Previously Unreported Complication of Coronary Artery Bypass Grafting: Suture Rupture Resulting in Patient's Death

Traditionally, the manner of death in most hospital autopsy cases is natural, in which death is due to the natural course of disease or reasonably anticipated outcomes of medical interventions. Some cases fall into a potential gray zone between natural and accident, including rare or unanticipated outcomes of medical interventions. We present a case of a patient postcoronary artery bypass graft. Autopsy revealed the proximal anastomosis of the aorta‐to‐first‐diagonal‐coronary‐artery‐to‐second‐obtuse‐marginal‐artery graft was detached from the aorta. A broken suture was present at the disconnected anastomosis, with intact knots but was broken along its length. In‐hospital mortality rates of CABG range from 1% to 3%, with several autopsy studies identifying surgical complications as the cause of death in one‐third of perioperative deaths. No publications were found that described suture rupture as directly relating to the cause of death. This case report describes a previously unreported complication of coronary artery bypass grafting.     

Do Schools Cause Crime in Neighborhoods? Evidence from the Opening of Schools in Philadelphia

Objectives

To assess the impact of schools on crime in neighborhoods.

Methods

We utilize data of charter and public schools in Philadelphia to estimate the effect of school openings on neighborhood crime patterns between 1998 and 2010. We estimate the change in crime in areas surrounding schools before and after their opening compared to areas where schools were always open with Poisson regression models. We also estimate changes in crime in census tracts as schools are added compared to census tracts that never had schools. Finally, we compare estimates from Poisson regression models to those derived from permutation tests where schools are randomly assigned different opening dates.

Results

We find no evidence that school openings increase crime relative to locations where schools were always open or never had schools. The models generally produce null effects, though there is some evidence for a reduction in property crimes for public school openings and a reduction in violent crimes for charter school openings within certain distances. Estimates at the census tract level show that changes in the number of schools are not associated with any changes in crime relative to tracts with no schools.

Conclusions

Contrary to a large theoretical and empirical literature, the results suggest that school locations play a minimal role in neighborhood crime production in Philadelphia. Future research should investigate specific contexts and mechanisms, such as land-use characteristics and travel patterns to schools, which may interact with specific school settings in ways that are related to crime production.

     

Dispositional Mindfulness Moderates the Relationship Between Occupational Stressors and Perceived Stress Among Law Enforcement Personnel

Law enforcement personnel (LEPs) experience occupational stressors that can result in poor health outcomes and have a negative impact on the communities they serve. Dispositional mindfulness, or receptive awareness and attention to present moment experience, has been shown to negatively predict perceived stress and to moderate the relationship between stressors and negative stress-related outcomes. The current study is an investigation of the moderating role of specific facets of dispositional mindfulness (i.e., nonreactivity, nonjudging, and acting with awareness) in the relationship between occupational stressors and perceived stress in a sample of LEPs. As hypothesized, nonreactivity significantly moderated the relationship between operational stressors and perceived stress, such that LEPs low in nonreactivity exhibited a significant relationship between stressors and perceived stress, whereas those high in nonreactivity did not. Nonjudging also moderated the relationship between organizational stressors and perceived stress; however, unexpectedly, LEPs high in nonjudging evidenced a significant relationship between stressors and perceived stress, whereas those low in nonjudging did not. Potential implications of these findings for LEP stress reduction interventions are discussed.     

Follow the leader: testing a deductive approach for studying parliamentary party leadership roles

Parliamentary party group leaders (PPG leaders) are crucial – yet understudied – actors in modern representative democracies. Inspired by the literature on parliamentary roles, we test a deductive approach in order to explore the attitudes and behaviours of PPG leaders. Given their common duties, such as monitoring group members and securing party cohesion, we expect that PPG leaders across several countries would exhibit a common pattern that distinguishes them from other MPs. However, neither a common, nor a distinguished pattern of attitudes and behaviour is confirmed by our results based on Partirep MP Survey data. This, together with other theoretical difficulties, points us to the need to study PPG leaders’ roles by using in-depth single-country studies.     

When does open government shut? Predicting government responses to citizen information requests

Methods for the analysis of “big data” on citizen-government interactions are necessary for theoretical assessments of bureaucratic responsiveness. Such big data methods also stand to benefit practitioners' abilities to monitor and improve these emerging transparency mechanisms. We consider supervised latent Dirichlet allocation (sLDA) as a potential method for these purposes. To this end, we use sLDA to examine the Mexican government's (non)responsiveness to all public information requests filed with the federal Mexican government during the 2003–2015 period, and to identify the request topics most associated with (non)responsiveness. Substantively, our comparisons of the topics that are most highly predictive of responsiveness and nonresponsivess indicate that political sensitivity plays a large and important role in shaping official behavior in this arena. We thus conclude that sLDA provides unique advantages for, and insights into, the analysis of (i) textual records of citizen–government interactions and (ii) bureaucratic (non)responsiveness to these interactions.     

