examiner's Office between 2005 and 2012 including the first case report of suicide involving eight gunshot wounds to the head. In addition, a review of the literature concerning multiple self‐inflicted gunshot wounds to the head is performed. The majority of reported cases document two gunshot entrance wound defects. Temporal regions are the most common affected regions (especially the right and left temples). Determining the capability to act following a gunshot wound to the head is necessary in crime scene reconstruction and in differentiation between homicide and suicide.     

Corneal‐Smart Phone: A novel method to intelligently estimate postmortem interval

The changes of postmortem corneal opacity are often used to roughly estimate the postmortem interval (PMI) in forensic practice. The difficulty associated with this time estimate is the lack of objective means to rapidly quantify postmortem corneal changes in crime scenes. This study constructed a data analysis model of PMI estimation and implemented an intelligent analysis system for examining the sequential changes of postmortem corneal digital images, named Corneal‐Smart Phone, which can be used to quickly estimate PMI. The smart phone was used in combination with an attachment device that provided a darkroom environment and a steady light source to capture postmortem corneal images. By segmenting the corneal pupil region images, six color features, Red (R), Green (G), Blue (B), Hue (H), Saturation (S), Brightness (V) and four texture features Contrast (CON), Correlation (COR), Angular Second Moment (ASM), and Homogeneity (HOM), were extracted and correlated with PMI model. The results indicated that CON had the highest correlation with PMI (R² = 0.983). No intra/intersubject variation in CON values were observed (p > 0.05). With the increase in ambient temperature or the decrease in humidity, the CON values were increased. PMI prediction error was <3 h within 36 h postmortem and extended to about 6–8 h after 36 h postmortem. The correct classification rate of the blind test samples was 82%. Our study provides a method that combines postmortem corneal image acquisition and digital image analysis to enable users to quickly obtain PMI estimation.     

Genetic data analysis of nine STRs in two Caribbean Colombian populations: César and Guajira.

POPULATION: We have analyzed the distribution of the allele frequencies and parameters of forensic interest at nine short tandem repeat (STR) loci (CSF1PO, D3S1358, D5S818, D7S820, D13S317, FGA, TH01, TPOX, and vWA) in a sample population of 165 unrelated individuals from César and Guajira, Caribbean populations of Colombia.     

朝贡体系下古代东亚秩序形成与维系的内在逻辑——批判地借鉴英国学派的分析方法

古代东亚秩序的形成与维系,同历史悠久的朝贡体系有着直接的关系。因此,要有效揭示古代东亚秩序的内在逻辑,应当批判地借鉴以历史主义见长的英国学派的分析方法,探讨朝贡体系的运行机制和内在本质。在古代,中国与朝鲜长时段的朝贡体系实质上是一种由中国主导并以其特有文化为基础、周边诸政权普遍认可和积极参与的特殊国际制度。就中国而言,完全独立的政治体制、自给自足的经济结构、等级制的世界观,使其对外部的需求仅限于其他政权对其至高无上地位的承认及其对相关制度安排的服从。而对周边诸政权来说,只有与实力超强的中国建立朝贡关系,它们才能获得合法性和安全保障,并取得与中国贸易的机会,从而实现生存与发展两大目标。由此可以得出如下结论:在缺乏文化共识的前提下,由地区强国主导,可以促成某种功能性的国际制度,使地区秩序得以维护,并在交往过程中反向促成文化认同。这一结论修正了英国学派关于共有文化与国际制度的关系的观点。