Determination Of Cause Research Articles

Deaths from asthma: a series of cases and their presentations, and the impact on local and global health

Abstract Introduction/Objective Asthma is a lung disease usually characterized by chronic inflammation that affects at least 300 million people globally at all life stages. Asthma is defined by respiratory symptoms such as coughing, wheezing, shortness of breath, and chest tightness with expiratory airflow limitation.The prevalence of asthma is increasing worldwide. Asthma is often under-diagnosed and under-treated, particularly in low- and middle-income countries. Severe disease can result in reduced quality of life or even premature death. Epidemiologic studies are being utilized to compare international incidences of asthma between populations so that etiologic mechanisms involved in the development of asthma can be discovered through research. Asthma prevalence studies require large numbers and high response rates amongst a random population to establish prevalence and severity with reasonable precision. Despite advances in treatments, guidelines, and preventable factors, deaths from asthma account for 250,000 premature deaths each year. Pathology has a key role in asthma identification through examination endobronchial biopsies and whole lung postmortem examination Methods/Case Report We present a series of asthma deaths with variable clinical presentations and histopathologic findings. The postmortem gross and histologic findings highlight the varying severities that asthma can have on the lungs. Knowledge of the clinical symptom presentations, identification of gross findings, appropriate sampling of lung tissue, identification of microscopic acute and chronic features help identify asthma related changes. Understanding common lifestyle, environmental, genetic, and medical care factors that serve as asthma triggers and their role in the onset or continuation of an acute exacerbation will allow for accurate determination of cause, contributing cause, and manner of death. This information, listed on the death certificate, is what helps correlate asthma prevalence with mortality allowing for appropriate allocation of funds for research, prevention and treatment. Results (if a Case Study enter NA) EP abstract Conclusion Outlined are the impacts that asthma can have on individuals, communities, and health systems globally but also ways to identify when death may be or is likely the result of asthma. While asthma cannot be cured, measuring the prevalence of disease and accurately determining asthma as the cause or contributing cause of death can help raise awareness and mitigate the consequences of severe disease.

Neurological Symptoms and Cause of Death Among Young Children in Low- and Middle-Income Countries

The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies. To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival. This cross-sectional study was conducted between December 3, 2016, and July 22, 2022, at the 7 participating sites in the Child Health and Mortality Prevention Surveillance (CHAMPS) network (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa). Minimally invasive tissue sampling was performed at the CHAMPS sites with specimens from deceased children aged younger than 5 years. This study included deceased children who underwent a premortem neurological evaluation and had a postmortem-confirmed cause of death. Data analysis was performed between July 22, 2022, and January 15, 2023. Descriptive analysis was performed using neurological evaluations from premortem clinical records and from postmortem determination of cause of death (based on histopathology, microbiological testing, clinical records, and verbal autopsies). Of the 2127 deaths of children codified during the study period, 1330 (62.5%) had neurological evaluations recorded and were included in this analysis. The 1330 children had a median age of 11 (IQR, 2-324) days; 745 (56.0%) were male and 727 (54.7%) presented with neurological symptoms during illness before death. The most common postmortem-confirmed neurological diagnoses related to death were hypoxic events (308 [23.2%]), meningoencephalitis (135 [10.2%]), and cerebral malaria (68 [5.1%]). There were 12 neonates with overlapping hypoxic events and meningoencephalitis, but there were no patients with overlapping meningoencephalitis and cerebral malaria. Neurological symptoms were similar among diagnoses, and no combination of symptoms was accurate in differentiating them without complementary tools. However, only 25 children (18.5%) with meningitis had a lumbar puncture performed before death. Nearly 90% of deaths (442 of 511 [86.5%]) with neurological diagnoses in the chain of events leading to death were considered preventable. In this cross-sectional study of children aged younger than 5 years, neurological symptoms were frequent before death. However, clinical phenotypes were insufficient to differentiate the most common underlying neurological diagnoses. The low rate of lumbar punctures performed was especially worrying, suggesting a challenge in quality of care of children presenting with neurological symptoms. Improved diagnostic management of neurological emergencies is necessary to ultimately reduce mortality in this vulnerable population.

