Determining Bruise Etiology in Muscle Tissue Using Finite Element Analysis

Bruising, the result of capillary failure, is a common physical exam finding due to blunt trauma and, depending on location and severity, a potential indicator of abuse. Despite its clinical relevance, few studies have investigated the etiology of capillary failure. The goal of this study was to determine whether capillaries primarily fail under shear stress or hydraulic‐induced tensile stress. An arteriole bifurcating into four capillaries was modeled using ANSYS 14.0 ^®. The capillaries were embedded in muscle tissue and a pressure of 20.4 kPa was applied. Any tensile stress exceeding 8.4 × 10⁴ Pa was considered failure. Results showed that failure occurred directly under the impact zone and where capillaries bifurcated, rather than along the line of greatest shear stress, indicating that internal tensile stress is likely the primary mode of capillary failure in bruising. These results are supported by the concept that bruising can occur via blunt trauma in which no shearing lacerations occur.     

Is Violence Bad for Your Health? An Assessment of Chronic Disease Outcomes in a Nationally Representative Sample

Longitudinal offending research has grown substantially in the last two decades. Despite this increased scholarly attention, longitudinal investigations of the effects of offending on physical health have not kept pace. Acknowledging the intersections of criminology, criminal justice, and public health, this study examines the relationship between violent offending and chronic diseases among a nationally representative longitudinal sample of young adults. Results suggest that variation across offender typologies (i.e. adolescence-limited, adult-onset, and consistent violence during youth and young adulthood) significantly predicts experiencing chronic disease in early adulthood, with the risk being the most pronounced among those individuals, who demonstrate violence continuity. Study limitations and policy implications are discussed.     

A case of fatal overdose involving both hydromorphone and kratom

Kratom is a plant originating in Southeast Asia that has been used for its dose-dependent stimulant and opioid effects. The main active compound in kratom is mitragynine, an alkaloid with affinity for the mu-opioid receptor. Toxicity and fatalities related to kratom use have increased substantially in recent years. In this case report, we describe a 44-year-old man who was found deceased in bed. The only significant finding at autopsy was abdominal distension with >4 L of ascites. Toxicology testing was performed on femoral blood which showed 79 ng/mL of hydromorphone, 560 ng/mL of mitragynine, and 240 ng/mL of olanzapine. In addition, creatinine and urea in vitreous humor were significantly elevated, consistent with renal impairment. Death was attributed to hydromorphone toxicity with mitragynine being a contributing factor.     

Fat embolism syndrome associated with atraumatic compartment syndrome of the bilateral upper extremities: An unreported etiology

Fat embolism syndrome (FES) is a potentially life-threatening condition that develops when fat embolism leads to clinical symptoms and multisystem dysfunction. The classic triad of respiratory distress, neurologic symptoms, and petechial rash are non-specific, and the lack of specific laboratory tests makes the diagnosis of FES difficult. Although FES is most common after long bone fractures, multiple conditions some of which are atraumatic have been associated with the development of FES. We report a case of FES that occurred in the setting of a non-traumatic compartment syndrome of the upper extremities. The pathologic and clinical findings, pathophysiology, diagnostic challenges, and pathologic methods to properly diagnose FES are discussed with a review of the relevant literature. This case highlights the importance of the autopsy in making a diagnosis of FES in cases where death could otherwise be incorrectly attributed to multi-organ system failure, shock, or sepsis.     

