Fatal Clostridium perfringens Septicemia After Colonoscopic Polypectomy,Without Bowel Perforation

Since its introduction, colonoscopy has played an important role as a diagnostic, therapeutic, and screening tool. In general, colonoscopy is regarded as a safe procedure, but complications may occur. The most dreaded of these complications is colonic perforation. Bacteremia postprocedure may occur, and although it is not uncommon, it rarely results in clinically significant complications. Patients with IBD (inflammatory bowel disease) are a high‐risk population for bacteremia, which may leads to bowel wall overstepping by the bacteria. With regard to that, we report a fatal case of gas gangrene complicating colonoscopy polypectomy without bowel perforation in a healthy adult. To the best of our knowledge, only two other cases of retroperitoneal gas gangrene associated with colonoscopy polypectomy without bowel perforation have been described in international literature, but none of which was completed by a molecular biology analysis.     

How defense shapes the institutional organization of states

We analyze theoretically how the provision of military services explains the vertical and horizontal fragmentation of a state. The model innovates on the previous political economy literature which views such institutional arrangements arising only as a response to internal ”technological” forces, not to strategic interactions within the state and with neighboring states. The model explains how these interactions lead communities of individuals to choose among three alternative types of institutional arrangements: 1) a union, i.e., a setting wherein both the vertical and the horizontal fragmentation of a state is minimized; 2) an alliance, whereby a state becomes more vertically fragmented by creating an upper government tier devised to take advantage of economies of scale; 3) autonomy, where horizontal fragmentation is maximized, as no merging of communities occurs and no higher government tier is created. A series of simulations of the model define the conditions under which each alternative institutional arrangement emerges in equilibrium.     

Dynamics of State Modernization in Colombia: The Virtuous Cycle of Military Transformation

Military transformations are usually understood as linear processes involving diverse, steady, and costly initiatives to be achieved during a specific timeframe. However, other influencing elements, such as assessment, follow-up, and feedback from the personnel in charge of enforcing and evaluating their implementation, are often disregarded. This article seeks to bridge this information gap and provide a model to analyze the transformation of the military forces of Colombia as a virtuous cycle using the perceptions of its future implementers as its core and main evaluating resource. The questionnaire developed focuses on national interests and the roles and functions of the military forces, gathering the perceptions of officers who will be responsible for implementing the transformation. The statistical findings suggest that determining threats, factors of influence, obstacles, enhancers, and priorities such as drug trafficking, defense expenditure, conflict of interests, fiscal responsibility, and doctrine and policy are central to obtaining successful outcomes.     

Evidence About Harm: Dual Status Victim Participant Testimony at the International Criminal Court and the Straitjacketing of Narratives About Suffering

Criminal Law Forum - Although victims at the International Criminal Court (ICC) are not parties, they can apply to become “victim participants” and may be authorized by an ICC Chamber...     

Bear attack--A unique fatality in Finland

Fatalities due to animal bites, the vast majority of which are associated with dogs and big cats, are relatively uncommon and rarely described in the literature. Especially rare are fatal bear attacks on humans. We herein present a forensic investigation of a fatal assault, involving numerous bites on a 42-year-old man in Finland by an European brown bear (Ursus arctos arctos).     

Dental identification by comparison of antemortem and postmortem dental radiographs: influence of operator qualifications and cognitive bias

Dental forensic identifications based on comparison of antemortem and postmortem radiographs provide effective and reliable evidence. There are no standardized procedures for assessing similarities between different types of dental radiographs (e.g. orthopantomograms, bitewings, and periapical radiographs), and the operator's subjective judgment can considerably affect identification. The purpose of this study is to evaluate the potential influence of experts' qualifications, training, and cognitive bias on the accuracy of identification. Seventy-eight differently qualified and experienced experts underwent an identification test. The expert sample was composed of 10 specialists in emergency care (ER), 10 specialists in legal medicine (ML), 20 pregraduate dental students (STU), 12 dentists (DENT), 20 dentists educated in forensic odontology (DENT-TRA), and 6 experienced forensic odontologists (FOR). The simulated cases required participants to assess the possible matching of 42 postmortem intraoral radiographs with 16 antemortem panoramic radiographs. Accuracy and specificity for the different operator groups were as follows: ER, 0.76-0.70; ML, 0.76-0.88; STU, 0.89-0.82; DENT, 0.87-0.97; DENT-TRA, 0.88-0.92; and FOR, 0.97-1. As evidenced by high rates of accuracy and repeatability, the most experienced forensic odontologist consistently outperformed operators less or differently educated and trained, especially for difficult cases. In our sample, the dentists who received additional education in forensic odontology did not necessarily perform better than dentists who had not received this additional education. Some cognitive bias, mainly the so-called observer effect, emerged as a possible source of outcome variability among the operator groups.