Detection of ketosis in vitreous at autopsy after embalming

Ketosis occurs in ketoacidosis or malnourishment. When either is suspected in relation to a death, it may be important to analyze for ketosis at autopsy. We encountered a case where starvation was suspected in a deceased nursing home resident, where the body had been embalmed prior to autopsy. Gas chromatography (GC) was unable to separate acetone from formaldehyde, a component of embalming fluid. The Acetest is a simple test that can detect acetone and acetoacetate in body fluids. We validated the Acetest with GC on vitreous. The Acetest and GC were consistent except at very low levels of acetone or acetoacetate. The sensitivity of the Acetest for acetoacetate in vitreous was 10 mg/dL, consistent with early starvation. Significant interference from embalming fluid did not occur. The Acetest was negative in the described case. The Acetest is a simple and useful test for the detection of ketosis in embalmed autopsies.     

Changing Sides or Changing Minds? Party Identification and Policy Preferences in the American Electorate

Scholars have long debated the individual-level relationship between partisanship and policy preferences. We argue that partisanship and issue attitudes cause changes in each other, but the pattern of influence varies systematically. Issue-based change in party identification should occur among individuals who are aware of party differences on an issue and find that issue to be salient. Individuals who are aware of party differences, but do not attach importance to the issue, should evidence party-based issue change. Those lacking awareness of party differences on an issue should show neither effect. We test our account by examining individuals' party identifications and their attitudes on abortion, government spending and provision of services, and government help for African Americans using the 1992-94-96 National Election Study panel study, finding strong support for our argument. We discuss the implications of our findings both for the microlevel study of party identification and the macrolevel analysis of partisan change.     

Correlation of the incidence of cocaine and cocaethylene in hair and postmortem biologic samples

Hair samples are useful as a matrix for drug testing because drugs can be detected in hair for longer periods than in blood or urine. The authors report a prospective comparison of the detection of cocaine and cocaethylene in routine postmortem biologic specimens to the detection of cocaine and cocaethylene in hair. The authors collected hair samples from various areas of the head in 53 autopsy cases, prepared them, and analyzed them by gas chromatography/mass spectrometry (GC/MS) for cocaine and cocaethylene. The authors compared the results of hair analysis with the results of toxicologic analysis performed on routine postmortem samples by enzyme multiplied immunoassay technique and GC/MS. Cocaine was found in either biologic fluids or in hair in 16 of 53 samples tested. Nine samples were positive for cocaine in both biologic fluids and hair. Five samples contained cocaine only in biologic fluids, and two contained cocaine only in hair. Cocaethylene was present in two cases. Drug screening of hair provides additional information in some autopsy cases, but the authors have not made hair analysis a routine practice. It may prove useful to save hair samples in all cases for later analysis if warranted by additional history or autopsy findings.     

Reworking Bandung internationalism: decolonization and postcolonial futurism in Burma/Myanmar

ABSTRACT

This commentary examines how futurity has been imagined across politics and political economy in Burma/Myanmar. Three areas are discussed: the revolutionary horizons of anti-colonialists, who combined Buddhist and Marxist ideas of historical progress; the developmental socialism of the early independence area, with its industrial telos and modernist commitments; and a contemporary development project in southern Myanmar, where processes of dispossession are troubling earlier temporal imaginaries. I suggest that a vision of postcolonial transformation coheres across anti-colonial and early independence claims to futurity. This temporal imaginary, which I call postcolonial futurism, promises transitions from farm to factory, peasant to the proletariat, and precapital to capital. This imaginary resonated widely. Today, however, scholars of South and Southeast Asia argue that modernist promises of transition now lack empirical and political purchase amid ongoing dispossession and trends towards low-wage, informal labour. Yet in the wake of postcolonial futurism, responses to dispossession are creating novel political possibilities. Responding to Kuan-Hsing Chen’s call to rework Bandung internationalism in the present, I consider how struggles over dispossession today indicate both openings and limits for the making of new political futures. Integrating Glen Coulthard’s work on colonialism and dispossession, I argue that decolonizing subjectivity is central to this process.     

The interplay between economic and political logics: path dependency in health care in England

The purpose of this article is to use the ideas of path dependency to understand why policies implemented by governments for health care in England were and are suboptimal in terms of the control of total costs, the equitable distribution of hospital services, and efficiency in delivery. We do this by relating the economic logic of achieving these objectives to the political logic of a state-hierarchical system in which ministers are accountable for the effects of policies and doctors largely decide the supply and demand of health care. The initial policy path of the National Health Service (NHS) controlled costs but lacked systems to achieve equity and efficiency in the funding of hospitals. Policies were introduced to achieve equity, but not efficiency, in the 1970s. The Thatcher government sought efficiency through a budgetary squeeze in the 1980s, which culminated in the NHS funding crisis of 1987 - 1988. The result was the policies of the NHS internal market, which promised efficiency by introducing a purchaser-provider split and a system of provider competition in which money would follow the patient. These promises justified an injection of extra funds for three years, but only a pallid model of the internal market was implemented. The Blair government abandoned the rhetoric of competition but maintained the purchaser-provider split and continued to constrain total NHS costs, which resulted in the funding crisis of 1998 - 1999. Current policies are to substantially increase spending on health care and reintroduce a system of provider competition in which money will follow the patient.     

A comparison between direct and indirect methods available for human bite mark analysis

Comparison techniques used in bite mark analysis are many and varied, the choice of technique depending largely on personal preference. Until recently, no one technique has been shown to be better than the others, and very little research has been carried out to compare different methods. This study evaluates and compares the accuracy of direct comparisons between suspects' models and bite marks with indirect comparisons in the form of conventional traced overlays of suspects' models or a new method using photocopier-generated overlays. Artificial bite marks in pigskin were made using standardized sets of models and recorded as photographs and fingerprint powder lifts on tape. The bite mark photographs and fingerprint lifts were coded and randomized so that a blind comparison could be made with the models, traced overlays, and photocopier-generated overlays using a modified version of the American Board of Forensic Odontology Scoring (ABFO) System for Bite Marks. It was found that the photocopier-generated overlays were significantly more accurate at matching the correct bite mark to the correct models irrespective of whether the bite mark was recorded photographically or as a fingerprint lift. The photocopier-generated overlays were also found to be more sensitive at matching the correct bite marks to the correct models than the other two methods used. The modified ABFO scoring system was able to discriminate between a correct match and several incorrect matches by awarding a high score to the correct match.     

Polydrug fatality involving metaxalone

A 29-year old female with a history of depression was found dead in a hotel room. The death scene investigation found empty pill bottles and an empty liter bottle of wine. Metaxalone, a centrally acting muscle relaxant, along with citalopram, ethanol, and chlorpheniramine were identified in the postmortem samples and quantitated by gas chromatography-mass spectrometry. The concentration of metaxalone in femoral vein blood was 39 mg/L. The heart blood concentration was 54 mg/L. Femoral vein blood concentrations of citalopram and chlorpheniramine were 0.77 mg/L and 0.04 mg/L, respectively. Ethanol levels were 0.13 g/dL in vitreous and 0.08 g/dL in heart blood. Other tissue samples were also analyzed. The authors consider the metaxalone concentrations toxic and potentially fatal. The citalopram concentrations were lower than those reported in fatal cases for this drug alone. Death was ascribed to polydrug abuse/overdose with metaxalone a major contributor. This represents the first reported case to our knowledge in which a metaxalone overdose significantly contributed to death.