Additional Information In Cases Research Articles

Consensus pregnancy-related criteria for suicide and unintentional overdoses using a Delphi process.

Suicide and unintentional overdose are leading manners of preventable death during and within a year of pregnancy. Recently, the Utah Maternal Mortality Review Committee (MMRC) developed 10 criteria to guide pregnancy-related classification of these deaths. Our objective was to (1) evaluate if consensus could be reached across experts in maternal mortality review when applying criteria to the determination of pregnancy-relatedness in mock MMRC case evaluation and (2) assess how additional case information shifted participants' determination of pregnancy-relatedness in these mock cases. We used a modified Delphi process to evaluate criteria for pregnancy-related suicides and unintentional overdose. The study team developed base case scenarios to reflect the 10 proposed criteria. Base scenarios varied in timing of death (prenatal or delivery, early postpartum (<6 months), late postpartum (6-12 months)) and level of additional information available (e.g., informant interviews, social media posts). Consensus in favor of a criterion was met when ≥75% of participants identified a case as pregnancy-related in at least 1 scenario. Fifty-eight participants, representing 48 MMRCs, reviewed scenarios. Of 10 proposed criteria, 8 reached consensus. Overall, participants classified 19.4% of base case scenarios as pregnancy-related, which increased to 56.8% with additional information. Pregnancy-related classification changed across timing of death and with availability of additional information (prenatal or delivery 27.7% versus 84.6%; early postpartum 30.0% versus 58.3%; late postpartum 0.0% versus 25.0%, respectively). We identified consensus supporting the application of 8 standardized criteria in MMRC determinations of pregnancy-relatedness among suicide and unintentional overdose deaths.

The significance in detecting and determining out-of-scope findings for volatile organic compounds in forensic casework

To provide an appreciation for identifying unknown peaks in headspace gas chromatography and a process for reporting additional information for volatile organic compounds (VOCs) in cases. VOCs are frequently abused as inhalants (gases or solvents). They are often abused due to their accessibility and low cost. VOCs are used in a variety of products including household and commercial items such as gasoline, compressed air duster products, nail polish, glues, paints, and varnishes. They are abused because they can be inhaled or insufflated. Abusing these substances can lead to serious health problems including the possibility of death due to chemical asphyxia and/or central nervous system depression. Routine testing procedures can be used to identify many such compounds. Cases for which VOCs were detected that were not in the routine scope of testing were identified during 2020 to 2022. The samples (all blood except for one gastric case) were originally analyzed using either headspace gas chromatography with flame ionized detection (GC/FID) and/or headspace gas chromatography/mass spectrometry (GC/MS). Where possible, if laboratory testing was performed in addition to volatile testing, volatile testing was performed first to limit evaporation of volatile compounds. Based on the results the sample either had further testing performed or an experienced forensic toxicologist was consulted to determine the next course of action. Unknown peaks identified through volatile toxicological testing include 1,1-Difluoroethane (DFE), Chlorodifluoromethane (Freon22), and components found in gasoline such as butane, pentane, benzene, etc. It is important to establish a process to determine when additional peak identification is needed. Frequently, this is provided through case history, but that is not always readily available. Depending on the sample matrix, the detected analytes, and their volatility, results were reported either qualitatively or quantitatively. Case reports for select samples will be discussed further to demonstrate the inherent value of this approach. Challenges exist with the use of headspace gas chromatography in the identification of unknown peaks. These peaks can provide vital information about a case. It is important to be vigilant when assessing such data since these peaks can often be missed or overlooked due to limits in the method. Identified unusual peaks in the chromatography should be interpreted with caution and additional case information needs to be sought. The significant findings from the out-of-scope headspace gas chromatography analysis can provide key toxicological information in cases when no other additional results are found.

