One Quintillion Ways to Have PTSD Comorbidity: Recommendations for the Disordered DSM-5

Galatzer-Levy and Bryant (Perspect Psychol Sci 8:651–662, 2013) have calculated the number of ways that Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013) posttraumatic stress disorder (PTSD) symptoms can be combined as over 600,000. They concluded that the amount is astounding and the category is rendered amorphous. PTSD often occurs in the context of polytrauma or comorbidity. The epidemiological literature indicates that the most common comorbid conditions in cases of PTSD include major depressive disorder (MDD), chronic pain, neurocognitive disorder due to traumatic brain injury (e.g., mild), and alcohol use disorder, with premorbid personality disorder possible, as well (which we consider as exacerbated due to the traumatic incident at issue, as in borderline personality disorder). We calculated the possible symptom combinations for each of these disorders and then in comorbid combination with PTSD (e.g., PTSD with MDD, but also when all six conditions are present). The number of symptom combinations in full polytrauma involving all six conditions listed is truly astounding, over one quintillion. Also, we reviewed the range of PTSD comorbidities, which adds to the symptom heterogeneity in cases. We make recommendations to prioritize symptoms in disorders as primary (e.g., unique, marker), secondary (e.g., core essential), and tertiary (e.g., common, cross-diagnostic). The latter tertiary type of symptoms in a disorder, if any, should be kept apart in its own criterion. This approach might help make the next version of the DSM more clinically useful both to clinicians and to court.     

Obama’s Foreign Policy: “Smart Power,” Realism and Cynicism

This article reviews the foreign policy of the Obama administration with a special focus on the Middle East. It shows the gap between the lofty rhetoric of the President, a great orator, and the decisions taken by the Administration. This gap is the inevitable result of the normal play of forces in the decision-making process involving many actors and the interplay of domestic policies and foreign policy. The author argues that if Obama’s foreign policy is analyzed in electoral and domestic terms then it is quite wrong to argue, as some have done, that it is dumb. Smart in electoral terms, however, does not necessarily mean smart on the international stage.     

Quantification of Perspective‐Induced Shape Change of Clavicles at Radiography and 3D Scanning to Assist Human Identification

Change in perspective between antemortem and postmortem imaging sessions (radiograph to radiograph and surface scan to radiograph) may cause different 2D renderings of the same osseous element complicating comparisons for identification. In this study, clavicle shape changes due to radiographic positioning and 3D laser scanning were examined in 20 right‐side specimens, as pertinent to chest radiograph comparisons. Results indicate substantial changes in clavicle form with short source‐to‐image receptor distance, elevation of the element from the image receptor, and movement of the element away from the center beam (10% mean square for shape). Although quantitative shape differences were small when the clavicle was in close opposition to the image receptor (3% mean square), important qualitative differences remained with large distances from the center beam (e.g., conoid tubercle presence/absence). The significance of these results for image superimposition and computer‐automated‐shape‐based searches of radiographic libraries to find matching candidates is discussed.     

Anthropological Facial Approximation in Three Dimensions (AFA3D): Computer‐Assisted Estimation of the Facial Morphology Using Geometric Morphometrics

This study presents Anthropological Facial Approximation in Three Dimensions (AFA3D), a new computerized method for estimating face shape based on computed tomography (CT) scans of 500 French individuals. Facial soft tissue depths are estimated based on age, sex, corpulence, and craniometrics, and projected using reference planes to obtain the global facial appearance. Position and shape of the eyes, nose, mouth, and ears are inferred from cranial landmarks through geometric morphometrics. The 100 estimated cutaneous landmarks are then used to warp a generic face to the target facial approximation. A validation by re‐sampling on a subsample demonstrated an average accuracy of c. 4 mm for the overall face. The resulting approximation is an objective probable facial shape, but is also synthetic (i.e., without texture), and therefore needs to be enhanced artistically prior to its use in forensic cases. AFA3D, integrated in the TIVMI software, is available freely for further testing.     

The politics of currency crises in Sweden: Policy choice in a globalised economy

In the two‐pronged debate on ‘globalising markets’ the ‘society‐centered’ perspective claims nation‐states are losing economic control whereas the ‘state‐centred’ perspective holds that ‘business as usual’ is possible. Both views are oversimplified. Looking at Sweden's 1992 currency crisis, we suggest that studies over time provide insights about the significance of political craftsmanship. We argue that market influence on domestic policy making should be regarded as a variable contingent on a fortuitous (from the point of view of market actors) confluence of political and economic circumstances. Our analysis suggests that this confluence, to some extent, can be controlled or manipulated by the state.     

Metropolitan-scale Planning in Neo-liberal Times: Financial and Political Obstacles to Urban Form Transition

Just as rising concern about its environmental, economic, social, health and quality of life downsides generates loud calls for a departure from the dispersed car-oriented urban model, conditions for such a transition have become more uncertain. The intended urban shift is hampered by dissonance between the generation of metropolitan-scale planning visions and the anti-interventionist characteristics of the current neo-liberal age. The paper identifies impeding effects of neo-liberalism—notably, public funding hardship and political dynamics—on attempts at carrying out transformative metropolitan planning. The difficulty in preventing major failures in the operation of cities under neo-liberalism is reflective of its inability, at a broader societal scale, to regulate the economy and thus avert economic and social crises. The paper draws its empirical substance from the gap in Toronto, Canada, between metropolitan planning visions and the urban development reality.     

