Pontomedullary lacerations in unhelmeted motorcyclists and bicyclists: a retrospective autopsy study

ABSTRACT: Pontomedullary lacerations (PMLs) have often been reported in car occupants and pedestrians, are less frequently described in motorcyclists, and are very rarely described in bicyclists. The aim of this study was to determine the frequency of brainstem PMLs among fatally injured motorcyclists and bicyclists as well as the frequency of concomitant cranial, facial, and cervical spine injuries in such cases. A possible underlying mechanism of PML in fatally injured motorcyclists and bicyclists might thus be established. Of 443 cases of fatally injured motorcyclists and bicyclists, a sample of 381 cases of fatally injured motorcyclists and bicyclists with head injury of Abbreviated Injury Scale score of 3 or greater was formed and further analyzed. This group was composed of 345 men and 36 women. The average age was 48.8 ± 20.8 years (range, 15-99 years). In the analyzed sample group, there were 158 motorcyclists and 223 bicyclists. Partial PMLs were present in 44 cases (12%) within the sample of 381 head injuries, which breaks down to 40 men and 4 women. In our study, the impact area on the head and the specific skull base fracture type were good predictors of either PML occurrence or absence (B = -2.036, Wald = 161.312, P < 0.01, for the whole model). Impact to the chin, with or without a skull base fracture, most often led to this fatal injury due to impact force transmission, either through jawbone or vertebral column. Also, lateral head impact, the most frequent in bicyclists, with subsequent hinge fracture, PML, and frontoposterior hyperextension of the head that is associated with upper spine fracture, could be possible mechanisms of brainstem injury in fatally injured motorcyclists or bicyclists. Our study showed that the jawbone, as well as other facial bones, could act as shock absorbers, and their fracture could diminish energy transfer toward the skull and protect the brain and brainstem from injury.     

Forensic aspects of water intoxication: four case reports and review of relevant literature

Water intoxication (WI) is a rare condition that originates from over-consumption of water, with a potentially fatal outcome. Increased water intake (polydipsia) is followed by urination of high amount of diluted urine (polyuria) which are the main initial symptoms of WI. We present four case reports of WI. Two of them are unusual pediatric clinical cases using medical documentation and police case files, one of which is related to child abuse, and the other to a psychiatric disorder. The other two cases are fatal adult cases submitted to autopsy from a psychiatric hospital. Also, we present a diagnostic algorithm for polydipsia and polyuria before death. WI is usually seen in patients with psychiatric disorders, victims of child abuse or torture, drug abusers or it can be iatrogenically induced.     

Estimation of explosive charge mass used for explosions on concrete surface for the forensic purpose

The method of choice used by most terrorists for achieving political goals remains the utilization of explosive devices and there is always visible evidence at a crime scene after the deployment of such devices. Given favorable circumstances, forensic analysis can determine the cause of the explosion — the type of the explosive device, the means of detonation, the type and mass of the explosive charge that has been used and perhaps provide information to lead to the identity of the individual who may have constructed or deployed the explosive device, etc. Evidence of an explosion may take the form of a crater or other damage which may provide some information facilitating and estimating the mass of explosive material used. This paper reports the findings obtained by performing experimental explosions of known charges on a concrete surface, in order to establish the correlation between the charge weight and the effects of the explosion. Known masses of explosives were fired and the dimensions of craters made by explosions were measured. Five empirical equations for estimation of the explosive charge mass from crater dimensions were used.     

Frequency and severity of injuries in correlation with the height of fall

The main aim of this study was to examine the correlation between the height of fall and the frequency, extensiveness, and type of injuries of certain body regions and organs. The specific objective was to determine characteristic injuries of the analyzed body regions in relation to the certain height of fall. The study included 660 cases of fatal falls from height (469 males and 191 females). Results support the hypothesis that the frequency and extent of the injured body regions and organs are related to the fall height. Head injuries are characteristic of the falls from heights up to 7 m and beyond 30 m. Brain injuries in high falls from heights beyond 30 m show an absence of contre coup contusions and macroscopically evident intracranial bleeding. The extensiveness of chest injuries is significantly statistically associated with fall height. In cases of high falls, the frequency of abdominal injuries is not significantly statistically related to the height of fall. Liver injuries are the most common abdominal injury and the critical height of fall at which the liver injury occurs is 15 m. Injuries of liver and spleen are concomitant in high falls from heights beyond 24 m, irrespective of the manner of impact. The height of fall over 15 m appears to be a reasonable boundary height beyond which the injuries of two or three body regions are generally associated.     

Critical legal and environmental view on the Ramsar Convention in protection from invasive plant species: an example of the Southern Pannonia region

The emergence and continued expansion of one of the most dangerous causes of biodiversity loss and habitat alteration such as invasive species at some Ramsar wetlands of the Southern Pannonia raise a series of questions of both an environmental as well as a legal character relevant to these fragile ecosystems. The Ramsar Convention provides a set of general instructions and guidelines, but it does not establish an adequate mechanism of sanctions that could be imposed on states or individuals who violate its provisions. Fully aware of the importance of wetlands and their wildlife for a healthy living environment and human welfare, the authors of this paper describe the present conditions of invasive plant species at some Ramsar Sites and briefly analyze the current legal framework for the implementation of the Ramsar Convention. Finally, the authors propose innovative normative solutions that would improve the protection of wetlands and contribute to the suppression and prevention of the presence of invasive species not only in this region, but also worldwide.     

