Further investigations into the speed of cerebral swelling following blunt cranial trauma

An anesthetized sheep model of traumatic brain injury (TBI) has been developed to assess early changes in intracranial pressure (ICP) following closed head injury. Immediately after TBI, a transient (<10 min) hypertensive response occurred, followed by significant and prolonged systemic hypotension. ICP demonstrated a biphasic response, being seven times baseline values of 8 ± 2 mm Hg 10 min after injury, decreasing to 25 ± 2 mm Hg by 30 min, and then increasing to values exceeding 30 mm Hg by 4 h postinjury. ICP was always significantly higher than baseline values, which combined with hypotension, reduced cerebral perfusion pressure to less than 60% of normal. This early and sustained increase in ICP after craniocerebral trauma acutely alters cerebral perfusion pressure and brain oxygenation and provides a potential pathophysiological explanation for immediate clinical manifestations in humans following significant TBI.     

The association between body mass index and pulmonary thromboembolism in an autopsy population

Abstract: To evaluate the association between obesity and pulmonary thromboembolism (PTE) in a forensic context, 160 autopsy cases of fatal PTE were compared with age‐ and gender‐matched controls. The mean age of cases was 66 years (range 26–98 years; M/F 74:86). The mean body mass index (BMI) of cases with PTE was 30.88 (range 14.95–79.51), which was significantly higher than in the controls (mean BMI = 25.33; range 12.49–61.84) (p < 0.0001). Comparing the group with PTE with controls showed that five (3.1%) compared to 20 (12.5%) were underweight, 39 (24.4%) compared to 67 (41.88%) were of normal weight, 49 (30.63%) compared to 43 (26.88%) were overweight, 43 (26.88%) compared to 24 (15%) were obese, and 24 (15.0%) compared to six (3.75%) were morbidly obese. In each category of above‐normal BMIs, there were significantly greater numbers in the groups with PTE: overweight (p < 0.01), obese (p < 0.001), and morbidly obese (p < 0.0001).     

Animal-related fatalities--part II: characteristic autopsy findings and variable causes of death associated with envenomation, poisoning, anaphylaxis, asphyxiation, and sepsis

In addition to blunt and sharp trauma, animal-related fatalities may result from envenomation, poisoning, anaphylaxis, asphyxiation, and sepsis. Although the majority of envenomation deaths are caused by hornets, bees, and wasps, the mechanism of death is most often anaphylaxis. Envenomation resulting from the injection of a poison or toxin into a victim occurs with snakes, spiders, and scorpions on land. Marine animal envenomation may result from stings and bites from jellyfish, octopus, stonefish, cone fish, stingrays, and sea snakes. At autopsy, the findings may be extremely subtle, and so a history of exposure is required. Poisoning may also occur from ingesting certain fish, with three main forms of neurotoxin poisoning involving ciguatera, tetrodotoxin ingestion, and paralytic shellfish poisoning. Asphyxiation may follow upper airway occlusion or neck/chest compression by animals, and sepsis may follow bites. Autopsy analysis of cases requires extensive toxinological, toxicological, and biochemical analyses of body fluids.     

Fournier Gangrene and Unexpected Death

Abstract: Fournier gangrene represents a rare but progressive perineal infection that may result in rapid death. A 70‐year‐old man with poorly controlled diabetes mellitus and alcohol abuse is reported who was found unexpectedly dead. He had last been contacted the night before his death. At autopsy, the most striking finding was deep necrotic ulceration of the scrotum with exposure of underlying deep muscles and testicles, with blood cultures positive for Escherichia coli. Death was, therefore, attributed to necrotic ulceration/gangrene of the perineum (Fournier gangrene) that was due to E. coli sepsis with underlying contributing factors of diabetes mellitus and alcoholism. In addition there was morbid obesity (body mass index 46.9), cirrhosis of the liver, and marked focal coronary artery atherosclerosis with significant cardiomegaly. Fournier gangrene may be an extremely aggressive condition that can result in rapid death, as was demonstrated by the rapid progression in the reported case.     

Skepticism and Sanction: The Benefits of Rejecting Moral Responsibility

It is sometimes objected that we cannot adopt skepticism about moral responsibility, because the criminal justice system plays an indispensable social function. In this paper, I examine the implications of moral responsibility skepticism for the punishment of those convicted of crime, with special attention to recent arguments by Saul Smilansky. Smilansky claims that the skeptic is committed to fully compensating the incarcerated for their detention, and that this compensation would both be too costly to be practical and would remove the deterrent function from incarceration. I argue that the skeptic is not committed to full compensation of the offender, and that the costs of such compensation would in any case be far smaller than Smilansky thinks. In fact, I claim, the costs of the criminal justice system to which the skeptic is committed might be very much lower than the costs ?C economic, social and moral ?C we currently pay as a consequence of our system of punishment.     

Family Violence and Children’s Behavior Problems: Independent Contributions of Intimate Partner and Child-Directed Physical Aggression

Using data from a diverse sample of 581 families living in predominantly low-income, rural communities, the current study sought to investigate the longitudinal associations among father-perpetrated intimate partner violence (IPV) and child-directed physical aggression perpetrated by the mother. The unique contributions of each of these types of family violence on children’s behavioral problems at school entry were also examined. Results confirm bidirectional associations between father-perpetrated IPV and maternal physical aggression directed toward the child, and indicate that both types of physical aggression contribute to child behavior problems at school entry.     

England,Englishness and Brexit

In the 1975 referendum England provided the strongest support for European integration, with a much smaller margin for membership in Scotland and Northern Ireland. By 2015 the rank order of ‘national’ attitudes to European integration had reversed. Now, England is the UK's most eurosceptic nation and may vote ‘Leave’, while Scotland seems set to generate a clear margin for ‘Remain’. The UK as a whole is a Brexit marginal. To understand the campaign, we need to make sense of the dynamics of public attitudes in each nation. We take an ‘archaeological’ approach to a limited evidence‐base, to trace the development of attitudes to Europe in England since 1975. We find evidence of a link between English nationalism and euroscepticism. Whatever the result in 2016, contrasting outcomes in England and Scotland will exacerbate tensions in the UK's territorial constitution and could lead to the break‐up of Britain.     

Stalin. New Biography of a Dictator

Stalin. New Biography of a Dictator . By Oleg V. Khlevniuk. Translated by Nora Seligman Favorov (New Haven and London: Yale university Press, 2015), pp.xvi + 392. Notes. Photographs. Index. AU$64.00 (cloth), distributed by Footprint Books in Australia.