bluuebunny/crossref_metadata_2025 huggingface dataset:
Pentosan polysulfate promotes proliferation and chondrogenic differentiation of adult human bone marrow-derived mesenchymal precursor cells
Authors: Ghosh Peter , Wu Jiehua , Shimmon Susan , Zannettino Andrew CW , Gronthos Stan , Itescu Silviu
Published: February 2010

Introduction

This study was undertaken to determine whether the anti-osteoarthritis drug pentosan polysulfate (PPS) influenced mesenchymal precursor cell (MPC) proliferation and differentiation.

Methods

Human MPCs were maintained in monolayer, pellet or micromass cultures (MMC) for up to 10 days with PPS at concentrations of 0 to 20 μg/ml. MPC viability and proliferation was assessed using the WST-1 assay and 3H-thymidine incorporation into DNA, while apoptosis was monitored by flow cytometry. Proteoglycan (PG) biosynthesis was determined by 35SO42- incorporation and staining with Alcian blue. Proteoglycan and collagen type I and collagen type II deposition in pellet cultures was also examined by Toluidine blue and immunohistochemical staining, respectively. The production of hyaluronan (HA) by MPCs in MMC was assessed by ELISA. The relative outcome of PPS, HA, heparin or dextran sulfate (DS) on PG synthesis was compared in 5-day MMC. Gene expression of MPCs in 7-day and 10-day MMC was examined using real-time PCR. MPC differentiation was investigated by co-culturing with PPS in osteogenic or adipogenic inductive culture media for 28 days.

Results

Significant MPC proliferation was evident by day 3 at PPS concentrations of 1 to 5 μg/ml (P < 0.01). In the presence of 1 to 10 μg/ml PPS, a 38% reduction in IL-4/IFNγ-induced MPC apoptosis was observed. In 5-day MMC, 130% stimulation of PG synthesis occurred at 2.5 μg/ml PPS (P < 0.0001), while 5.0 μg/ml PPS achieved maximal stimulation in the 7-day and 10-day cultures (P < 0.05). HA and DS at ≥ 5 μg/ml inhibited PG synthesis (P < 0.05) in 5-day MMC. Collagen type II deposition by MMC was significant at ≥ 0.5 μg/ml PPS (P < 0.001 to 0.05). In MPC-PPS pellet cultures, more PG, collagen type II but less collagen type I was deposited than in controls. Real-time PCR results were consistent with the protein data. At 5 and 10 μg/ml PPS, MPC osteogenic differentiation was suppressed (P < 0.01).

Conclusions

This is the first study to demonstrate that PPS promotes MPC proliferation and chondrogenesis, offering new strategies for cartilage regeneration and repair in osteoarthritic joints.
Endogenous Steroids Measured by High-Specificity Liquid Chromatography-Tandem Mass Spectrometry and Prevalent Cardiovascular Disease in 70-Year-Old Men and Women
Authors: Naessen Tord , Sjogren Ulrika , Bergquist Jonas , Larsson Marita , Lind Lars , Kushnir Mark M.
Published: February 2010

Context: There is a need for increased knowledge about endogenous sex hormone levels and clinical outcomes of risk/benefit. Immunoassays have poor specificity to reliably measure low steroid concentrations in elderly.

Objective: The objective of the study was to evaluate plasma steroid concentrations with regard to prevalent cardiovascular disease (CVD) in elderly, using mass spectrometry.

Setting: The study was conducted at a university hospital research unit.

Design and Methods: Plasma samples were analyzed from 202 70-yr-olds as part of a large population-based study, Prospective Investigation of the Vasculature in Uppsala Seniors. Twenty-eight of these had prevalent CVD. Eleven steroids were quantified, using liquid chromatography-tandem mass spectrometry. Women with current/previous menopausal hormone therapy (n = 35) were excluded.

Results: Men without prevalent CVD had higher plasma 17β-estradiol (E2), compared with women. Men with prevalent CVD, compared with those without, had lower 17-hydroxypregnenolone (17OHPregn), 17-hydroxyprogesterone, and higher estrone/androstenedione and E2/testosterone (T) (aromatase activity). Women with prevalent CVD had lower pregnenolone, 17OHPregn, and dehydroepiandrosterone (DHEA) but higher DHEA/17OHPregn, androstenedione/DHEA, E2/T, E2/estrone, and E2/SHBG. The aromatase index, E2/T, was higher for prevalent CVD in both sexes. Adjustment for statin use, smoking, and body mass index yielded additional significant differences in men, whereas some were lost in women. Logistic regression indicated strong associations between prevalent CVD and low 17OHPregn, adjusted odds ratio of 0.18, 95% confidence interval (0.06–0.61); P = 0.006, in women and low 17-hydroxyprogesterone, 0.45 (0.25–0.80); P = 0.007 in men, most likely caused by increased throughput (consumption) toward estrogen synthesis.