Quantified Explosives Transfer on Surfaces for the Evaluation of Trace Detection Equipment

Trace explosive test surfaces are often required for the evaluation of trace detection equipment to determine the equipment performance. Test surfaces of C‐4, Detasheet, Semtex‐H, TNT, and HMTD were prepared by transferring trace amount of explosive deposited on polytetrafluoroethylene (PTFE) transfer strips onto different surfaces (Kraft paper, hard plastic, woven fabric, and soft vinyl). The amount of explosive transferred was deduced from the amount of explosive remaining on the PTFE strips after transfer, as quantified by direct analysis using tandem mass spectrometry with thermal desorption. From the data set of over 2000 transfers, we experienced lower transfer efficiency for Semtex‐H and Detasheet, and for soft vinyl and hard plastic. However, the rapid quantification mass spectrometric method allowed the transfer efficiency to be determined for all test surfaces used in an evaluation of trace explosive detectors, thereby permitting only the test surfaces with desired transfer to be accepted for the assessment.     

Evaluation of the IDS One-Step ELISA kits for the detection of illicit drugs in hair

This work presents the validation of a new immunological assay, the One-Step enzyme-linked immunosorbent assay (ELISA) tests from International Diagnostic Systems Corp. for the screening of drugs of abuse (cannabis, amphetamines, opiates, and cocaine) in human hair, with subsequent GC-MS confirmation. After decontamination and segmentation into small pieces, 50 mg of hair sample were incubated in 1 ml of methanol during 16 h at 40 degrees C. A 100 microL aliquot was collected and evaporated to dryness in presence of 100 microL of methanol/hydrochloric acid (99:1, v/v) to avoid amphetamines loss. The dried extract was dissolved in 100 microL of the "sample and standard diluent" solution included in the kit. This solution was submitted to analysis according to the recommended instructions of the manufacturer. During the validation phase, GC-MS confirmations were conducted according to our fully validated and published methods for opiates, cocaine, cannabis, and amphetamines determinations in hair. In a last development step, these procedures were slightly modified to directly confirm ELISA results by GC-MS using the methanolic extract. Ninety-three specimens were simultaneously screened by the ELISA tests (103 for tetrahydrocannabinol (THC)) and confirmed by GC-MS. Twenty were found positive for cannabis (THC: 0.10-6.50 ng/mg), 21 for cocaine (0.50-55.20 ng/mg), 24 for opiates (6-acetylmorphine (6-AM): 0.20-11.60 ng/mg, MOR: 0.20-8.90 ng/mg, codeine (COD): 0.20-5.90 ng/mg), and 13 for amphetamines (AP: 0.20 and 0.27 ng/mg, methamphetamine (MAP): 0.30 and 1.10 ng/mg, methylenedioxymethamphetamine (MDMA): 0.22-17.80 ng/mg). No false negative results were observed according to the Society of Hair Testing's (SoHT) cutoffs (0.5 ng/mg for cocaine, 0.2 ng/mg for opiates and amphetamines, and 0.1 ng/mg for THC). The One-Step ELISA kits appear suitable due to their sensitivity and specificity for drug of abuse screening in hair. This technology should find interest in workplace drug testing or driving license regranting, especially when many samples have to be tested with a high rate of negative samples, as ELISA is an easy and high-throughput method.     

Pattern detection in forensic case data using graph theory: application to heroin cutting agents

Pattern recognition techniques can be very useful in forensic sciences to point out to relevant sets of events and potentially encourage an intelligence-led style of policing. In this study, these techniques have been applied to categorical data corresponding to cutting agents found in heroin seizures. An application of graph theoretic methods has been performed, in order to highlight the possible relationships between the location of seizures and co-occurrences of particular heroin cutting agents. An analysis of the co-occurrences to establish several main combinations has been done. Results illustrate the practical potential of mathematical models in forensic data analysis.     

Complex Suicide by Self‐stabbing and Drowning: A Case Report and a Review of Literature

Sharp force injuries and drowning are methods exceptionally combined in complex suicides. We report a challenging case of complex suicide by self‐stabbing and drowning that illustrates the difficulty in discriminating between homicide and suicide in such circumstances of death. The corpse of a young man was found submerged in a river, stabbed nine times with two wounds that had penetrated the thorax and had caused lung injuries and a hemopneumothorax. The postmortem and histological examinations were consistent with a death caused by drowning, but the manner of death still remained undetermined. Police investigation finally concluded to a suicide, although no suicide note had been left and the victim had no underlying diagnosed mental disorder. The parameters that may help distinguish suicide from homicide at the autopsy should be interpreted in light of a thorough forensic investigation to determine the exact manner of death in such a case.