Exploration of a new hepatitis a surveillance system in Beijing, China: based on molecular epidemiology

BackgroundThe incidence of hepatitis A virus (HAV) infection is low in Beijing, China, but the risk of outbreaks still exists. It is difficult to identify possible sources of infection among sporadic cases based on a routine surveillance system. Therefore, a more effective surveillance system needs to be established.MethodsThe epidemiological data of hepatitis A were obtained from a routine surveillance system. Patients with HAV confirmed at the local hospitals were asked to complete a questionnaire that included additional case information and possible sources of infection. Serum and fecal specimens were also collected for testing HAV RNA by polymerase chain reaction. In addition, the 321-nucleotide segment of the VP1/2A junction region was sequenced to determine the HAV genotype.ResultsIn 2019, 110 HAV cases were reported in Beijing, with an incidence rate of 0.51/100,000. 61(55.5%) of these patients were male. The greatest proportion of these patients were aged from 30 to 60 years. The rate was lower in suburban and rural areas compared to urban areas. Contaminated food consumption, particularly seafood consumption, was the primary potential source of infection. Among the 16 specimens of confirmed HAV cases that could be sequenced, 93.8% were HAV IA, and 6.3% were HAV IB. In addition, the samples collected from all HAV sequences in this investigation showed 89.4–100% nucleotide homology. Two groups (each with three sporadic cases) showed 100% nucleotide homology. The three sporadic cases in one group had the same possible source of infection: contaminated salad with raw vegetables and seafood. In the other group, the three sporadic cases did not have an epidemiological connection.ConclusionsIn a low HAV prevalent area, such as in Beijing, incorporating molecular epidemiology into the routine surveillance system could help inform possible clusters of outbreaks and provide support for earlier control of HAV transmission. Nevertheless, increased sampling from detected cases and improved specimen quality are needed to implement such a system.

Left atrial filling index in prediction of exercise induced pulmonary hypertension in patients with asymptomatic primary mitral regurgitation

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. In patients with chronic mitral regurgitation (MR), left atrium (LA) is one of the first cardiac structures, that are affected by progressive volume overload. Previous studies have shown that higher LA filling index (FI) could be a potential negative prognostic marker and it may provide additional information in cases where surgical valve correction is considered. Purpose. The aim of this study was to evaluate the connection between the LA FI and exercise–induced pulmonary hypertension (EIPH) in patients with asymptomatic primary moderate to severe MR. Methods. The study sample consisted of 50 patients (age 61.88 ± 12.88 years) with asymptomatic primary moderate to severe MR and preserved left ventricular (LV) ejection fraction (EF) (&amp;gt;60%). All of the patients underwent resting and stress (bicycle–ergometry as per protocol 25 + 25W every 3 minutes) echocardiography. The ratio of the early–diastolic mitral inflow peak velocity (E) and LA reservoir strain was calculated as the LA FI. EIPH was considered as systolic pulmonary artery pressure (SPAP) ≥60 mmHg during peak stress. Results. EIPH was identified in 13 (26%) patients with primary asymptomatic MR. LA FI at rest, during initial and peak stress was higher in patients with EIPH (p = 0.041, p = 0.023 and p = 0.036, respectively). LA FI at rest (r = 0.334; p = 0.044), during initial (25W) stress (r = 0.371; p = 0.037) and during recovery phase (r = 0.408; p = 0.023), weakly correlated with SPAP during maximal achieved workload. In univariate logistic regression analysis, LA FI during initial and peak stress was significantly related to EIPH (Table 1). According to ROC analysis, LA FI &amp;gt;6.46 during initial stress could predict EIPH with 70.0% sensitivity and 75.0% specificity (p = 0.023). LA FI &amp;gt;9.59 during peak stress could distinguish the possibility of underlying EIPH with 60.0% sensitivity and 94.3% specificity (p = 0.036). Conclusions. Resting and exercise LA FI was higher in subjects with EIPH. LA FI during stress could be the potential predictor of EIPH in patients with asymptomatic primary MR and preserved LV EF. Table 1 Parameter β Chi-Square Odds ratio Standard error 95% CI p value LA FI at rest 1.21 3.549 3.271 0.106 0.984 - 1.489 0.071 LA FI during initial (25 W) stress 1.535 6.056 4.812 0.195 1.047 - 2.250 0.028 LA FI during peak stress 1.662 7.364 4.646 0.236 1.047 - 2.638 0.031 LA FI during recovery phase 1.257 3.998 3.139 0.129 0.976 - 1.619 0.076 LA - left atrium FI - filling index Abstract Figure. Picture 1