Conclusions: Prevalent CVD was associated with indications of lower androgen precursors, increased aromatase activity, and higher estrogen levels in both sexes. Results might represent an endogenous response to a condition of developing atherosclerosis, rather than a causative relationship. Furthermore studies are needed.
Genome-Wide Association Study of Bone Mineral Density in Premenopausal European-American Women and Replication in African-American Women
Authors: Koller Daniel L. , Ichikawa Shoji , Lai Dongbing , Padgett Leah R. , Doheny Kimberly F. , Pugh Elizabeth , Paschall Justin , Hui Siu L. , Edenberg Howard J. , Xuei Xiaoling , Peacock Munro , Econs Michael J. , Foroud Tatiana
Published: February 2010

Context: Several genome-wide association studies (GWAS) have been performed to identify genes contributing to bone mineral density (BMD), typically in samples of elderly women and men.

Objective: The objective of the study was to identify genes contributing to BMD in premenopausal women.

Design: GWAS using the Illumina 610Quad array in premenopausal European-American (EA) women and replication of the top 50 single-nucleotide polymorphisms (SNPs) for two BMD measures in African-American (AA) women.

Subjects: Subjects included 1524 premenopausal EA women aged 20–45 yr from 762 sibships and 669 AA premenopausal women aged 20–44 yr from 383 sibships.

Interventions: There were no interventions.

Main Outcome Measures: BMD was measured at the lumbar spine and femoral neck by dual-energy x-ray absorptiometry. Age- and weight-adjusted BMD values were tested for association with each SNP, with P values determined by permutation.

Results: SNPs in CATSPERB on chromosome 14 provided evidence of association with femoral neck BMD (rs1298989, P = 2.7 × 10−5; rs1285635, P = 3.0 × 10−5) in the EA women, and some supporting evidence was also observed with these SNPs in the AA women (rs1285635, P = 0.003). Genes identified in other BMD GWAS studies, including IBSP and ADAMTS18, were also among the most significant findings in our GWAS.

Conclusions: Evidence of association to several novel loci was detected in a GWAS of premenopausal EA women, and SNPs in one of these loci also provided supporting evidence in a sample of AA women.
Vitamin D Status and Its Relation to Muscle Mass and Muscle Fat in Young Women
Authors: Gilsanz Vicente , Kremer Arye , Mo Ashley O. , Wren Tishya A. L. , Kremer Richard
Published: February 2010

Context: Vitamin D insufficiency has now reached epidemic proportions and has been linked to increased body fat and decreased muscle strength. Whether vitamin D insufficiency is also related to adipose tissue infiltration in muscle is not known.

Objective: The objective of the study was to examine the relationship between serum 25-hydroxyvitamin D (25OHD) and the degree of fat infiltration in muscle.

Design: This was a cross-sectional study.

Outcome Measures and Subjects: Measures were anthropometric measures, serum 25OHD radioimmunoassay values, and computed tomography (CT) values of fat, muscle mass, and percent muscle fat in 90 postpubertal females, aged 16–22 yr, residing in California.

Results: Approximately 59% of subjects were 25OHD insufficient (≤29 ng/ml), of which 24% were deficient (≤20 ng/ml), whereas 41% were sufficient (≥30 ng/ml). A strong negative relationship was present between serum 25OHD and CT measures of percent muscle fat (r = −0.37; P < 0.001). In contrast, no relationship was observed between circulating 25OHD concentrations and CT measures of thigh muscle area (r = 0.16; P = 0.14). Multiple regression analysis indicated that the relation between 25OHD and muscle adiposity was independent of body mass or CT measures of sc and visceral fat. Percent muscle fat was significantly lower in women with normal serum 25OHD concentrations than in women with insufficient levels and deficient levels (3.15 ± 1.4 vs. 3.90 ± 1.9; P = 0.038).

Conclusions: We found that vitamin D insufficiency is associated with increased fat infiltration in muscle in healthy young women.
Enhancement of surface quality using a newly developed technique in turning operations
Authors: El-Hossainy T M
Published: February 2010

Every machining operation leaves characteristic evidence on the machined surface. This evidence takes the form of finely spaced micro irregularities left by the cutting tool. A two-pass technique was introduced for enhancing the surface roughness for different cutting conditions and workpiece materials based on the feed marks (pattern) left by the tool in the machining operation. An important drawback of this technique is that the time taken for its two passes represents twice the time of regular machining. Another drawback is the difficulty of adjusting the tool in the second pass with the appropriate accuracy. For solving these problems, a tool design is provided in this paper to achieve the same results of the two-pass technique in one pass. The objective of this research is to compare this technique using different methods (regular or one pass, two passes, new tool) using different cutting conditions and different workpiece materials. In addition to the surface roughness, straightness and roundness errors are measured for these methods (two passes, new tool) and compared with regular cutting. Improvement of surface roughness was shown as the straightness and roundness errors decrease by using this new technique. In practice, the new tool technique improves the surface roughness, straightness error, and roundness error by more than 58, 65, and 50 per cent respectively at the proposed cutting condition (50 m/min cutting speed, 0.2 mm/rev feed, and 1 mm depth of cut) for all workpiece materials used.
Parametric finite-element studies on the effect of tool shape in friction stir welding
Authors: Li H , Mackenzie D , Hamilton R
Published: February 2010

