Elevated morphine concentrations determined during infant death investigations: artifacts of withdrawal of care

Abstract:  Three cases are reported of elevated postmortem blood morphine concentrations (189–3036 ng/mL) that were observed during the course of death investigations involving three children ranging in age from 1 week to 2 years, all of whom underwent withdrawal of life support. In all three cases, the presence of opiates in postmortem blood was indicated by immunoassay (ELISA) and quantitative confirmatory analysis of free morphine concentrations in postmortem blood was performed by solid-phase extraction followed by gas chromatography/mass spectrometry (GC/MS) in the selected ion monitoring mode. While the practice of withdrawing life support from terminally ill patients, with the accompanying administration of narcotics/analgesics has been reported in the medical literature, it has not been adequately described in the forensic literature. The implications of this practice on the forensic toxicological interpretation of morphine findings are discussed. To our knowledge, this is the first report of postmortem morphine concentrations arising directly from administration in conjunction with withdrawal of care in pediatric patients.     

大鼠死后肌动蛋白降解与死亡时间的相关性

目的观察大鼠死后不同时间心肌、肝、脾、肺、肾、脑和骨骼肌肌动蛋白（actin）的降解规律,为晚期死亡时间（postmortem interval,PMI）的推断寻找客观指标。方法28只SD大鼠随机分为7组,经机械性窒息致死后．分别置于20℃恒温箱内,于0、24、48、72、96、120和168h后剖取以上器官,应用免疫印迹技术检测各组织内actin的含量,SPSS11．5软件对所得数据进行方差分析。结果大鼠死后上述各器官actin含量均随PMI的延长而逐渐下降,与PMI相关,决定系数（R2）均在0．75以上。但actin在上述各器官内的降解速度有显著差异（P〈O．05）,在脑组织中降解速度最快,其余依次为肺、脾、肝、肾、心肌和骨骼肌。结论尽管大鼠死后心肌、肝、脾、肺、肾、脑和骨骼肌actin的降解规律具有组织差异性,但是actin在上述组织中的含量变化与PMI相关．有助于较晚期PMI的推断。     

Pig-mentation: postmortem iris color change in the eyes of Sus scrofa

Experienced forensic pathologists and examiners may be familiar with the phenomenon of postmortem iris color change; however, only Knight, Simpson's forensic medicine, Arnold, London, 1997; Ref. 1 and Saukko and Knight, Knight's forensic pathology, 3rd ed., Arnold, London, 2004; Ref. 2 have referred to it in the literature, and to date, there have been no published scientific research studies on this taphonomic artifact. A controlled experiment was conducted of postmortem changes to isolated Sus scrofa eyes. The eyes (n = 137) were separated into three groups and each sample was observed for 3-day postmortem at a different temperature. In addition, a Sus scrofa head was obtained to observe postmortem changes of eyes in situ. All isolated blue eyes in the experiment, at room temperature and higher, changed to brown/black within 48 h. The in situ blue eye, at room temperature, turned brown/black within 72 h. If iris color consistently changes postmortem in humans, then this taphonomic artifact must be incorporated into victim identification protocol, including disaster victim identification software, and autopsy reports to prevent inaccurate victim identification and inappropriate exclusion from the identification process.     

电针时间对急性心肌缺血大鼠保护作用及心肌核转录因子- κB表达水平的影响

目的 观察电针时间对急性心肌缺血大鼠心脏保护作用及对心肌核转录因子-κB(nuclear transcrip-tic factor-κB,NF-κB)表达的影响,探讨电针干预急性心肌缺血的机制.方法 将SD大鼠随机分成正常组、模型组和电针即刻组、电针1d组、电针3d组、电针5d组、电针7d组,每组6只.采用结扎心脏冠状动脉左前降支法制备急性心肌缺血大鼠模型.电针心经"神门-通里"段,每次30 min,频率2 Hz、强度为1 mA的断续波分别进行即刻、1 d、3 d、5 d、7 d的电针治疗.用PowerLab 16导生理记录仪记录心电图;酶联免疫法检测血清肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、缺血修饰白蛋白(ischemia modified albumin,IMA)水平;Western blot检测心肌组织NF-κB蛋白表达水平,荧光定量PCR检测NF-κB mRNA表达水平.结果 与正常组比较,模型组大鼠ST段抬高,血清CK、CK-MB、IMA水平显著升高(P<0.05),NF-κB蛋白及mRNA表达水平显著升高(P<0.05).与模型组比较,即刻电针组大鼠血清IMA水平差异无统计学意义(P>0.05),CK、CK-MB水平显著降低(P<0.05),其他各电针组CK、CK-MB、IMA水平逐渐降低,以电针7 d组降低最为显著(P<0.05);即刻电针组、电针1 d组大鼠心肌组织中NF-κB蛋白及mRNA差异无统计学意义(P>0.05),电针1 d、3 d、5 d、7 d组表达水平呈下降趋势,以电针7 d组下降最为显著(P<0.05).结论 电针心经从第3天开始改善急性心肌缺血,且在治疗7 d后效果最为明显,其机制可能与逆转心肌组织NF-κB表达有关.     