O9.6. SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFECTS OF CANNABIS USE IN ADOLESCENCE ON IQ IN LONGITUDINAL STUDIES ACCOUNTING PRE-EXPOSURE BASELINE PERFORMANCE

BackgroundCannabis use in adolescence is a known risk factor for developing schizophrenia. Decline in intellectual functioning is a well-studied phenomenon of schizophrenia. Schizophrenia in its first classification was conceptualized as a dementia - ‘Dementia Praecox’ indicating a dominance of effect of cognitive symptoms on functioning at that time. First episode psychosis patients with histories of cannabis use compared to those without cannabis use have superior cognitive functioning suggesting different disease phenotypes. Our aim was to investigate whether cannabis had an effect on full scale IQ in general population samples to further inform understanding of this disease pathway.MethodsWe developed a search strategy through an iterative approach with a qualified information specialist. We searched three databases: Medline, Embase and PsychInfo. We included conference abstracts and full text publications in English. We contacted authors for additional information in cases where an effect size was not calculable. We included longitudinal studies of non-help-seeking young people in the community with a pre-drug exposure standardized measure of IQ prior to the age of 18 and a comparable measure at subsequent follow up. We defined the case group as individuals with a history of heavy cannabis use (more than 25 lifetime uses, at least weekly use for 6 months and/or meeting criteria for a cannabis use disorder) and the control group as similar young people who had no or very minimal experimental exposure to cannabis (<5 lifetime uses). Two reviewers independently extracted the data and assessed for bias using the Newcastle-Ottawa risk of bias tool. We performed random effects meta-analysis in Stata version 14 given expected heterogeneity in measurement of cannabis use across studies.ResultsWe identified 7 cohort studies detailed in 6 reports including over 650 subjects and 5600 controls. Study designs included twin cohorts, representative cluster sampled community cohorts and birth cohort studies. Range of follow up was between 2 and 23 years. All studies showed relative decline in IQ of which two were statistically significant. Our findings show that cannabis use in youth is associated with modest IQ differences that equate to approximately to a 2-point decrease in young cannabis users. Studies examining twin pairs showed that twins discordant for cannabis use did not have divergent cognitive trajectories, however these analyses were relatively underpowered to find an effect.DiscussionOur findings demonstrate the harmful effects of cannabis use on brain development in young people. These findings are of public health importance and provide further evidence for the detrimental effects of early cannabis use on mental health and cognition.

Phylogenetic Placement of Isolates Within the Trans-Eurasian Clade A.Br.008/009 of Bacillus anthracis.

The largest phylogenetic lineage known to date of the anthrax pathogen Bacillus anthracis is the wide-spread, so-called Trans-Eurasian clade systematically categorized as the A.Br.008/009 group sharing two defining canonical single-nucleotide polymorphisms (canSNP). In this study, we genome-sequenced a collection of 35 B. anthracis strains of this clade, derived from human infections, animal outbreaks or soil, mostly from European countries isolated between 1936 and 2008. The new data were subjected to comparative chromosomal analysis, together with 75 B. anthracis genomes available in public databases, and the relative placements of these isolates were determined within the global phylogeny of the A.Br.008/009 canSNP group. From this analysis, we have detected 3754 chromosomal SNPs, allowing the assignation of the new chromosomal sequences to established sub-clades, to define new sub-clades, such as two new Spanish, one Bulgarian or one German group(s), or to introduce orphan lineages. SNP-based results were compared with that of a multilocus variable number of tandem repeat analysis (MLVA). This analysis indicated that MLVA typing might provide additional information in cases when genomics yields identical genotypes or shows only minor differences. Introducing the delayed mismatch amplification assay (DMAA) PCR-analysis, we developed a cost-effective method to interrogate for a set of ten phylogenetically informative SNPs within genomes of A.Br.008/009 canSNP clade strains of B. anthracis. By this approach, additional 32 strains could be assigned to five of ten defined clades.