The success of the friction-stir-welding (FSW) process, and the weld quality produced, depends significantly on the design of the welding tool. In this paper the effects of variation in various tool geometry parameters on FSW process outcomes, during the plunge stage, were investigated. Specifically the tool shoulder surface angle and the ratio of the shoulder radius to pin radius on tool reaction force, tool torque, heat generation, temperature distribution, and size of the weld zone were investigated. The studies were carried out numerically using the finite-element method. The welding process used AA2024 aluminium alloy plates with a thickness of 3 mm. It was found that, in the plunge stage, the larger the pin radius, the higher force and torque the tool experiences and the greater the heat generated. It was also found that the shoulder angle has very little effect on energy dissipation or on temperature distribution.
Wear behaviour of ceramic biocomposites based on hydroxiapatite nanopowders
Authors: Gingu O , Benga G , Olei A , Lupu N , Rotaru P , Tanasescu S , Mangra M , Ciupitu I , Pascu I , Sima G
Published: February 2010

The biomaterials most widely used for hard tissue implants (in orthopaedics, dental implants, and skull bones) are Ti-based biomaterials and Ti coated with hydroxiapatite (HAP). Because metallic biomaterials have some disadvantages as reported previously (mainly due to the difference between the mechanical characteristics of the human bone and the metallic implant), biocomposites have become an interesting solution to improve the hard tissue implants for the human body. This article presents the experimental results concerning the processing of HAP/Ti biocomposites by powder metallurgy technology. The initial powder mixture consists of HAP powder particles (<200 nm) reinforced with 100μm titanium particles in the ratio 3:1 (wt%). Two different sintering routes are used: spark plasma sintering (SPS) at (1000—1100)°C for 10 or 20 min and two-step sintering (TSS) with the first step at 900 °C/1 min, followed by the second step at 800 °C for 300, 600, 900 or 1200 min. The ball-on-disc dry wear tests are developed using, as a moving counterpiece, DIN 100Cr6 tool steel balls (6 mm diameter; Ra<3.2μm; HRc 60—64; density>7.6 g/cm3). The tribological behaviour of the processed biocomposites is appreciated on the basis of the coefficient of friction and wear rate, corroborated with the wear track depth. The final remarks of this article underline the potential use of SPS technology to obtain HAP/Ti biocomposites with comparable wear properties as similar materials processed by more complex technologies. Also, TSS allows processing HAP/Ti materials comparable with the SPS-ed ones from the point of view of the wear behaviour, except for the dwell time of the second step, which is critical for the wear behaviour.
Discrete tonal noise investigation of the cross-flow fan with block-staggered impellers
Authors: Li Y , Ouyang H , Tian J , Du Z , Zheng Z
Published: February 2010

Experimental and numerical studies have been carried out to investigate the detailed effects of discrete tonal noise on a cross-flow fan (CFF) with block-staggered impellers in an air-conditioner indoor unit. First, the aeroacoustic and aerodynamic performance of the CFF with different impellers was obtained through experiments. Then the two-dimensional (2D) computational fluid dynamics (CFD) model was established to solve the pressure fluctuations on noise-generating surfaces. The flow character and noise sources are discussed on the basis of the CFD simulation results. The noise properties generated by different block-staggered impellers are predicted by using the Ffowcs Williams and Hawkings equations from the surface pressure fluctuations provided by the CFD simulations, and the relations between noise property and stagger angle have been discussed. The influence of the spanwise length of a CFF has also been considered during the noise calculation, and the relative results are compared with the traditional pure 2D model. The predicted results are evaluated by comparisons with the experimental data both in time and frequency domains.
Frequency optimization of a wind turbine blade in pitching motion
Authors: Maalawi K Y , Badr M A
Published: February 2010

This article presents a mathematical model for optimizing frequencies of a wind turbine blade in pitching motion. Related design problems include the excessive blade torsional vibrations induced by continuous pitching, which is necessary to limit the power output and protect generator from damages in severe wind conditions. This, in turn, can have adverse effects on the fatigue life of the blades and might cause catastrophic failures near the resonant frequencies. The study considers a blade tapered linearly towards the tip representing the effective aerodynamical surface for producing the needed power. The blade inboard portion is modelled by an equivalent torsional spring simulating the torsional stiffness near the root. The model provides exact solutions of the resulting governing differential equation by utilizing analytical Bessel's functions of the first kind, where the functional behaviour of the torsional frequency has been thoroughly examined. The associated optimization problem is formulated by considering two forms of the objective function. The first one is represented by a direct maximization of the fundamental frequency, while the second one considers minimization of the square of the difference between the fundamental frequency and its target or desired value. In both strategies, an equality constraint is imposed on the total structural mass in order not to violate other economic and performance requirements. Design variables encompass the blade tapering ratio, chord, and shear wall thickness distributions, which are expressed in dimensionless form, making the formulation valid for a variety of blade configurations. In fact, the mathematical procedure implemented can be regarded as a beneficial design tool, in which significant increase in the overall stiffness/mass ratio level of the blade structure combined with full separation of the frequency from the undesired range that resonates with the pitching frequencies can be achieved.
Demographic and referral patterns of people detained under Section 136 of the Mental Health Act (1983) in a south London Mental Health Trust from 2005 to 2008
Authors: Borschmann Rohan D , Gillard Steven , Turner Kati , Lovell Kath , Goodrich-Purnell Norman , Chambers Mary
Published: February 2010