Detergent: an alternative approach to traditional bone cleaning methods for forensic practice

Osteological assessment of human remains forms an essential part of forensic work, especially during the examination of extensively decomposed, dismembered, or burnt bodies. Currently employed methods for removal of adherent soft tissue reflect practices often used by museum curators, notably insect consumption, enzymatic maceration, or boiling of the bones, with subsequent manual removal of material. This study was designed to assess the effectiveness of detergents for the purpose of soft-tissue removal from animal-derived specimens. The results indicate that such a means is comparable to enzymatic maceration but with fewer health and safety issues and greater advantages regarding transportation and availability of materials when an investigator is in a fieldwork scenario.     

The development and application of a diatom-based quantitative reconstruction technique in forensic science

Diatoms are a group of unicellular algae that have been recorded and classified for over 200 years and have been used in a range of applications in forensic science. We have developed a quantitative diatom-based reconstruction technique to confirm drowning as a cause of death and localize the site of drowning in two recent, high-profile, case studies. In both case studies we collected diatom samples from the local and/or regional area to act as a control in the examination of diatom assemblages associated with lungs and clothing. In Case Study 1 the modern analog technique suggested that all lung and clothing samples have statistically significant similarities to control samples from shallow water habitats. In Case Study 2, the analog matching suggested that the majority of lung samples show a statistically significant relationship to samples from a pond, indicating that this was the drowning medium.     

Mental health correlates of the victim-perpetrator relationship among interpersonally victimized adolescents

This research examines mental health correlates of different victim-perpetrator relationships among adolescent victims of interpersonal violence. A large and nationally representative sample of adolescents (N = 4,023) responded to structured telephone interviews concerning mental health functioning (posttraumatic stress disorder-PTSD, major depressive disorder, substance abuse/dependence, and delinquency). Those reporting histories of sexual (n = 321) and/or physical (n = 688) assault were queried about specific aspects of their assaults, including their relationship with the perpetrator. After controlling for demographic and assault-related risk factors, the victim-perpetrator relationship remained a significant risk factor for mental health problems. Adolescents sexually assaulted by nonstrangers were at increased risk for PTSD; those sexually assaulted by acquaintances or people they did not know well were at increased risk for delinquency. Adolescents who were physically assaulted by a family member were at increased risk for PTSD. Explanations for the findings and the need for consistent assessment methods across related studies are discussed.     

Twelve short tandem repeat loci Y chromosome haplotypes: genetic analysis on populations residing in North America

A total of 2443 male individuals, previously typed for the 13 CODIS STR loci, distributed across the five North American population groups African American, Asian, Caucasian, Hispanic, and Native American were typed for the Y-STR loci DYS19, DYS385a/b, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS437, DYS438 and DYS439 using the PowerPlex Y System. All population samples were highly polymorphic for the 12 Y-STR loci with the marker DYS385a/b being the most polymorphic across all sample populations. The Native American population groups demonstrated the lowest genetic diversity, most notably at the DYS393 and DYS437 loci. Almost all of the 12-locus haplotypes observed in the sample populations were represented only once in the database. Haplotype diversities were greater than 99.6% for the African Americans, Caucasians, Hispanics, and Asians. The Native Americans had the lowest haplotype diversities (Apaches, 97.0%; Navajo, 98.1%). Population substructure effects were greater for Y-haplotypes, compared with that for the autosomal loci. For the apportionment of variance for the 12 Y-STRs, the within sample population variation was the largest component (>98% for each major population group and approximately 97% in Native Americans), and the variance component contributed by the major population groups was less than the individual component, but much greater than among sample populations within a major group (11.79% versus 1.02% for African Americans/Caucasians/Hispanics and 15.35% versus 1.25% for all five major populations). When each major population is analyzed individually, the R(ST) values were low but showed significant among group heterogeneity. In 692 confirmed father-son pairs, 14 mutation events were observed with the average rate of 1.57x10(-3)/locus/generation (a 95% confidence bound of 0.83x10(-3) to 2.69x10(-3)). Since the Y-STR loci reside on the non-recombining region of the Y chromosome, the counting method is one approach suggested for conveying an estimate of the rarity of the Y-haplotype. Because the Y-STR loci are not all in disequilibrium to the same extent, the counting method is a very conservative approach. The data also support that autosomal STR frequencies can be multiplied by the upper bound frequency estimate of a Y-haplotype in the individual population group or those pooled into major population groups (i.e., Caucasian, African American, Hispanic, and Asian). These analyses support use of the haplotype population data for estimating Y-STR profile frequencies for populations residing in North America.