What can glove impression evidence reveal about assailants? A pilot study

Impressions and marks are expected components of any crime scene. There is nothing more disappointing for fingerprint experts than finding glove marks at a crime scene. The forensic expert’s primary task in such cases is to compare the characteristic features of glove impressions with the characteristics of a suspect. The aim of the present study was to determine whether additional information could be obtained from glove prints. Specifically, whether they could be used to help to predict the sex and stature of a suspect was investigated, as was the potential for ascertaining additional information in cases where such prints were recovered from diverse objects with different diameters. Male and female participants wore latex gloves, and after ink was applied to the gloves they grasped objects of different diameters (2, 4, 6 and 8 cm). Impressions of gloved flat hands were also obtained. Phalangeal and finger lengths were measured digitally via software. Sex and stature were successfully estimated based on impressions derived from gloved flat hands and from prints on various grasped objects. A regression equation was developed for stature prediction, and a discriminant equation was developed for sex prediction.

Internal validation of latest generation STR kits for direct STR typing from reference samples

Forensic STR kits are manufactured by various biotechnology companies. Differences in primer designs and proprietary chemicals, as well as the availability of instruments in each laboratory, may result in performance differences. As such, internal validation is a necessary step prior to adopting a new kit, especially if accreditation is sought. Here, we evaluated three latest generation direct STR kits (Thermo Fisher Scientific’s GlobalFiler® Express, Promega’s PowerPlex® Fusion 6C, and Qiagen’s Investigator® 24plex GO!) for direct STR typing of reference samples as part of ISO17025:2017 implementation. Thirty buccal swab samples (untreated cotton swabs) were used to optimize the parameters that could affect test results, such as the amount of swab used, PCR cycle number, and electrophoretic injection condition. Each kit was then used for direct STR typing of additional one hundred untreated buccal swabs. A scoring system based on profile quality was used to evaluate the kits: high-quality, minor-issue, moderate-issue, and critical-issue. GlobalFiler® Express kit showed the highest number of high-quality profiles (i.e. full profile with no quality flag), followed by PowerPlex® Fusion 6C and Investigator® 24plex GO!. Non-standard loci typed in the kits (e.g. DYS391 and “Quality Sensors”) provided additional information in cases where amelogenin-Y failed to amplify and also where inhibitors were present. In summary, we selected the GlobalFiler® Express kit for direct STR typing of untreated buccal swab samples due to its superior performance.

Pericarditis constrictiva: multimodalidad

Constrictive pericarditis is a clinical condition that demonstrates signs and symptoms of diastolic heart failure, caused by an abnormally enlarged and rigid pericardium, and a subsequent decrease in ventricular filling due to lower distensibility. Among the causes of constrictive pericarditis are the inflammation due to infection (viral, mycobacterial, or fungal), connective tissue diseases, or cardiac surgery. Two-dimensional (2-D) transthoracic ultrasound and in the Doppler mode is the main diagnostic tool in the evaluation of heart failure. It can also identify constrictive pericarditis in the majority of patients by means of real-time movement techniques and haemodynamic findings. Likewise, computed tomography and magnetic resonance provide additional information for the diagnosis and management of constrictive pericarditis, and are particularly useful when the cardiac ultrasound findings are inconclusive. The haemodynamic evaluation by cardiac catheterisation can occasionally provide additional information in cases in which the non-invasive images show suggestive of inconclusive findings of constrictive pericarditis.

Cyclosporiasis Surveillance - United States, 2011-2015.