This study aimed to retrospectively examine demographic and referral data for all detainees under Section 136 of the Mental Health Act (1983) at a ‘place of safety’ in one London Mental Health Trust over a three-year period. Data were collected for 887 consecutive detentions and indicated a clear over-representation of black detainees compared with their representation in the local population. A high proportion of detentions (41.2%) did not result in hospital admission. Implications for practice and service user experience should be considered as long as Section 136 remains an entry point to mental health services for many black people. There are implications for interprofessional practice where Mental Health Trust resources are expended supporting Section 136 detentions in which no hospital treatment follows.
Section 136 of the Mental Health Act: a new literature review
Authors: Borschmann R D , Gillard S , Turner K , Chambers M , O'Brien A
Published: February 2010

Section 136 of the Mental Health Act 1983 (amended) provides police officers in the United Kingdom with the authority to remove individuals who appear to be suffering from a mental illness from any public place to a designated ‘place of safety’ for appropriate assessment. A considerable amount of research has been dedicated to investigate who is detained under this section and how it is implemented. A review of the literature revealed a high prevalence of schizophrenia, personality disorders and mania in individuals detained under Section 136 and an over-representation of black detainees. Several studies also reported poor communication between different agencies and poor levels of knowledge regarding the implementation of the section. There is a lack of qualitative research exploring detainee and professional experience of Section 136 and in particular the patient pathway to mental health care via Section 136 experienced by black detainees. Implications for clinical practice, multi-agency collaboration and future research are discussed.
Medicolegal issues arising when pacemaker and implantable cardioverter defibrillator devices are deactivated in terminally ill patients
Authors: McGeary Aine , Eldergill Anselm
Published: February 2010

The number of patients receiving pacemakers and implantable cardioverter defibrillator (ICD) devices continues to increase dramatically. In this paper, the issue of when it is appropriate to deactivate these devices if the patient becomes terminally ill and the medicolegal implications of this action are examined. This appears to constitute a withdrawal of treatment. However, the issue has never come before the courts and therefore no medicolegal guidance exists on the point. This paper highlights a lack of knowledge among health-care staff regarding switching off electromechanical devices in terminally ill patients. We propose some guidance and recommendations for dealing with this issue when it arises in practice, and highlight some important differences between pacemakers and ICDs that will influence decision-making. Conclusions are expressed regarding how this issue should be dealt with in the postmortem setting and in the antemortem setting, where the issue of capacity and consent will influence decisions regarding deactivating these devices.
Homicide and allied inquiries: in whose best interests?
Authors: Prins Herschel
Published: February 2010

Over a decade ago the present author presented some comments on homicide inquiries in this journal. Since then there have been a number of important developments, including the increase in the number of such inquiries and changes in their constitution and functions. A somewhat neglected area has been soliciting the views of those who chair such inquiries. The present contribution endeavours to remedy this deficiency.
A comparison of suicide and undetermined deaths in Cornwall across national and local agencies
Authors: Shankar Rohit , Mascas Alin , Laugharne Richard , Wilkinson Ellen , O'Muirithe Barry
Published: February 2010

We looked to evaluate the reporting pathways and statistics between relevant stakeholders for reporting suicides and undetermined deaths in Cornwall. We checked on the correlation of the numbers provided for suicides and open verdicts given by different national and regional agencies including the local Coroner's office, Office of National Statistics (ONS), Cornwall Partnership NHS Trust (CPT) and The National Confidential Inquiry (NCI) into suicides for Cornwall. We examined the data of suicides and open verdicts presented by these agencies between the years 2000 and 2002. Our study shows that the data transfer between the relevant agencies (local Coroner, ONS, CPT and NCI) can be inaccurate. These inaccuracies not only prevent establishment of clear records but could also impact on policy decisions. It is also important to recognize that NHS trusts involved in mental health are being evaluated on their record on suicide prevention which in some senses is the most important outcome measure, thus making it important for inspecting bodies to look out for and take account of different figures from different agencies.
The use of Section 136 (Mental Health Act 1983) in Gloucestershire
Authors: Laidlaw J , Pugh D , Riley G , Hovey N
Published: February 2010

The small number of published studies on the use of Section 136 (S136) of the Mental Health Act 1983 may reflect neither the current situation nor the true national picture as most of the research comes from large urban centres and was published before 1997. We studied the use of S136 between 2002 and 2006 in Gloucestershire, a rural English county with a population of approximately 585,000, by analysing data held by the police and local mental health services. On average 192 subjects (range 176–203) were detained each year under S136, equating to a population rate of 32.8 S136 detentions per 100,000 per year in Gloucestershire. In contrast to other published studies, ethnic minorities, particularly Afro-Caribbean males, were over-represented only in a minor way. Of those individuals detained, about a third were admitted, a lower rate than in other studies. Acts or threats of self-harm were common (55%), but acts or threats of violence (28%) and evidence of intoxication (16%) were present in a minority, suggesting that detainees are more likely to pose a risk to themselves than others.
The Nature and Management of Aggressive Incidents in a Medium Secure Unit
Authors: Parkes John
Published: February 2010

