Computational Study of Fracture Characteristics in Infant Skulls Using a Simplified Finite Element Model

Skull fracture characteristics are associated with loading conditions (such as the impact point and impact velocity) and could provide indication of abuse or accident‐induced head injuries. However, correlations between fracture characteristics and loading conditions in infant and toddler are ill‐understood. A simplified computational model representing an infant head was built to simulate skull responses to blunt impacts. The fractures were decided through a first principal strain‐based element elimination strategy. Simulation results were qualitatively compared with test data from porcine heads. This simplified model well captured the fracture pattern, initial fracture position, and direction of fracture propagation. The model also very well described fracture characteristics found in studies with human infant cadaveric specimens. A series of parametric studies was conducted, and results indicated that the parameters studied had substantial effects on fracture patterns. Additionally, the jagged shapes of sutures were associated with strain concentrations in the skull.     

A comparative evaluation of the disulfur dinitride process for the visualisation of fingermarks on metal surfaces

The disulfur dinitride process for fingermark visualisation was first reported a decade ago, with promising results obtained for a range of materials including metals. However, the friction sensitive nature of the material and difficulty of synthesis made routine use difficult. Many of these issues have since been addressed, making equipment and chemicals available to build an understanding of how the effectiveness of disulfur dinitride compares to other fingermark visualisation processes currently used on metal surfaces. This enables more informed advice to be given on selection of processes for treatment of metal items, an area of operational interest that encompasses weapons used in violent crime and the increasing incidence in metal theft. This paper reports a comparative study into the effectiveness of disulfur dinitride, cyanoacrylate fuming, vacuum metal deposition, gun blueing and wet powder suspensions on brass, bronze, copper and stainless steel. Experiments were conducted with the surfaces exposed to a range of environments including long term ageing, water/detergent washing, acetone washing and high temperature exposure. The results indicate that disulfur dinitride is an effective process for fingermark visualisation on metal surfaces, including those exposed to adverse environments, and may offer potential improvements over existing processes for those surfaces. Further work, including pseudo-operational trials, is recommended.     

IS JUSTICE SERVED BY MORE PEOPLE REPRESENTING THEMSELVES IN COURT?

Justice Donald B. King proposes a streamlined system for couples with assets under $400,000. He explores the problem of nearly 50% of couples going through divorce without attorney representation. He proposes close judicial management of such cases and removal of the need for unnecessary discovery and other expensive procedures.     

Private credentialing of health care personnel: an antitrust perspective. Part One

This Article explores the antitrust and other implications of private credentialing and accrediting programs in the health care industry. Although such programs are usually sponsored by powerful competitor groups, they serve the procompetitive purpose of providing useful information and authoritative advice to independent decision makers. Part One examines the risk that credentialing will sometimes be unfair to competitors and deceive consumers. Its survey of common-law, antitrust, and regulatory interventions to correct such unfairness and deception seeks to determine the degree of oversight to which credentialing and similar activities have been and should be subjected. In recommending that judicial or regulatory scrutiny should be limited to discovering whether standards and practices have a rational relation to a procompetitive purpose, the Article argues that greater intrusion into credentialing schemes would be inconsistent with market theory and first amendment values and would discourage line-drawing efforts that stimulate competition and facilitate consumer choice. By emphasizing throughout that personnel certification and institutional accreditation embody ideology and opinion as well as factual information, Part One sets the stage for the argument in Part Two that antitrust law can and should be used to contest the dominance of a single ideology of health care and to facilitate the development of alternative sources of consumer information. The Article's overall thesis is that, whereas the quality of advice given to the public about health care personnel and similar matters should not be closely regulated, neither should the supply of competing information and opinion be artificially curtailed.     

Is "ten days" really ten days?--the National Labor Relations Act's strike notice requirement in the healthcare industry

Nearly thirty years ago, Congress amended the National Labor Relations Act (Act) and provided employees of healthcare institutions with the right to strike and picket. At the same time, Congress added a new Section 8(g) requiring a labor organization to provide a healthcare institution with ten days' notice before engaging in various types of concerted activity--primarily strikes and picketing--against the institution. Thus, Section 8(g) is an important statute for healthcare employers. But since the time Congress added Section 8(g), the National Labor Relations Board has taken various views on Section 8(g) and whether "ten days" is really ten days. This Note explores the purposes of Section 8(g), as well as the reach and limits of its language, noting areas in which the board may wish to reconsider its application of the statute. Ultimately, the Note provides a checklist for healthcare employers to keep in mind with respect to Section 8(g).     

Solid-phase extraction for profiling of ecstasy tablets

A solid-phase extraction (SPE) procedure has been developed for impurity profiling of illicit tablets containing 3,4-methylenedioxy-N-methyl-amphetamine (MDMA, ecstasy). Following initial comparison of liquid-liquid extraction and solid-phase extraction, SPE was found to be preferable because it afforded higher extraction efficiencies and shorter extraction times. Procedure blank samples were also analyzed to identify constituents of the extracts which did not originate in the ecstasy tablets. The developed procedure was subsequently applied to 12 samples of seized ecstasy tablets and a comparison was made of these samples to determine similarities and obtain inferences with respect to commonality of origin.     

Postmortem investigation of lamotrigine concentrations

Lamotrigine is a relatively new anticonvulsant. Therapeutic plasma concentrations generally range from 1 to 4 mg/L, although several studies have shown that good control of epilepsy has been achieved with concentrations reaching 10 mg/L generally, with little toxicity. In overdose, however, the drug has been linked to ECG changes that may suggest a possible arrythmogenic effect and hence cardiac toxicity. Lamotrigine has also been shown to cause encephalopathy and thus neurotoxicity. There is no information concerning postmortem lamotrigine concentrations and their interpretation. We describe lamotrigine concentrations in postmortem specimens including blood, liver, bile, vitreous humour, and urine from eight cases. A high performance liquid chromatography (HPLC) method is described with extraction procedures for the various tissues. Two possible groups were identified. The first being the "broader therapeutic" group with blood concentrations ranging from 0.9 to 7.2 mg/L and corresponding liver concentrations ranging from 16 to 36 mg/kg. The second being a "supratherapeutic" group with blood concentrations ranging from 20 to 39 mg/L and corresponding liver concentrations ranging from 53 to 350 mg/kg. Although none of the eight cases described were attributed to overdose by lamotrigine alone, the cause of death for one of the three cases in the "supratherapeutic" group was given as mixed drug toxicity. Cause of death for the remaining two cases in this group was reported as epilepsy. However, both these cases showed elevated concentrations of lamotrigine and both were co-medicated with valproic acid. Such co-administration has been shown in the literature to lead to elevated lamotrigine concentrations and a reduction in lamotrigine dose has been recommended. With such data, we highlight the importance of monitoring lamotrigine concentrations in cases co-medicated, particularly with valproic acid.