Improved estimation of postmortem interval based on differential behaviour of vitreous potassium and hypoxantine in death by hanging

Many formulae are available to estimate the relation between the potassium ([K+]) and hypoxantine ([Hx]) concentration in the vitreous humour and the postmortem interval (PMI). Typically these have been based on a correlation test and linear regression using the postmortal interval as the independent variable and [K+] or [Hx] as the dependent variable in order to estimate the confidence interval. However, a recent study has shown that a more precise measurement of PMI can be obtained if [K+] is used as the independent variable. The regression lines obtained from the most recent deceased subjects with forensic relevance received for autopsy in the Institute of Legal Medicine are [K+] = 5.589 + 0.174PMI and [Hx] = 26.459 + 3.017PMI, by changing the variables, we obtain PMI=3.967[K+] - 19.186 (R2 = 0.688, P < 0.001) and PMI = 0.172 [Hx] + 0.170 (R2 = 0.518, P < 0.001). In this paper we propose the cause of death as an extra factor which modifies the relationship and gives even greater precision in estimating PMI. In cases of death by hanging the results are considerably improved with [K+] = 5.224 + 0.225PMI and [Hx] = 15.161+4.957PMI, respectively, and consequently, PMI = 3.631[K+] - 17.334 (R2 = 0.818, P< 0.001) and PMI = 0.153[Hx] - 0.368 (R2 = 0.757, P < 0.001): the slope is less and the precision is obviously enhanced.     

Modeling the Referral Decision in Sexual Assault Cases: An Application of Random Forests

This paper examines the decision to refer a sexual assault case for prosecution using a sample of 730 reported sexual assaults in which the victim received a medical/forensic examination. The decision to refer a case for prosecution was modeled using an algorithmic modeling technique, Random Forests. The key advantages of this modeling approach include its superiority in predicting case outcomes and its ability to easily uncover nonlinear relationships. Key results indicate that the likelihood of referral increased when sperm was found and documented, when the victim could identify the suspect, and as the severity of nongenital injury increased. Neither the presence nor the severity of genital injury impacted the decision to refer a case for prosecution. On the whole, suspect and report characteristics had the largest impact on referring cases for prosecution, with victim characteristics having little influence.     

‘Playing the Judicial Card’: Litigation Strategies during the Process of Ratification of the Lisbon Treaty

During the process of ratification of the Lisbon Treaty, a number of constitutional jurisdictions were activated by political actors. In playing ‘the judicial card’, opponents of ratification decided to seek political goals through judicial means, and thus they were obliged to develop litigation strategies. This article explores such strategies and the responses that courts gave them. It shows that constitutional proceedings with regards to the Lisbon Treaty became a political battleground governed by legal logics, in which the interpretation of European clauses, the democratic deficit of the Union and the tensions underlying the European judicial dialogue were privileged objects of discussion between claimants and courts in which law and politics intertwined.     

Retropharyngeal Hematoma Secondary to Cervical Spine Surgery: Report of One Fatal Case

A 53‐year‐old woman suffering from radicular pain due to cervical herniation underwent a spinal surgery consisting of anterior cervical discectomy and fusion with an implantable titanium cage. Five hours after the procedure, the patient developed cervical swelling and dyspnea. An emergency surgery permitted evacuation of a deep cervical hematoma and intubation of the patient, who died some minutes later. The family of the deceased lodged a complaint with the public prosecutor because of unclear circumstances of death. After analysis of the medical records by two forensic pathologists, a medicolegal autopsy was ordered. Massive retropharyngeal and mediastinal hematomas were diagnosed. Pathological study confirmed acute cervical hemorrhage, but failed to detect the source of bleeding. The forensic pathologists concluded that death was due to mechanical asphyxia secondary to pharyngeal compression by the cervical hematoma. To the best of our knowledge, death secondary to retropharyngeal hematoma in this neurosurgical context is rarely encountered.     