The study describes and analyses incident reports over a three-year period in a medium secure unit. A low threshold of reporting was encouraged and substantial numbers of `minor' incidents were reported. The frequency of incidents peaked in the evenings. The use of seclusion and manual restraint is reported and these were used more frequently where staff were the target of aggression.
The Single Joint Expert
Authors: Samuels Alec
Published: February 2010

The new concept in civil litigation is that of the single joint expert (SJE). Is it a good concept or a bad concept? What are the merits and demerits? What changes in practice are emerging?
Cannabis and Violent Crime
Authors: Niveau Gérard , Dang Cécile
Published: February 2010

We present a series of 12 cases of violent crime, which were all committed under the influence of cannabis in Geneva, Switzerland, between 1996 and 2000. The crimes were committed by eleven males and one female, with a mean age of 26 years, who were using only cannabis at the time they acted. Most of them were chronic users. Five subjects had a past psychiatric history. Five had a personality disorder. Only three had been sentenced in the past for violent acts. At the time of the aggression, all of them exhibited adverse and acute effects of cannabis. All of them were judged by the court to be partially or totally non-responsible. Three cases are presented in more detail. Our data suggests that cannabis could have a specific role in the development of violent behaviour patterns and that detection of its adverse effects should be systematic in criminal responsibility evaluation.
1. Traumatic Basal Subarachnoid Haemorrhage Caused by the Impact of a Golf Ball
Authors: Watanabe-Suzuki Kanako , Suzuki Osamu , Nozawa Hideki , Kosugi Isao , Ishii Akira
Published: February 2010

A 50-year-old male was hit by a high-speed golf ball on the left lateral side of his neck. He collapsed immediately and was sent to hospital, where he was pronounced dead. The autopsy showed an extensive basal subarachnoid haemorrhage. Careful gross and histological examinations disclosed a rupture of the right vertebral artery at a site very close to the bifurcation. It was estimated that the impact of the golf ball on the left side of his neck resulted in the rupture of the contralateral vertebral artery, owing to its hyperextension. Although there are many reports on traumatic basal subarachnoid haemorrhage, the present type of trauma seems rare to our knowledge.
2. An Unusual Suicide by Stabbing
Authors: Rautji R , Rudra A , Behera C , Kulshrestha P , Dogra T D
Published: February 2010

A 50-year old cobbler, employed in a paramilitary unit, was found dead in a pool of blood in his shop inside the unit line in the morning. He had multiple stab wounds on his chest and was alleged to have committed suicide by repeated self-stabbing on the chest with a sharp iron chisel, which was found clenched in his right hand by the investigating officer. Fifteen wounds were communicating with the chest cavity, injuring the vital anatomical structures. The individual, according to the unit personnel, was not suffering from any physical or mental disorder and was not on any medication.
Childhood Homicide: A 1990-2000 retrospective study at the Institute of Legal Medicine in Lausanne, Switzerland
Authors: Romain Nathalie , Michaud Katarzyna , Horisberger Beat , Brandt-Casadevall Conxita , Krompecher Thomas , Mangin Patrice
Published: February 2010

The authors retrospectively reviewed all homicides of children under 15 years of age referred to the Institute of Legal Medicine in Lausanne from January 1990 to December 2000. We report on 41 cases during this eleven-year period. Among those, 17 newborns and 24 older children, a higher proportion of males was found. Regarding newborn homicides, when the identity of the mother was known she was always identified as the perpetrator. With non-newborn homicides, the majority of the victims were killed at home and knew the offender. Two common profiles of these homicides could be determined. In the first scenario, one of the parents shot all the children and committed suicide afterwards. The second profile is defined as `fatal child abuse' and concerned younger victims whose cause of death was the result of a cranio-cerebral trauma from battering or shaken baby syndrome.
Blood Analysis by Headspace Gas Chromatography: Does a deficient sample volume distort ethanol concentration?
Authors: Jones A W , Fransson M
Published: February 2010

This study was prompted by a recent judgment in the Royal Courts of Justice ( Gregory v. Director of Public Prosecutions, 2002) in a case of driving a motor vehicle after consuming too much alcohol (Road Traffic Act 1988). An expert witness for the defence alleged that a deficient volume of blood in the tube sent for analysis meant an excess amount of sodium fluoride (NaF) preservative, which would increase the concentration of ethanol, determined by headspace gas chromatography (HS-GC), owing to a salting-out effect. The prosecution did not produce expert evidence to rebut this argument and the drunk driving suspect was acquitted.