Problem/ConditionCyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis, which is transmissible by ingestion of fecally contaminated food or water. Cyclosporiasis is most common in tropical and subtropical regions of the world. In the United States, foodborne outbreaks of cyclosporiasis have been linked to various types of imported fresh produce (e.g., basil, raspberries, and snow peas). Validated molecular typing tools, which could facilitate detection and investigation of outbreaks, are not yet available for C. cayetanensis.Period Covered2011–2015.Description of SystemCDC has been conducting national surveillance for cyclosporiasis since it became a nationally notifiable disease in January 1999. As of 2015, cyclosporiasis was a reportable condition in 42 states, the District of Columbia, and New York City (NYC). Health departments voluntarily notify CDC of cases of cyclosporiasis through the National Notifiable Diseases Surveillance System and submit additional case information using the CDC cyclosporiasis case report form or the Cyclosporiasis National Hypothesis Generating Questionnaire (CNHGQ).ResultsFor the 2011–2015 surveillance period, CDC was notified by 37 states and NYC of 2,207 cases of cyclosporiasis, including 1,988 confirmed cases (90.1%) and 219 probable cases (9.9%). The annual number of reported cases ranged from 130 in 2012 to 798 in 2013; the annual population-adjusted incidence rate ranged from 0.05 cases per 100,000 persons in 2012 to 0.29 in 2013. A total of 415 patients (18.8%) had a documented history of international travel during the 14 days before illness onset, 1,384 (62.7%) did not have a history of international travel, and 408 (18.5%) had an unknown travel history. Among the 1,359 domestically acquired cases with available information about illness onset, 1,263 (92.9%) occurred among persons who became ill during May–August. During 2011–2015, a total of 10 outbreaks of cyclosporiasis associated with 438 reported cases were investigated; a median of 21 cases were reported per outbreak (range: eight to 162). A food vehicle of infection (i.e., a food item or ingredient thereof) was identified (or suspected) for at least five of the 10 outbreaks; the food vehicles included a berry salad (one outbreak), cilantro imported from Mexico (at least three outbreaks), and a prepackaged salad mix from Mexico (one outbreak).InterpretationCyclosporiasis continues to be a U.S. public health concern, with seasonal increases in reported cases during spring and summer months. The majority of cases reported for this 5-year surveillance period occurred among persons without a history of international travel who became ill during May–August. Many of the seemingly sporadic domestically acquired cases might have been associated with identified or unidentified outbreaks; however, those potential associations were not detected using the available epidemiologic information. Prevention of cases and outbreaks of cyclosporiasis in the United States depends on outbreak detection and investigation, including identification of food vehicles of infection and their sources, which could be facilitated by the availability of validated molecular typing tools.Public Health ActionSurveillance for cases of cyclosporiasis and efforts to develop and validate molecular typing tools should remain U.S. public health priorities. During periods and seasons when increased numbers of domestically acquired cases are reported, the CNHGQ should be used to facilitate outbreak detection and hypothesis generation. Travelers to areas of known endemicity (e.g., in the tropics and subtropics) should follow food and water precautions similar to those for other enteric pathogens but should be advised that use of routine chemical disinfection or sanitizing methods is unlikely to kill C. cayetanensis. Health care providers should consider the possibility of Cyclospora infection in persons with persistent or remitting-relapsing diarrheal illness, especially for persons with a history of travel to areas of known endemicity or with symptom onset during spring or summer. If indicated, laboratory testing for Cyclospora should be explicitly requested because such testing is not typically part of routine examinations for ova and parasites and is not included in all gastrointestinal polymerase chain reaction panels. Newly identified cases of cyclosporiasis should be promptly reported to state or local public health authorities, who are encouraged to notify CDC of the cases.

Genetic resolution of applied biosystems™ precision ID Ancestry panel for seven Asian populations.

