The value of examination aids in victim identification: a retrospective study of an airplane crash in Nepal in 2002

After the crash of an airplane in Nepal in the year 2002, the dental status of the 14 European victims was examined at autopsy as well as after additional removal of the soft tissue and compared with antemortem findings which were available in 11 cases. Re-examination of all jaws showed that nine composite fillings and seven root fillings as well as one parapulpal pin could not be detected during autopsy. Because tooth-coloured restorations may be overseen even by an experienced expert, the findings underline the necessity of performing a full resection of both jaws and removal of the soft tissue. Furthermore, X-ray analysis of the jaws and the use of phosphoric acid or ultra violet radiation for recognizing tooth-coloured restorations are recommended.     

Fatal thoracic compression after being partially run over by an automobile

The authors report on a fatal pedestrian accident in which the victim lay on the street and got under a car being run over by one of the front wheels. Both the car driver and the killed pedestrian were strongly alcohol-intoxicated at the time of the accident (2.45 a.m.). After the car had come to a standstill, the pedestrian remained trapped under the car until she was rescued by the fire brigade. On the basis of the autopsy findings and the technical expert opinion it could be reconstructed that the pedestrian's death was not caused by the consequences of being run over by the car, but by the subsequent compression of her thorax in the final accident position.     

Mixed fatal poisoning caused by taking L-methadone and chloral hydrate

A 42-year-old female drug user who was enrolled in a methadone maintenance program was found dead in her apartment. Cause of death was an intoxication with chloral hydrate and L-methadone. Trichloroethanol (TCE), the primary metabolite of chloral hydrate, was quantified by solid phase microextraction (SPME) and GC/MS in heartblood (27 micrograms/ml) and urine (338 micrograms/ml). D- and L-methadone were differentiated by chiral HPLC, which showed that only L-methadone had been taken. The quantitation of L-methadone and its metabolite EDDP was carried out by GC/MS from heartblood (1300 ng/ml and 86 ng/ml, respectively), urine (5239 ng/ml and 4960 ng/ml, respectively) and gastric contents (159 ng/ml and 122 ng/ml, respectively). The concentrations of both--trichloroethanol and methadone--were in toxic ranges.     

Recent developments in medicine and law

This article addresses important developments in the field of medicine and the law during the last year and highlights some of the significant areas of law affecting health care providers that should be considered. Actions against health care providers may include challenges to peer review immunity, allegations concerning the practice of medicine across state lines without a license, and even accusations of wrongfully assisting a patient to commit suicide. These areas are addressed in turn by this article. Finally, antitrust developments over the last year are briefly addressed as an emerging area of concern for providers forming complex practice networks in today's health care arena.     

Varieties of Sharing. Handlungsorientierungen,Strukturen und Arbeitsbedingungen eines neuartigen Feldes

The paper deals with a segment of the digitization of work: It examines the forms and conditions of work in the so-called sharing economy (SE). Based on the analysis of 67 internet platforms, three segments – the “exchange and gift economy”, the “niche and side job economy” as well as the “platform economy” – are distinguished as separate institutional spheres of the SE. On this basis, five dimensions of work in these segments are comparatively analyzed. It is shown that patterns of work differ among the three segments with view to activity patterns, gratification, qualification requirements, the role of technology and control mechanisms. The paper then discusses a shift in the determinants of work: it is argued that classical factors no longer prevail, but are partly supplemented, partly replaced by “internet communities” and the socio-technical structures and strategies of the platform providers. Not least, the absence of formal employment contracts in platform-user-relationships stands out.     

Bilingualism and the pronunciation of Latvian intonations

For 50 years after World War II, Latvia was incorporated into the former Soviet Union. Although in theory the use of regional languages was not discouraged, in practice knowledge of Russian was obligatory. Since restoration of the country’s independence in 1991, Latvian has again become the official language, and knowledge of Russian is widespread but optional. These political events have created a natural experiment in the possible effects of almost universal bilingualism on a language. In this study, we examine the phonetic characteristics of the Latvian syllable intonations across generations. Native speakers of Latvian, ranging from retirement age to teens, were recorded reading a word list, sentences, and a short narrative. We find that younger speakers who used Latvian only about half of the time showed fading in their pronunciation of the intonations.     

Decapitation as a result of suicidal hanging

A report is presented on a 47 year old man who committed suicide by hanging himself from a staircase bannister of an apartment house. The man, weighing 144 kg jumped with the noose of a 2 cm thick and 2 m long hemp rope around his neck and was completely decapitated. Death from typical "normal" suicidal hanging is usually due to cerebral ischaemia caused by compression of the carotid (and vertebral) arteries. Except for bleeding at the clavicular insertions of the sternocleidomastoid muscles there are only occasional injuries to the cervical soft parts or hyoid bone and/or laryngeal cartilage. A fall with a noose around the neck, on the other hand, is associated with more frequent injuries to cervical structures through additional axial traction and radial shearing forces of the tightening noose. Complete decapitation can occur in rare cases under extreme conditions (heavy body weight, inelastic and/or thin rope material, fall from a great height).     

Fatal neck injuries caused by blank cartridges.

We report three cases where fatal neck injuries were caused by blanks from starting pistols. The weapons were loaded with blank cartridges or tear gas cartridges. Neither live ammunition nor any form of projectile was used. All three cases involved a contact discharge. The gas pressure caused by firing the weapons created extensive wound cavities in all three cases. Each victim died from blood loss as a result of ruptured cervical vessels; there were no air embolisms. In one case, a man shot himself eight times with two different starting pistols, and the wounds could be matched to each gun by the muzzle imprint marks on the neck.