Z穴位注射丹参注射液治疗慢性阻塞性肺疾病缓解期34例

目的 观察穴位注射丹参注射液治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）缓解期的临床疗效。方法 将68例COPD缓解期患者随机单盲分为治疗组34例及对照组34例,治疗组在常规综合治疗基础上加用丹参注射液穴位注射（选穴：定喘、肺俞、肾俞、脾俞、足三里）,每周1次,3个月为1个疗程;对照组采用常规综合治疗,治疗3个月。两组患者均在治疗前后使用COPD评估测试（COPD assessment test TM,CAT）进行评分,并检测第1秒用力肺活量(forced expiratory volume in one second,FEV1)及其占预计值的百分比(FEV1%)、FEV1与用力肺活量（forced vital capacity,FVC）的比值（FEV1／FVC）,及检测血液T细胞亚群（CD4+、CD8+、CD4+/CD8+）的变化情况。 结果 治疗后治疗组CAT评分显著低于对照组（P<0.01）;CD4+ T细胞百分比、CD4+/CD8+比值显著高于对照组(P<0.05,或P<0.01),CD8+ T细胞百分比显著低于对照组(P<0.01)。治疗后治疗组FEV1、FEV1%、FEV1／FVC显著高于对照组（P<0.01）。结论 在常规治疗基础上穴位注射丹参注射液可以改善COPD缓解期患者生活质量,改善肺通气功能,提高患者免疫力。     

交易成本和价格歧视理论在著作权合理使用中的定位与适用

经济学交易成本理论和价格歧视理论是数字时代强化著作权保护,限制合理使用的主要理论依据.由于某些合理使用是为克服交易成本过高的市场失灵而设,交易成本理论和价格歧视理论对合理使用范围的缩小具有一定的解释力.但是,它们不是确定合理使用范围的唯一标准.除交易成本外,外部性的内部化和公共利益也是影响合理使用适用的重要因素.当存在正外部性无法有效内部化的市场失灵,或者基于维护公共利益,也应考虑适用合理使用规则,以确保作品正外部性的充分释放.     

非政府组织志愿失灵的产权分析

我们在充分肯定非政府组织积极作用的时候,却未能辩证地认识到非政府组织的志愿失灵问题。从新制度经济学的产权视角来分析非政府组织的产权关系,并查找出非政府组织志愿失灵问题的根本动因。     

Governance,Proceduralisation and Justice: Some Challenges to the Legal Paradigm

In 1989, Rudolf Wiethöltner alleged that we are witnessing a ‘failure of law’ in terms of its obligation to achieve ‘just law’. This paradox at the very heart of law – in essence, the impossibility of the realisation of legal justice twinned with the law's inability to cease trying to attain this goal – has been accommodated to a degree by the utilisation of a proceduralist paradigm that relies upon the contingency of governance, but this is now coming under renewed scrutiny. This article will put forward three arguments in this respect. The first section will argue that the turn to governance and the resultant procedural paradigm are both consequences of the ‘failure of law'; the second will point to the inherent weaknesses of the procedural paradigm that can be said to stem from this very failure; while the third will discuss some of the challenges issued to those still reliant upon the legal paradigm.     

DEVELOPMENTAL ISSUES IN THE IMPACT OF CHILD MALTREATMENT ON LATER DELINQUENCY AND DRUG USE*

Developmental psychopathology emphasizes the impact that early childhood maltreatment has on adolescent and early adult development. The life‐course perspective, however, emphasizes more proximal events—adolescent maltreatment, for example—as developmentally disruptive. Prior research suggests that childhood maltreatment is a risk factor for adolescent delinquency and drug use. However, the results appear to depend on a loose definition of childhood. This study utilizes a four‐category maltreatment classification—never, childhood‐only, adolescence‐only, and persistent—to re‐examine the maltreatment‐delinquency relationship. Using data from the Rochester Youth Development Study, we find no relationship between childhood‐only maltreatment and adolescent delinquency or drug use; yet, we do find a consistent impact of adolescence‐only and persistent maltreatment on these outcomes.     

法律的维度--从空间上解读法律失败

现代国家法追求统一性和确定性 ,它存在于非特定的地点和时间空间中。植根于特定地理和时间的地方性规范和地方正义会因地点和时间的不同而不同 ,所以现实社会中会存在现代国家法与地方性规范及地方正义的内部逻辑上的矛盾。它们之间的矛盾是无法消除的 ,只能被减小。我们可以通过建立在社会科学基础上的立法来从空间的角度考虑制定法律以减小矛盾 ,也可以 (为了发展目前没有案例法的民法系统 )通过对已出版的法院案例的法学研究形成的教义来发展案例法以减小矛盾