论保证责任约定期间的法律规制

保证责任期间可以约定,但是否应有明确的、最长期限的限制,这不仅应考虑保证人与债权人间的公平问题,更要结合保证责任期间的性质、当事人合同自由的实现程度、制度推理的现实性基础等因素来考虑。结论是对约定保证期间应尽量保证合同自由,取消来自强行法的限制。     

Party survival in parliament: Explaining party durability in lower-house parliaments

Approximately 70 per cent of the parties emerging in the post-Second World War era failed to keep their seats in parliament. Party survival is an important issue, especially in parliamentary democracies, where parties are the means through which voters’ preferences are linked to government policy outputs. Using an event history modeling framework, and data from 37 democracies, covering 830 parties, this article analyses two questions regarding party durability. First, when do parties fail? Second, which parties survive longer? The article shows that most parties fail at the beginning of their lifespan, and disappear before the end of their fourth term in parliament. Moreover, it is found that moderate policy position, distinct ideology and participation in governing coalitions increase the duration of party survival, even when controlling for party size. This article contributes to the extensive literature about the electoral benefits of ideological moderation and distinct policy positions by showing the long-term benefits of these factors. Moreover, the long-term benefit of party participation in government in terms of survival overcomes the short-term cost of ruling.     

Postfeeding Larval Dispersal Behavior of Late Season Blow Flies (Calliphoridae) in Southern Ontario,Canada

Postfeeding dispersal involves migration of larvae away from their food source in order to pupate. Puparia are difficult to find, yet are important for estimating PMI, and missing puparia during collection can result in inaccurate estimations. This study investigates the late season maggot dispersal patterns for blow flies at coyote carcasses in two habitats with an aim to improving puparia collection procedures. Puparia samples collected from various dispersal distances and directions tested the spatial distribution patterns of the various species using the variance/mean ratio (VMR). Lucilia illustris was the most common species to emerge, with a preferred minimum dispersal distance of more than 50.8 cm and an overall VMR value of 14.91, indicating this species had a clumped distribution pattern. These findings highlight that current collection procedures that use random sampling from under carcasses do not adequately account for the spatial distribution of larvae.     

不同温度下离体人静脉血ATP含量与死亡时间的关系

目的探讨在环境温度变化条件下,人体静脉血ATP降解与死亡时间的关系。方法健康志愿者48名,随机分为6组,肱静脉取静脉血,置于10℃、15℃、20℃、25℃、30℃和35℃下保存;每4h应用ATP检测仪对不同温度下的ATP含量进行检测;应用SPSS统计软件进行回归分析,MATLAB软件进行差值函数分析拟合。结果各温度组ATP值随死亡时间延长均呈下降趋势,从取血即刻的1 573.683 E-13mol/L,降至6.00 E-13mol/L左右,所经历的时间分别为236h(10℃)、163h(15℃)、124h(20℃)、92h(25℃)、72h(30℃)和64h(35℃),对所得数据进行回归分析,得到各温度组下ATP含量变化与PMI关系的二元三次曲线方程(R2范围为0.976～0.990);进行差值拟合,得到10～35℃范围内ATP含量变化与PMI关系的三元四次曲面方程。结论在不同温度下,人体静脉血ATP降解与PMI关系符合三元四次方程分布,利用差值函数拟合的方法可在温度变化条件下进行死亡时间推断。     

我国军事法制概念的含义

军事法制是军事法学基础理论中最基本的范畴之一,它对军事法制实践有着重要的指导意义.我国军事法学界对军事法制概念的认识还存在较多分歧,军事法制应是军事法律制度的静态构架、军事法律制度的订立和实行的动态过程、军事法律制度处于权威地位的机制及秩序共同构成的三位一体的系统性概念.我国的军事法制概念应同时从上述三个方面理解,缺一不可.     

Flualprazolam distribution in postmortem samples

The constant emergence of novel psychoactive substances is troubling to both public health officials and legislators. Additionally, sufficient data collection for each new compound can take months up to years. Flualprazolam, a triazolobenzodiazepine, quickly garnered attention as a sedative drug that likely expresses adverse reactions similarly to alprazolam. This study focuses on the distribution of flualprazolam in multiple common postmortem matrices. Central blood, vitreous humor, liver homogenate, brain homogenate, gastric contents, and urine samples from death investigation cases were quantitated when available. Samples were screened with liquid chromatography quadrupole time-of-flight with limit of detection set at 4 ng/ml and quantitated on liquid chromatography tandem mass spectrometry, with concentration range from 4 to 256 ng/ml. From August 2018 to September 2020, 24 central blood samples were quantitated for flualprazolam. Central bloods of 22 cases had concentrations above the limit of quantitation. The average flualprazolam central blood concentration was 16.3 ng/ml with a median of 9.95 ng/ml (4.24–48.0). Additional analyses for unconjugated flualprazolam were performed on at a total of 15 urine samples ( = 14.4, 4.07–36.1 ng/ml), 23 brain homogenates ( = 23.2, 3.99–69.3 ng/g), 23 liver homogenates ( = 50.7, 13.6–156 ng/g), five vitreous humor samples ( = 7.70, 4.03–12 ng/ml), and 12 gastric contents samples ( = 0.36, 0.02–2.51 mg). The cause of death for 13 of the 24 cases listed flualprazolam as a contributing factor of death.