Massively parallel sequencing (MPS) offers additional information in cases that lack reference samples for comparison. The HID-Ion AmpliSeq Ancestry Panel is a forensic multiplex platform consisting of 165 autosomal markers designed to provide biogeographic ancestry information. We analyzed seven different population groups from Asia to assess the accuracy and reliability of analysis, using this panel. In this study, we have designated 750 unrelated Asians, from southern China (n = 99), Beijing (n = 100), Japan (n = 101), Korea (n = 100), Vietnam (n = 100), Nepal (n = 100), India (n = 51), and Pakistan (n = 99). The likelihood ratios of 750 Asians were calculated, using the Torrent Server and the HID SNP Genotyper Plugin Version 4.3.2. The results reveal that all Northeast Asians (China, Japan, and Korea), and Vietnamese, were predicted as East Asians with the highest ethnicity likelihood values from reference data. Although the samples from Nepal, India and Pakistan (Southwest Asians), were predominantly predicted as South Asians, there were seven cases of which results revealed as Europeans, with similar likelihood patterns. Population structure analysis indicated that Southwest Asians have a genetic profile that is distinguishable from those of other Asian populations. This panel was validated for potential usefulness in forensic analysis and the findings could be used as a basis for building additional Asian specific reference databases. Nevertheless, additional analyses comprising larger sample sizes will be necessary, especially Southeast Asians, to fully understand the Asian population structure, and to discriminate them with further details.

Personalized structural image analysis in patients with temporal lobe epilepsy

Volumetric and morphometric studies have demonstrated structural abnormalities related to chronic epilepsies on a cohort- and population-based level. On a single-patient level, specific patterns of atrophy or cortical reorganization may be widespread and heterogeneous but represent potential targets for further personalized image analysis and surgical therapy. The goal of this study was to compare morphometric data analysis in 37 patients with temporal lobe epilepsies with expert-based image analysis, pre-informed by seizure semiology and ictal scalp EEG. Automated image analysis identified abnormalities exceeding expert-determined structural epileptogenic lesions in 86% of datasets. If EEG lateralization and expert MRI readings were congruent, automated analysis detected abnormalities consistent on a lobar and hemispheric level in 82% of datasets. However, in 25% of patients EEG lateralization and expert readings were inconsistent. Automated analysis localized to the site of resection in 60% of datasets in patients who underwent successful epilepsy surgery. Morphometric abnormalities beyond the mesiotemporal structures contributed to subtype characterisation. We conclude that subject-specific morphometric information is in agreement with expert image analysis and scalp EEG in the majority of cases. However, automated image analysis may provide non-invasive additional information in cases with equivocal radiological and neurophysiological findings.

Prognostic classification of MDS is improved by the inclusion of FISH panel testing with conventional cytogenetics

Cytogenetics is a critical independent prognostic factor in myelodysplastic syndromes (MDS). Conventional cytogenetics (CC) and Fluorescence in situ hybridization (FISH) Panel Testing are extensively used for the prognostic stratification of MDS, although the FISH test is not yet a bona fide component of the International Prognostic Scoring System (IPSS). The present study compares the utility of CC and FISH to detect chromosomal anomalies and in prognostic categorization. GTG-Banding and FISH Panel Testing specifically for -5/-5q, -7/-7q, +8 and -20q was performed on whole blood or bone marrow samples from 136 patients with MDS. Chromosomal anomalies were found in 40 cases by CC, including three novel translocations. FISH identified at least one anomaly in 54/136 (39.7%) cases. More than one anomaly was found in 18/54 (33.3%) cases, therefore, overall FISH identified 75 anomalies of which 32 (42.6%) were undetected by CC. FISH provided additional information in cases with CC failure and in cases with a normal karyotype. Further, in ten cases with an abnormal karyotype, FISH could identify additional anomalies, increasing the number of abnormalities per patient. Although CC is the gold standard in the cytogenetic profiling of MDS, FISH has proven to be an asset in identifying additional abnormalities. The number of anomalies per patient can predict the prognosis in MDS and hence, FISH contributed towards prognostic re-categorization. The FISH Panel testing should be used as an adjunct to CC, irrespective of the adequacy of the number of metaphases in CC, as it improves the prognostic classification of MDS.

The Role of OsiriX Based Virtual Endoscopy in Planning Endoscopic Transsphenoidal Surgery for Pituitary Adenoma.

