Sudden unexpected death in epilepsy: is death by seizures a cardiac disease?

RESULTS: Sudden unexpected death in epilepsy (SUDEP) gains more and more acknowledgment across the various interdisciplinary fields. Accordingly, we performed in a prospective setting a case-control study of all SUDEP cases in a well-defined part of Denmark (Northern Jutland), between January 1998 and September 2000. We attempted to look into the cardiopathologic mechanism behind this phenomenon by assessing the degree of myocardial fibrosis in SUDEP patients versus controls. The histologic evaluation was possible in 65% of the cases (15/23) whose death was attributed to SUDEP and in 71% (15/21) of controls. Forty percent of the SUDEP cases (6/15) presented several foci of fibrotic changes in the deep and subendocardial myocardium in contrast to 1 control (6.6%, P = 0.03). None of the subjects from the SUDEP group showed fibrotic changes in their conduction system as compared with 1 control (6.6%). The quantitative evaluation of fibrosis demonstrated a trend toward more fibrosis in the deep and subendocardial myocardium of the SUDEP cases. Forty percent of cases in the SUDEP group were men (6/15), characteristically young at time of death (mean age 38 years) and with a late epilepsy onset (mean age 21 years). Antemortem, 73% of the SUDEP patients (11/15) had experienced infrequent seizures (self-reported). We conclude that the SUDEP cases displayed significant fibrosis of the myocardium when this was assessed by qualitative means. This fibrosis may be the consequence of myocardial ischemia as a direct result of repetitive epileptic seizures, which, associated with the ictal sympathetic storm, may lead to lethal arrhythmias.     

Beyond the merchant and the clergyman: assessing moral claims about development cooperation

This article proposes to move beyond the categories of altruism and self-interest in the analyses of the motives for development cooperation. This opposition ignores the inherently moral nature of development policy. The article illustrates the shortcomings of such a perspective by tracing the metaphor of the merchant and the clergyman as archetypical figures shaping Dutch development policy. Through these images the suggestion of an opposition between moral and amoral motives in the history of development has gained a strong foothold within the interplay of scholars, policy makers and public opinion. We go on to assess claims about economy, security, solidarity, prestige and guilt, and ecology, which have been brought forward to legitimise Dutch foreign aid. This analysis calls for research on the dynamics of the transnational exchanges of ideas, interests and expectations, especially during episodes when the moral validity of policy has been explicitly contested.     

On the autofluorescence of fingermarks

The autofluorescence of fingermarks is used for their detection. The components responsible for this autofluorescence are largely unknown. Thin layer chromatography and fluorescence spectroscopy were used to identify autofluorescent components and evaluate their forensic value. Based on our results, tryptophan is hypothesized to be a major contributor to the autofluorescence when part of peptides or proteins, id est, not in its free form. Part of the autofluorescence could be assigned to a kynurenine derivative. Pheophorbide A, a metabolite of chlorophyll, is inferred as a red fluorescent fingermark component. Chlorophyll is a plant pigment which implies that dietary information can potentially be retrieved from fingermarks.     

Polluting Environment, Polluting Constitution: Is a 'Polluted' Constitution Worse than a Polluted Environment?

The Indian Supreme Court has been praised as one of the mostsocially active courts in the world, especially so in the environmentalfield. Yet it is arguable that many of the benefits claimedfor judicial involvement are far from real. Three phases ofacti­vism are identified. In the 1970s, the Court developedthe concept of environmental rights based on ensuring that thedirective principles of state policy and the funda­mentalright to life contained the Constitution worked in mutual support.This was followed by a period when the Court extended liabilityprinciples. The most recent and most controversial phase hasinvolved the Court increasingly acting in an exec­utivefunction and effectively both making and implementing policies.The Court’s enthusiasm in environmental matters has nowdented India’s institutional balance. By being preparedto judicialise all problems of life into problems of law, theCourt has undermined the strength of citizens to engage collectivelywith institutions of the State—the Court should now withdrawfrom its self-imposed alchemist role.     

New Europeans: Naturalisation and citizenship in Europe

A case is made for a cross‐national analysis of acquisition of citizenship by foreign residents in Europe, frequently regarded as a prime indicator of formal integration. After a brief review of theories and concepts and of legislation and policy, the article evaluates the quality of data on the subject and suggests how they may be improved and harmonised. Analysis of the main patterns and trends for the period from 1980 indicates that Europe has experienced an increasing number of naturalisations while rates have remained stable. There is a trend towards higher rates of acquisition of citizenship by non‐EU nationals, particularly amongst refugees.