The Relationship Between Mental Disorders and Types of Crime in Inmates in a Brazilian Prison

This cross‐sectional study conducted in prisons in the city of Salvador, Bahia, Brazil, investigated the association between the presence of psychiatric disorders in 462 prisoners and the types of crimes committed by them. Psychiatric diagnosis was obtained by means of the Brazilian Portuguese version of the Mini‐International Neuropsychiatric Interview. A statistically significant association was found between some psychiatric disorders and specific groups of crime: lifelong substance addiction with sex crimes and homicide; antisocial personality disorder with robbery and with kidnapping and extortion; borderline personality disorder with sex crimes; and lifelong alcohol addiction with fraud and conspiracy and with armed robbery and murder. It was concluded that the mental disorders considered more severe (psychosis and bipolar disorder) were not associated with violent crimes, suggesting that the severity of the psychotic disorder may be the factor that has caused psychosis to be associated with violent crimes in previous studies.     

Is There an Informative Effect of Law? An Experimental Test

Debates on how the law affects citizens' behaviour have traditionally focused on two mechanisms: deterrence and perceptions of legitimacy. In recent years, some scholars have suggested that the law may also affect compliance through expressive mechanisms that reveal information about the world (for example, by eliciting the risks associated with a particular behaviour). Dharmapala and McAdams have called this the informative effect of law. However, to date very little empirical evidence of the existence of such an effect has emerged. In this article, we present the results of an experiment that tests for three different hypotheses as to how this effect may be produced. Our findings show that legislators' sincerity or their access to expert knowledge is not sufficient to produce information effects. Instead, we suggest an ‘asymmetry’ hypothesis: the fact that a law is passed or rejected has an asymmetrical information effect on subjects' risk perceptions.     

Do different types of incubators produce different types of innovations?

Incubators are heterogeneous but there is a lack of understanding of the variety of innovation involved. We use four archetypes of incubator discussed in the literature (basic research, university, economic development and private incubator) and analyze their generation of different types of innovation (product, technological process and organizational innovation) during a 4 years period (2005–2008). In a sample of 80 incubators, we find that incubatees in some types of incubators are more prone to generate product and technological process innovations than those hosted in other types.     

A French hospital sentenced for unreasonable obstinacy

On 2 June 2009, the Nimes administrative court condemned the Hospital of Orange (France) for unreasonable obstinacy after neonatal resuscitation. On 14 December 2002, an apparently stillborn child was resuscitated after approximately 30 minutes of foetal distress. Cardiac activity was recovered, but the child has since suffered from severe disabilities. The court did not find any fault committed by the hospital regarding maternal care. However, the hospital was sentenced to compensate for the injuries caused by unreasonable obstinacy. According to the court, the medical team should have taken into account the harmful neurological consequences of prolonged foetal distress. The court did not condemn the act of resuscitation itself, but its excessive length. This court ruling serves as a basis for reflection regarding the limits by which unreasonable obstinacy should be set.     

Petechiae in hanging: a retrospective study of contributing variables

Petechiae, one of the classic signs of asphyxia, are thought to be more frequently observed in cases of hanging where part of the body is supporting the victim's weight, ie, cases of incomplete hanging. However, there is very little evidence-based medicine to support this claim. The present study is intended to evaluate the relationship between petechiae and the type of hanging (complete vs. incomplete). Furthermore, several other variables were analyzed to determine if they contribute significantly to the presence of petechiae. An 8.5-year retrospective study of 206 cases of death by hanging reviewed autopsy reports for the presence of petechiae. For each case, the following information was also compiled: gender and age, height and weight, body mass index, the type of hanging (complete or incomplete suspension), the type of ligature used (narrow or wide), and whether or not the victim had received cardiopulmonary resuscitation maneuvers. Statistical analysis revealed that the incidence was higher among incomplete hanging victims compared with cases of complete suspension and that the incidence of petechiae varied inversely with the height of the victims. The other factors were not shown to contribute significantly to the presence of petechiae.     

Self-inflicted burns: the value of collaboration between medicine and law

Self-inflicted burns are rare in France, but they lead to major, often life-threatening complications. The authors reviewed medical data for patients hospitalized in a burn center from January 2004 to December 2008. Thirty-eight cases of self-inflicted burns were compared with 220 accidental burns. Women were predominantly affected (57.9%, n = 22). A psychiatric history (71%, n = 27) was more frequent in this population. The mean age of the victims was 38 years. The leading method of suicide was flame (94%, n = 36) associated with gasoline used as an accelerant (77.7%, n = 28). Mean total burn surface area (41.5%) and mortality (36.9%) were higher in the self-inflicted burn population. By recognizing epidemiological characteristics and patients at risk, we can better classify lesions related to self-immolation. It is important for the forensic physician to consult survival details to correlate these data with the results of autopsy.