Virtual endoscopy (VE) is the navigation of a 3D model reconstructed from radiological image data. The aim of this paper is to evaluate the role and accuracy of the virtual endoscopy realized using commercially available software, OsiriX, as a method of planning of surgical interventions. The computed tomographies of 22 patients with pituitary adenomas proposed for endoscopic approach were reconstructed using OsiriX. VE was performed prior to surgery to assess the surgical corridor and particular anatomy. We evaluated the following landmarks: inferior and middle turbinate, sphenoid ostia (SO), choanal arch (Ch), sphenoethmoidal recess (SER), sphenoid septa, sella turcica, carotid prominences and opticocarotid recesses (OCR). The intraoperative endoscopic images were reviewed and compared with the virtual images. The virtual images had a good resemblance with the actual surgical images. All the structures from the nasal cavity were identified and had a perfect matching except the SO which was identified in 8 cases in VE vs. 12 intraoperative. All the structures from the sphenoid sinus were identified with perfect matching except the ipsilateral carotid prominence (14 in VE vs. 10 intraoperative) and the contralateral carotid prominence (16 in VE vs. 18 intraoperative). The VE could not show the state of the sellar floor and did not offer any information about the sellar content. VE realized in OsiriX represents an affordable alternative to the specially designed systems, offering reliable data and good quality images that are useful for the preoperative planning, but some limitations are present such as inability to obtain additional information in cases where the sphenoid sinus is fully occupied by tumor or not aerated, inability to clearly differentiate between structures at the level of the sella, and impossibility to simulate working instruments.

Characteristics of Soil Humic Substances as Determined by Conventional and Synchrotron Fourier Transform Infrared Spectroscopy

Humic substances (HS) play an important role in soil fertility and carbon sequestration in soil. The structural characteristics of soil HS, extracted from two natural soils and a laboratory-incubated soil, were investigated by conventional beamline-based Fourier transform infrared radiation (CB-FTIR), a common FTIR technique based on a conventional thermal source, and synchrotron radiation-based (SR-FTIR) spectroscopy. The relative area of absorbance peaks that appeared at 2930, 2860, 1711, and 1635 cm –1 were calculated to make a comparison of the absorbance intensities. The absorption of aromatic functional groups of HS was stronger in SR-FTIR spectroscopy than in CB-FTIR spectroscopy. Compared with humic acid extracted with a 0.1 mol/l Na4P2O7 solution, the level of aliphaticity in humic acid extracted with a 0.1 mol/l NaOH solution was higher. The aliphaticity of humin associated with clay (HMc) was higher than that of humin associated with iron (HMi). These results suggest that SR-FTIR spectroscopy is a useful and nondestructive technique to study the structural characteristics of soil humic substances. Sequential extraction of soil humic substances with NaOH and Na4P2O7 solutions may be helpful in providing additional information in cases where differences in the material obtained from different extraction solutions occur. The aliphaticity and complexity of HMc were higher than those of HMi.

Increasing Student Interest and Engagement with Business Cases by Turning Them into Consulting Exercises

ABSTRACTHow can you get undergraduate students more interested and engaged with business cases? Instead of using the traditional case teaching format, turn the case into a consulting exercise. Give students only the managerial dilemma and some starting information, form them into consulting teams, and then have each team requests additional case information by submitting a restricted number of questions. Through successive rounds, teams will gather enough information and data to analyze the situation and develop a set of recommendations. This approach transforms case‐based learning from a passive analysis of case details to an active process of discovery through smart questioning.