Allele frequencies and population data for 17 Y-chromosome STR loci in a Serbian population sample from Vojvodina province

Seventeen Y-chromosomal STR (short tandem repeat) loci were analyzed in a group of 185 healthy unrelated male individuals (n=185) from the population of Serbian province of Vojvodina. After minimal haplotype STR loci analysis we observed 129 different haplotypes. The most frequent haplotype was found in 13 copies, and total haplotype diversity was 99.11%. After analysis of additional eight Y-STR loci (DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635 and YGATAH4) there were 176 different haplotypes observed, out of which 168 appeared in single copies, and 7 haplotypes appeared twice. The most frequent haplotype was found in three copies. The haplotype diversity (99.94%) and discrimination capacity (95.13%) were calculated. Comparisons were made with previously published haplotype data on neighbouring population samples and significant differences were demonstrated at DYS19, DYS389II and DYS393 loci. Pairwise comparison of populations revealed that our sample was significantly different only from Hungarian sample (RST=23.98%, p=0.0091).     

Legal independence vs. leaders' reputation: Exploring drivers of ethics commissions' conduct in new democracies

The article addresses the emerging debate in delegation scholarship over the role of legal independence vs. reputational activism of agency leaders, in shaping de facto independence. The study explores a transitional context, analysing the enforcement styles of Serbian and Macedonian ethics commissions. Through a qualitative analysis of the commissions' enforcement styles, and a quantitative analysis of their rhetorical patterns, the article finds that the commissions' de facto independence was not a function of their legal independence but rather of the reputational craft of their leaders. In new democracies, the role of structural agency insulation is minimized both in containing as well as in fostering de facto independence: informal networks, on the one hand, provide non‐institutional routes for principals to undermine agencies' de facto independence; external conditionality and increased policy salience, on the other hand, provide reputational opportunities for agency leaders to overcome low legal independence.     

Suicidal single gunshot injury to the head: differences in site of entrance wound and direction of the bullet path between right- and left-handed--an autopsy study

The aim of this study was to determine the differences in the anatomical site of a gunshot entrance wound and the direction of the bullet path between right- and left-handed subjects who committed a suicide by a single gunshot injury to the head. The retrospective autopsy study was performed for a 10-year period, and it included selected cases of single suicidal gunshot head injury, committed by handguns. We considered only contact or near-contact wounds. The sample included 479 deceased, with average age 47.1 ± 19.1 years (range, 12-89 years): 432 males and 47 females, with 317 right-handed, 25 left-handed, and 137 subjects with unknown dominant hand. In our observed sample, most cases involved the right temple as the site of entrance gunshot wound (about 67%), followed by the mouth (16%), forehead (7%), left temple (6%), submental (2%), and parietal region (1%). The left temple, right temple, and forehead were the sites of the gunshot entrance wounds, which were the best predictors of the handedness of the deceased (Spearman ρ = 0.149, P = 0.006). Our study showed that the direction of the bullet intracranial path in cases of suicide was even a more potent predictor of the handedness of the deceased (Spearman ρ = 0.263, P = 0.000; Wald = 149.503, P = 0.000).     

Fatal subarachnoid hemorrhage during sexual anal self-stimulation in a female: a case report

Sudden death after sexual activity is a well-known entity, but it is rare in females. Herein we present a case of fatal, massive subarachnoid hemorrhage from a ruptured berry-shaped aneurysm, during sexual anal self-stimulation. A 39-year-old woman was found dead on a couch, with the wooden handle of a spring twirl whisk inserted inside her anus and rectum as a dildo-like object. External examination was unremarkable with no signs of injuries. Intracranial examination showed a massive subarachnoid hemorrhage, up to 6 mm in thickness, especially around the brainstem and the inferior side of the brain. After removing the blood clots, the saccular aneurysm was found at the site of the bifurcation of the left internal carotid. In this case study, we underline the utility of forensic autopsy, as well as death scene investigation, in reconstructing the mechanism of death, as well as the dynamics of the event.     

Security sector reform: The building of security in Bosnia and Herzegovina

This article addresses the issue of Security Sector Reform (SSR) in Bosnia and examines whether the reform of security structures has enhanced security of Bosnia as a whole. The experience of recent armed conflict, and fragmentation and ethnicization of security structures have created special challenges for SSR in Bosnia. Transformation of the security sector in Bosnia is made even more complicated by the plethora of international actors involved in the process. The article argues that, despite the complexity of the task, SSR has produced some notable results, particularly in redressing the balance of power between the state and entities in the spheres of defence, policing and intelligence. However, while some of the SSR initiatives appear to be very successful in their main objective, they have inadvertently created some new security risks and/or displaced problems into another area. Thus, the question remains whether Bosnia's security has been enhanced in the process. The article identifies two main obstacles which block further progress in the building of security in Bosnia: first, the lack of local ‘ownership’ of SSR, and second, the Dayton constitutional arrangements. The article concludes that until these two fundamental issues are effectively addressed Bosnia will remain a weak, marginalized country filled with insecurity, divisions and adversity.