Polyclonal systemic immunoblast proliferation: an unusual hematologic entity presenting as a medical examiner case

A 43-year-old woman who was receiving oral antibiotics for several days for a superficial foot infection developed a persistent rash, fever, and lymphadenopathy, despite discontinuation of the antibiotic and administration of steroids for a presumed drug reaction. Hours after a subsequent visit to the emergency room for worsening symptoms, she died at home. At autopsy, there was a florid, systemic proliferation of polyclonal plasma cells and immunoblasts infiltrating nearly every organ and tissue of the body, most notably the lymph nodes and spleen. The polyclonal nature of the process was confirmed by immunofixation electrophoresis and immunohistochemistry. Cases of fatal polyclonal systemic immunoblast proliferations are extremely rare, and the trigger for such proliferations is not always known. We review the literature on this unusual entity and discuss the clinical and pathologic findings.     

Great Expectations: Understanding Bali and the Climate Change Negotiations Process

This article reviews the December 2007 United Nations Climate Change Conference in Bali. It considers expectations for the meeting and whether the event delivered on these expectations. It also evaluates the long-term context of the meeting and examines the discussions in Bali on the post-2012 period (when the Kyoto Protocol's first 'commitment period' expires). The article finds that the Bali meeting did not necessarily meet public expectations or respond directly to the latest scientific assessments calling for urgent action. However, the article also finds that Bali was successful in the context of the prevailing political and diplomatic realities and the immense complexity of the climate change challenge – a problem that does not lend itself to a 'quick fix' solution. The article concludes that Bali produced a solid outcome that gives direction to future talks and sets a clear deadline for their completion. Finally, it argues that, contrary to some experts' opinion, the lack of detail in the Bali outcome may prove to be a strength rather than a weakness, since it provides flexibility to negotiators as they try to craft a consensus by the end of 2009.     

Experimental design for acquiring relevant data to address the issue of comparing consecutively manufactured tools and firearms

The comparison of consecutively manufactured tools and firearms has provided much, but not all, of the basis for the profession of firearm and toolmark examination. The authors accept the fundamental soundness of this approach but appeal to the experimental community to close two minor gaps in the experimental procedure. We suggest that “blinding” and attention to appropriateness of other experimental conditions that would consolidate the foundations of our profession. We do not suggest that previous work is unsound.     

Police Prosecution Service Relationship within Criminal Investigation

The article concentrates on the police role in the investigative stage in various criminal justice systems and the relationship with each national prosecution service. It is shown that in this respect the police function varies significantly from country to country. According to its legal competencies and factual procedural possibilities, the article will give a short overview of the national differences but also show that similar mechanisms are developed.     

The Invisible Hand: Financial Pressures and Organisational Convergence in Multilateral Development Banks

This paper investigates how the unique financial model of multilateral development banks – dependent largely on issuing bonds in private capital markets to raise lending resources – came about in the early history of three different MDBs, and how this in turn shaped their operational characteristics. Historical research demonstrates that the World Bank, Inter-American Development Bank (IADB) and Andean Development Corporation (CAF) converged on organisational and operational arrangements very different to what their founders had intended, and much closer to one another, as a direct result of the need to secure sufficient resources to function as viable development lenders. The findings indicate that in the absence of governments willing or able to provide significant financing out of their budgets, MDBs tend to converge towards a single organisational model in order to maintain access to international capital markets. All three MDBs examined here modified their lending and financial policies in unexpected ways and, in the case of the IADB and CAF, even restructured their original membership, specifically for the purpose of securing adequate financial resources.