A small volume of blood and excess sodium fluoride might have increased the concentration of ethanol in the air-space in the tube sent for analysis but this does not mean that the result of the HS-GC analysis would be higher. This follows because prior to analysis an aliquot of blood is removed and diluted (~10 times) with n-propanol as the internal standard. The dilution lowers the concentration of NaF in the blood and for quantitative analysis the ratio of the ethanol to n-propanol response is measured. The use of a ratio also helps to compensate for any salting-out effect of ethanol. Our experiments showed that a deficient volume of blood and excess NaF actually lowered the concentration of ethanol by 2-3% compared with heparinised blood. Seemingly, n-propanol (n-PrOH) a 3-carbon straight chain alcohol is salted out slightly more effectively than the 2-carbon ethanol (EtOH) causing a lower peak area ratio (EtOH/n-PrOH) and a lower apparent concentration of ethanol. In a separate study, we showed that the concentration of ethanol was lowered even more when a 4-carbon alcohol (t-butanol) was used as the internal standard.
The Creation of Inter-Ethnic Images for Studies in Applied Psychology
Authors: VANEZIS MARIA , VANEZIS PETER , MINNIS HELEN , McMILLAN ALISON , GILLIES MARJORIE , SMITH SHUBULADE
Published: February 2010

The facial transformation programme, is an integral part of the computerised three-dimensional facial reconstruction system, employed at the University of Glasgow for forensic and historical cases. It was applied to the creation of inter-ethnic images for use in studies to assess the response of various groups to facial appearance in the assessment of racial stereotyping.

We initially acquired a three-dimensional facial image from a young black (Negroid) male volunteer, using our optical laser scanning system. This image was then used as a template over a Caucasian skull to produce a reconstruction using facial criteria applicable to white (Caucasian) males. The other image used was that of the facial template of the black male.

A commercially available electronic identikit system, E-FIT™ was then used to add appropriate hair styles and open eyes to both images. In addition, on the ‘Caucasian reconstruction’ we were able to reduce the contrast and lighting on the face. This was relatively straightforward as we were using greyscale images rather than colour. The shape of the nose and lips on the white male were also altered to be more in keeping with Caucasoid average measurements.

The resulting images were shown to a group of second-year clinical psychology students and their responses are discussed. Similar images may also be used in studies of racial stereotyping in different categories of professionals such as police, prison personnel, probation officers, social workers, potential employers, doctors, and others, in order to assess the response to individuals by facial appearance.
Fatal Pulmonary Thromboembolism in Singapore: Has anything changed?
Authors: LAU GILBERT , THAMBOO THOMAS PAULRAJ , LAI SIANG-HU
Published: February 2010

A previous study of fatal pulmonary thromboembolism (PE) during a five-year period (1989-1993) in Singapore found a low post-mortem prevalence of fatal PE (1.05%). The present study investigated cases of fatal PE among 10,097 coroner's post-mortems conducted between 1994 and 1998 at the Centre for Forensic Medicine, Health Sciences Authority, Singapore, and compared the results with the previous study.

There were 130 cases of fatal PE, representing a post-mortem prevalence of 1.29%. This is comparable to the previous study but is lower than most other published series from other countries. There was a shift towards younger subjects, with the modal age group being 40 to 49 years, compared with 70 to 79 years previously. A large proportion of subjects had risk factors for PE, with 42.3%, 23.8% and 11.5% having had a history of surgery, trauma or malignancy respectively. After the onset of immobility or trauma, 50% of subjects developed PE in the first seven days and 76.8% in the first two weeks. PE was not suspected as the cause of death in 74.6% of cases under medical care.

The incidence of fatal PE in Singapore remains low. However, a large proportion of cases continue to be unsuspected as the cause of death. It would appear that, on the whole, a correct clinical diagnosis of fatal pulmonary thromboembolism remains largely elusive.
Lies... Damned Lies... and Suicide Statistics!
Authors: SALIB EMAD , THOMAS NOIR
Published: February 2010

In the absence of any measurable outcome in psychiatry, suicide is now regarded as an outcome measure in Mental Health Services.

The National Service Framework (NSF) has set the reduction of the suicide rate by 20 per cent over the next seven years as a national priority. This article will examine how reliable suicide is as an outcome measure.
Can Shaking Alone Cause Fatal Brain Injury?
Authors: CORY C Z , JONES M D
Published: February 2010

A biomechanical model of a one-month old baby was designed and tested by Duhaime and co-workers in 1987 in an attempt to assess the biomechanics of the shaken baby syndrome (SBS). The study implied that pure shaking alone cannot cause fatal head injuries, a factor which has been applied in criminal courts. In an attempt to test the validity of the model a preliminary study was undertaken in which a replica was constructed and tested. The broad description of the design and construction of the Duhaime model allowed for variations and therefore uncertainties in its reproduction. It was postulated therefore that differences in certain parameters may increase angular head accelerations. To further investigate this observation, an adjustable replica model was developed and tested.

The results indicated that certain parameter changes in the model did in fact lead to an increase in angular head acceleration. When these parameter changes were combined and an injurious shake pattern was employed, using maximum physical effort, the angular head acceleration results exceeded the original Duhaime et al. (1987) results and spanned two scaled tolerance limits for concussion. Additionally, literature suggests that the tolerance limits used to assess the shaking simulation results in the original study may not be reliable. Results from our study were closer to the internal head injury, subdural haematoma, tolerance limits. A series of end point impacts were identified in the shake cycles, therefore, an impact-based head injury measure (Head Injury Criterion – HIC) was utilized to assess their severity. Seven out of ten tests conducted resulted in HIC values exceeding the tolerance limits (critical load value, Stürtz, 1980) suggested for children.