The application of vibrational spectroscopy in forensic analysis of biological evidence.

Vibrational spectroscopy is a powerful analytical domain, within which Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy stand as exemplars, offering high chemical specificity and sensitivity. These methodologies have been instrumental in the characterization of chemical compounds for an extensive period. They are particularly adept at the identification and analysis of minute sample quantities. Both FTIR and Raman spectroscopy are proficient in elucidating small liquid samples and detecting nuanced molecular alterations. The application of chemometrics further augments their analytical prowess. Currently, these techniques are in the research phase within forensic medicine and have yet to be broadly implemented in examination and identification processes. Nonetheless, studies have indicated that a combined classification model utilizing FTIR and Raman spectroscopy yields exceptional results for the identification of biological fluid-related information and the determination of causes of death. The objective of this review is to delineate the current research trajectory and potential applications of these two vibrational spectroscopic techniques in the detection of body fluids and the ascertainment of causes of death within the context of forensic medicine.

Determination of causes of post-operative dysphagia after anti-reflux surgery based on intra-operative planimetry.

Dysphagia after anti-reflux surgery (ARS) is one of the most common indications for re-operative anti-reflux surgery and a leading cause of patient dissatisfaction. Unfortunately, the factors affecting its development are poorly understood. We investigated the correlation between pre-operative manometric and the intra-operative impedance planimetry (EndoFLIP™) measurements and development of post-operative dysphagia. A review of patients who underwent index robotic ARS in our institution. Patients who underwent pre-operative manometry and intra-operative EndoFLIP™ were included in our study. Dysphagia was assessed pre-operatively and at 3-month after surgery. Fifty-five patients (26.9%) reported post-operative dysphagia, and 34 (16.6%) reported new or worsening dysphagia. On pre-operative manometry, patients with post-operative dysphagia had a lower distal contractile integral [868.7 (IQR 402.2-1447) mmHg s cm vs 1207 (IQR 612.1-2111) mmHg s cm, p = 0.006) and lower esophageal sphincter (LES) pressure [14.7 IQR (8.9-23.6) mmHg vs 20.7 IQR (10.2-32.6) mmHg, p = 0.01] compared to those without post-operative dysphagia. They were also found to have higher pre-operative cross-sectional surface area (CSA) [83 IQR (44.5-112) mm2 vs 66 IQR (42-93) mm2, p = 0.02], and distensibility index (DI) [4.2 IQR (2.2-5.5) mm2/mmHg vs 2.9 IQR (1.6-4.6) mm2/mmHg, p = 0.003] compared to patients without post-operative dysphagia. Additionally, the decrease in CSA [-34 (-18.5, -74.5) mm2 vs -26.5 (-10.5, -53.7) mm2, p = 0.03] and DI [-2.3 (-1.2, -3.7) mm2/mmHg vs -1.6 (-0.7, -3.3) mm2/mmHg, p = 0.03] measurements were greater in patients with post-operative dysphagia. Patients who developed dysphagia post-operatively had poorer pre-operative motility and a greater change in LES characteristics intra-operatively. This finding suggests the utility of pre-operative manometry and intra-operative EndoFLIP in identifying patients at risk of developing dysphagia post-operatively.

Structured case conference for sleep disturbances in nursing home residents with cognitive impairment

Structured case conference for sleep disturbances in nursing home residents with cognitive impairment Abstract: Background: Nursing home residents living with cognitive impairment often suffer from sleep disturbances. Pharmacological interventions are not recommended to be the first-choice therapy. In general, a wide variance of non-pharmacological interventions is available, but no clearly suitable intervention can currently be specified. Aim: The case report presents the procedure of a structured analysis to support the selection of non-pharmacological interventions to promote sleep. Methods: A structured case conference was held using a developed case management template to draw up an individual intervention plan. Results: Based on the description of the situation and the determination of causes, different interventions from six main topics were planned: "offering appropriate activations during daytime", "creating bedtime routines", "checking the sleep environment", "observation of potential physical and psychological causes", "reflection on night care routines", and "use of drug therapies only in exceptional cases". Conclusions: For a successful management of sleep disturbances in nursing home residents living with cognitive impairment, it is essential that the specific sleep-related symptoms and causes are assessed systematically and interprofessionally to be able to work towards an improvement with appropriate measures. In order to obtain adequate solutions, evidence-based expertise should be taken into consideration.

