Paan and Gutka Use in the United States: A Pilot Study in Bangladeshi and Indian-Gujarati Immigrants in New York City

Smokeless tobacco and areca nut are popular with South Asians and South Asian immigrants, most commonly used as paan and gutka. Their regular use leads to oral cancer. The South Asian community in the U.S. is rapidly growing, where paan and gutka are readily available. The study was the first exploration of the migration of the paan and gutka habits, and their use in the U.S.A 108-item questionnaire on paan and gutka usage and beliefs was administered to 138 first-generation Bangladeshi and Indian-Gujarati immigrant adults at community sites in the New York metropolitan area. Forty-five percent Indian-Gujaratis reported ever-regular paan use; of which 5% are current users. Thirty-one percent reported ever-regular gutka use; of which 77% are current users. Thirty-five percent Bangladeshis reported ever-regular paan use; of which 70% arc current users. Nine percent reported ever-regular gutka use; of which 67% are current users. Bangladeshis are more likely to identify paan as causing oral cancer. Indian-Gujaratis are more likely to identify gutka as causing oral cancer.Between the two communities, there were significant differences in paan and gutfca usage, migration effects, and oral career risk perception. There is a need for comprehensive migration studies on the determinants of usage, and for community-specific interventions for these carcinogenic products.     

The Legacy of the Maastricht-Urteil and the Pluralist Movement

Abstract:  The Maastricht-Urteil of the German Constitutional Court of October 1993 has left a deep mark on EU law. Although some may consider it as part of legal history, the decision has never been overruled, and the ideas behind it are very much alive. This article tries to examine the legacy of that decision. From a practical point of view, the article focuses on the following issues: the current situation in Germany; the influence on other constitutional or supreme courts and on constitutional reforms in some Member States; the influence on the European Court of Justice and on the Treaty establishing a Constitution for Europe. Regarding theory, three sections of the article discuss a number of widespread ' idées reçues ' contained in the Maastricht-Urteil on notions such as the state, constituent power ( pouvoir constituant ), and democracy. The next section presents the movement of legal pluralism as an attempt to come to terms with the Maastricht-Urteil and its legacy. It criticises the radical versions of legal pluralism in view of the damage they may cause to essential dimensions of the rule of law. The final section reflects on the real motives behind the Maastricht-Urteil and its legacy, and on possible future developments.     

Recovery and evaluation by cytologic techniques of trace material retained on bullets

Fragments of tissue, intermediate targets, and debris related to firing are embedded in the fine striations and deforming edges of bullets. Because most of these fragments are too small to visualize and process as histologic sections, this material is usually washed away when the projectiles are cleaned following removal at autopsy. By preserving the rinsing material that results from routine cleaning of projectiles, it may be possible to evaluate adherent material from the bullet by cytologic techniques, including filter preparations, cell blocks, and smears of macroscopic tissue fragments. Bullet-wash cytology produced cellular elements, tissue fragments, and inert material from intermediate targets. Different tissue elements could be documented with a given projectile; this information could be utilized to document the path of a bullet through the body or intermediate target. This initial study suggests that low- and high-velocity projectiles produce different types of tissue debris, with much more fragmentation and scarcity of cellular components in the high-velocity rounds. Inert material, resulting from intermediate targets, such as clothing, as well as gunshot residue on the bullet or debris from the barrel could be distinguished on preparations. There was a difference in tissue representation of adherent material on the bullet; connective tissue, mesothelial coverings, and fragments from organs with higher elastic and cohesive properties were seen with much greater frequency on the filters than were loosely cohesive and friable organs such as liver and spleen. The cytologic preparations from projectile washings reflect both the path taken by the bullet and the ballistic damage to the organs. Thus, the cytologic evaluation of bullet washings may be useful in the incorporation of gunshot wound evaluation to support documentation of the trajectory of the projectile.     

Nonfracture-associated fatal fat embolism in a case of child abuse

Fatal fat embolism is usually thought of as a sequel to long-bone fracture, although cases secondary to soft tissue injury and atraumatic conditions have been infrequently reported. In this case of a two-year-old child-abuse victim who sustained multiple blunt traumatic injuries without skeletal fractures, pulmonary and systemic (brain and kidney) fat emboli were identified. At autopsy, all thoracic and abdominal viscera were intact; cranial contents exhibited only diffuse symmetrical petechial hemorrhages of the white matter. Because of the severe and widespread nature of soft tissue hemorrhage, and the absence of a grossly discernible cause of death, fat embolism was suspected. Using a combination of frozen section with oil red O staining and formalin-fixed osmium stained tissues, the immediate cause of death was determined to be diffuse fat embolism. Review of the literature reveals a pathophysiologic basis for fat embolism in the absence of fracture, both as a consequence of an acute increase in local pressure at the site of trauma and an alteration of the emulsification of blood lipids during shock. In light of these findings, we present this case to remind the forensic science community to consider fat embolism as the cause of death in cases of blunt-force injury without fracture.