At this present stage the authors conclude that it cannot be categorically stated, from a biomechanical perspective, that pure shaking cannot cause fatal head injuries in an infant. Parameters identified in this study require further investigation to assess the accuracy of simulation and increase the biofidelity of the models before further conclusions can be drawn. There must now be sufficient doubt in the reliability of the Duhaime et al. (1987) biomechanical study to warrant the exclusion of such testimony in cases of suspected shaken baby syndrome.
Electrocution in South Delhi: A retrospective study
Authors: RAUTJI R , RUDRA A , BEHERA C , DOGRA T D
Published: February 2010

One hundred and fifty three unselected autopsy cases of electrocution received from South Delhi were studied during the period 1996-2001. Data for the study was gathered from autopsy reports and hospital records. The cases represented approximately 1.98% of all autopsy cases received from South Delhi at the All India Institute of Medical Sciences, New Delhi (India). Data was analysed with regard to the age and sex of the victim, season of the year, site of the body, time of day, place of occurrence and presence of entry and exit wounds on the body. Death occurred at the scene of the fatal event in 150 cases and three cases died in hospital. Three cases showed no electric burn marks on the body; the cause of death in one of these cases was polytrauma due to a fall from a height and one case had committed suicide.
Detecting the Dangerous, Violent or Criminal Patient: An analysis of referrals to maximum security psychiatric care
Authors: PIMM J , STEWART M E , LAWRIE S M , THOMSON L D G
Published: February 2010

Britain's high security hospitals provide care for mentally disordered patients who have dangerous, violent or criminal propensities. The State Hospital, Carstairs, takes referrals from the population of Scotland and Northern Ireland. This retrospective case-control study describes the sociodemographic and clinical characteristics of referrals (n=149) to the State Hospital during a 12-month period, and delineates differences between admitted (n=57) and rejected (n=92) patients.

The referrals had an average age of 31.1 years, and were mostly male (86.6%), single (64.4%) and unemployed (90.6%). Admitted patients were more likely to have a criminal history, to be psychotic, to have a family history of mental disorder and to be viewed by the assessor as having psychotic beliefs which contributed to the behaviour or alleged offence leading to the referral. Rejected patients were more likely to have been remanded to prison or assessed by specialist registrars.

Patients admitted to high security psychiatric care are more likely to show dangerous behaviour secondary to psychosis. These findings are in keeping with the requirements of mental health legislation and the admissions policy.
Burnt Wives: A study of homicides
Authors: KUMAR VIRENDRA , TRIPATHI C B
Published: February 2010

The death of married females nowadays is very common in India, usually being associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 47 (31%) were homicidal burns and these cases were analyzed in view of epidemiological and medicolegal aspects.

Homicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from extended families (i.e. multigenerational groups of related individuals living under a single roof) and the homicides occurred within the first few years of their marriages. The majority of the affected wives were 16-25 years of age (77%) at the time of the incident and sustained more than 70% total body surface area (TBSA) burn injuries. Many of them were doused with kerosene and set alight. Most died at the time of the incident or within the subsequent 24 hours, most commonly from shock.
Medicolegal Issues in Paediatric Practice: Proceedings of the 4th Northern Regional Paediatric Colloquium
Authors: COUSINS D A , BARRETT I , KAPLAN C A
Published: February 2010

Ethical dilemmas frequently arise in paediatric practice. Given the nature of the speciality, these issues are pertinent to both the medical and legal professions. It is of potential benefit for the professions to meet and discuss such cases outwith the immediate clinical setting. A series of such meetings have been held in the Northern region. We report the proceedings of the fourth meeting. Four cases were presented and the issues arising were debated. The key points from each discussion are described.
British Military Forensic Psychiatry
Authors: TURNER MARK A , NEAL LEIGH A
Published: February 2010

Military psychiatry has recently generated a lot of interest. In contrast there is virtually no literature on military forensic psychiatry. The first section of the paper is a brief review of British military psychiatric services and recent data on the prevalence of mental illness in British armed forces personnel. The second section summarizes the relevant aspects of the British military judicial and penal systems including the practice of summary justice, the court martial system, and sentencing and corrective training. The third section of the paper addresses issues which are particular to forensic psychiatry, including mental defences in relation to the military, the military offences of malingering and impersonation, risk assessment in military contexts and the notion of ‘temperamental unsuitability’ to military service.
A Study of Homicidal Deaths in Delhi
Authors: GUPTA AVNEESH , RANI MUKTA , MITTAL ANIL K , DIKSHIT P C
Published: February 2010

A meticulous post-mortem review was undertaken in the department of forensic medicine at the Maulana Azad Medical College (MAMC) to find out trends in homicides during the period 1992-1996. Standard procedures for autopsies and a review of the inquest papers were carried out. Out of 3,886 medico-legal autopsies performed in the department during the said period, only 232 cases (5.9%) were homicidal deaths. The commonest age group of the victims was 21-30 years (38%). Males were victimized three times more often than females. The incidence of crime was slightly more at night than in the daytime, though evenly distributed during the winter and summer seasons. In our series, sharp weapon injuries were the most common type (34.9%) followed by blunt force injuries (15.9%). Defence wounds were present in 35 cases (15%). Violent rage/quarrel was the motive in 61 cases (29%).
The Nearest Relative in Mental Health Law
Authors: ANDOH BENJAMIN , GOGO EMMANUEL
Published: February 2010