Real-time Sonoelastography for the Evaluation of Testicular Lesions

To evaluate the feasibility of using real-time sonoelastography (RTE) for the differentiation and characterization of testicular lesions. Institutional review board approval was obtained for this retrospective study, and the requirement to obtain informed consent was waived. Fifty patients (mean age, 42 years; age range, 18-81 years) with testicular lesions detected with gray-scale ultrasonography (US) and color and/or power Doppler US were evaluated with RTE between December 2004 and August 2010 to assess tissue elasticity of the testes. Stiff or "hard" lesions were suspected of being malignant. Testicular lesions with normal or decreased tissue stiffness ("soft" lesions) were considered benign. Findings from surgery and histopathologic examination were used as the reference standard in 34 cases, and findings from clinical and US follow-up were used as the reference standard in 16 cases. Sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic accuracy were calculated. Thirty-four of the 50 lesions (68%) were testicular tumors and 16 (32%) were of nontumorous origin. RTE showed the presence of hard lesions in all cases of testicular tumors and three cases of nontumorous lesions. Four lesions with an uncertain diagnosis when tested with gray-scale US and color and/or power Doppler US alone were soft at RTE and showed nontumorous character at follow-up. RTE showed a sensitivity of 100%, a specificity of 81%, a negative predictive value of 100%, a positive predictive value of 92%, and an accuracy of 94% in the diagnosis of testicular tumors. RTE demonstrated all testicular tumors as lesions with increased tissue stiffness. Because of its higher specificity, RTE can provide additional information in cases with indeterminate US findings.

Post-mortem virtual estimation of free abdominal blood volume

PurposeThe purpose of this retrospective study was to examine the reliability of virtually estimated abdominal blood volume using segmentation from postmortem computed tomography (PMCT) data. Materials and methodsTwenty-one cases with free abdominal blood were investigated by PMCT and autopsy. The volume of the blood was estimated using a manual segmentation technique (Amira, Visage Imaging, Germany) and the results were compared to autopsy data. Six of 21 cases had undergone additional post-mortem computed tomographic angiography (PMCTA). ResultsThe virtually estimated abdominal blood volumes did not differ significantly from those measured at autopsy. Additional PMCTA did not bias data significantly. ConclusionVirtual estimation of abdominal blood volume is a reliable technique. The virtual blood volume estimation is a useful tool to deliver additional information in cases where autopsy is not performed or in cases where a postmortem angiography is performed.

Association Between Culture Results of Corneal Scrapings and Culture and Histopathology Results of Corneal Tissues in Therapeutic Keratoplasty

To correlate the culture results of corneal scrapings with culture and histopathology results of corneal tissues in therapeutic keratoplasty. A retrospective analysis of the culture results of corneal scrapings and corneal tissues of eyes that received therapeutic penetrating keratoplasty at a tertiary eye care center between December 2006 and November 2008 was conducted. As per the preferred practice, those cases that did not respond to appropriate antimicrobial therapy and/or presented with a large infiltrate/perforation received therapeutic keratoplasty. The microbiology and histopathology findings of the corneal tissues were compared. Thirty-eight therapeutic keratoplasties were performed on 36 patients. Although all cases had histopathology and culture of the corneal tissue, corneal scrapings were not performed in 4 cases. Corneal scrapings and corneal tissues were culture-positive in 76% (26 of 34) and 60% (23 of 38) of cases, respectively. In 8 cases, the corneal scrapings and corneal tissues yielded identical organisms, whereas different organisms grew in 4 cases. In 6 cases, the corneal tissues were culture-positive but the corneal scrapings were sterile. In 20 cases, the corneal tissues were culture-positive for fungus and also showed fungal filaments in their corresponding histopathology specimens. Corneal tissue culture can provide additional information in cases undergoing therapeutic keratoplasty. It helps to determine the management of patients after keratoplasty.

Schema Effects of Rape Myth Acceptance on Judgments of Guilt and Blame in Rape Cases: The Role of Perceived Entitlement to Judge

Two experiments (N = 330) examined conditions that facilitate biasing effects of rape myth acceptance (RMA) on judgments of blame in rape cases. In both experiments, participants read a short vignette depicting a rape case. In Experiment 1, the amount of case-irrelevant information about defendant and plaintiff was varied. As predicted, high-RMA (vs. low-RMA) participants were less likely to blame the defendant the more irrelevant information they had read. In Experiment 2, participants in a social judgeability condition were made to believe that they had been subliminally exposed to additional case information although in fact no additional information had been presented. As predicted, compared to a control condition, participants' blame judgments were more biased by their RMA under social judgeability. Our findings reveal that the mechanism underlying the biasing effects of RMA may be the subjective feeling of entitlement to judge.