This article considers the concept of the ‘nearest relative’ in mental health law in England and Wales and argues, inter alia, for its retention in a way that avoids violation of the European Convention on Human Rights and the Human Rights Act 1998. It looks, first, at the meaning of nearest relative and then focuses on his/her role today, including its link with advance directives for mental health care, and on the tension between nearest relatives and approved social workers and the law. The problem exposed by JT v. United Kingdom in relation to the Human Rights Act 1998 and its implications for the future are considered. The impact of the Mental Health Bill (2002) on the nearest relative is discussed and recommendations to improve the present law are then suggested.
Circumstances of Crime in Homicidal Deaths
Authors: MOHANTY MANOJ KUMAR , MOHANTY SACHIDANANDA , ACHARYA SUNITI
Published: February 2010

Homicide patterns vary from country to country, influenced by many factors. In the two-year period from January 1998 to December 1999, 82 homicide victims were autopsied. The sex ratio was about three males for one female. The largest number of victims was found in the age group 21-30 years. Assaults with blunt weapons were the most common means. Acquaintances committed 34% of homicides. In contrast to males, the killing of a female by a stranger was rare. Revenge was the most common reason followed by arguments. In 40.2% of cases, the location of crime was outdoors, 37.8% were at the victim's house and in 9.7% of cases, the crime was committed at another domicile such as the offender's house, lodgings or a relative's house. In 14.7% of cases, the dead bodies were located away from the scene of crime.
Forensic Medical Aspects of Male-on-Male Rape and Sexual Assault in Greater Manchester
Authors: McLEAN IAIN A , BALDING VAL , WHITE CATH
Published: February 2010

Male-on-male rapes and sexual assaults comprise fewer than 10% of such assaults reported to the police, and so many physicians seldom encounter them. This paper provides an overview of the nature of sexual assault encountered by males, ensuing injuries, and comparisons with male-on-female assault cases.

The retrospective epidemiological study was on two cohorts seen at St. Mary's Sexual Assault Referral Centre, Manchester. The participants were Centre clients seen between October 1986 and mid-May 2003; 376 male cases (370 individual clients) and 7,789 female cases (7,403 individual clients). The main outcome measure was the presence of injury (abrasion, laceration, or bruise) to defined body areas. The results showed that 66% of male cases (when assault type was known) had been raped, significantly fewer than in female cases, (p 0.00, a 0.05, O.R. 0.474, 95% C.I. 0.357 to 0.63). Eighteen per cent of male cases that had a forensic medical examination presented with an anal injury, significantly more than in females (p 0.00, a 0.05, O.R. 6.101, 95% C.I. 4.216 to 8.829). Significantly fewer males than females sustained injuries to other body areas.

The conclusion was that males were significantly more likely (six times) than females to receive at least one injury to the anal area. Even so, males are five times more likely to have no anal injury.
1. Fatality Following a Sternal Bone Marrow Aspiration Procedure
Authors: BHOOTRA B L
Published: February 2010

A 58-year-old man was admitted to hospital for the investigation and treatment of pancytopaenia and anaemic heart failure but four days later he died following a sternal bone marrow aspiration procedure.

The autopsy revealed a significant haemopericardium as a result of a puncture wound of the heart. The thickness the body of the sternum was 2 to 3 mm. No other significant pathology was noted and death was ascribed to a haemopericardium due to a puncture wound of the heart associated with bone marrow aspiration. An inquest was held at which the doctor who undertook the procedure was found not to be negligent.
2. Suicide by a Transvestite or Sexual Asphyxia?
Authors: BHARDWAJ D N , RAUTJI R , SHARMA R K , DOGRA T D
Published: February 2010

Autoerotic asphyxial activity may at times result in unexpected death. Although the majority of deaths that occur during autoerotic asphyxial episodes are accidental, the possibility of suicide must always be entertained. In the case presented here, a 22-year-old married male was found hanging by his neck in his bedroom, which was locked from the inside. He was suspended by a ‘lungi’ (male wrap-around cloth) from the ceiling fan hook in his room, with his feet touching the ground. He was dressed in a brassière, panties, and silver anklets. There was no evidence of previous perverse behaviour, and investigation disclosed no evidence of previous autoerotic sexual activity, homosexual behaviour, drug abuse or suicidal ideation.
An Evaluation of Psychiatric Support to Magistrates' Courts
Authors: VAUGHAN PHILLIP J
Published: February 2010

A Court Protocol was introduced to Hampshire Magistrates' Courts on 1 January 2003 which enabled magistrates to seek information on mentally disordered defendants from local mental health workers in place of requesting a full psychiatric report. The scheme was evaluated by examining 48 case files of mentally-disordered defendants who were referred between 1 January 2003 and 31 December 2003. It was found that its use had significantly reduced the time taken from first appearance to disposal and significantly reduced inappropriate referrals to consultant psychiatrists. In many cases, defendants were spared repeated bail adjournments and lengthy remands in prison.