Forensic, legal, and clinical aspects of deaths associated with implanted cardiac devices

As the population ages, the prevalence of heart failure and individuals wearing an implanted cardiac device is increasing. The combination of different underlying pathophysiologies and (the combination of) implanted cardiac devices can become a challenge with regard to the determination of cause and manner of death in such individuals. Additionally, heart disease is frequently associated with mental disease, ranging from anxiety and depression to suicidality and suicide (attempts). At the same time, the correct diagnosis of cause and manner of death is the basis for quality assurance, further therapeutic advances, legal safety, and suicide prevention. By that, an interdisciplinary field between legal medicine, clinicians, and law enforcement opens up. In this field, the different participants can simultaneously benefit from and need each other. For example, legal medicine experts need investigatory results and clinical expertise for the interpretation of readout data of implanted cardiac devices in order to correctly determine the cause of death. A correctly determined cause of death can assist law enforcement and help clinicians to further improve various therapeutic approaches based on correct mortality data collection. In addition, it is the basis for identification of suicides of device carriers, allowing psychological and psychiatric experts to better understand the burden of mental disease in this particular cohort. Against this interdisciplinary background, this manuscript summarizes information about psychiatric comorbidities and suicidality while being on a device. Thereby, basic information on complications and malfunctions of implanted cardiac devices, device-associated deaths with particular emphasis on device manipulation is displayed as basic information needed for correct determination of the cause of death. Also, legal and ethical issues in this field are outlined. The final result is a proposal of an interdisciplinary assessment workflow for a conjoint approach to improve the diagnosis of deaths associated with implanted cardiac devices. It will allow for a differentiation between an individual who died with or due to the device.

Specific Training Improves the Detection and Management of Patient-Ventilator Asynchrony.

Patient-ventilator asynchrony is common in patients undergoing mechanical ventilation. The proportion of health-care professionals capable of identifying and effectively managing different types of patient-ventilator asynchronies is limited. A few studies have developed specific training programs, but they mainly focused on improving patient-ventilator asynchrony detection without assessing the ability of health-care professionals to determine the possible causes. We conducted a 36-h training program focused on patient-ventilator asynchrony detection and management for health-care professionals from 20 hospitals in Latin America and Spain. The training program included 6 h of a live online lesson during which 120 patient-ventilator asynchrony cases were presented. After the 6-h training lesson, health-care professionals were required to complete a 1-h training session per day for the subsequent 30 d. A 30-question assessment tool was developed and used to assess health-care professionals before training, immediately after the 6-h training lecture, and after the 30 d of training (1-month follow-up). One hundred sixteen health-care professionals participated in the study. The median (interquartile range) of the total number of correct answers in the pre-training, post-training, and 1-month follow-up were significantly different (12 [8.75-15], 18 [13.75-22], and 18.5 [14-23], respectively). The percentages of correct answers also differed significantly between the time assessments. Study participants significantly improved their performance between pre-training and post-training (P < .001). This performance was maintained after a 1-month follow-up (P = .95) for the questions related to the detection, determination of cause, and management of patient-ventilator asynchrony. A specific 36-h training program significantly improved the ability of health-care professionals to detect patient-ventilator asynchrony, determine the possible causes of patient-ventilator asynchrony, and properly manage different types of patient-ventilator asynchrony.

Role of High-Resolution Ultrasonography With Colour and Duplex Doppler in the Evaluation of Acute Scrotal Diseases.

Introduction The term 'acute scrotum' denotes the sudden initiation of pain in the scrotal region. Acute scrotum is a frequent medical condition in children and adults. Ultrasound facilitates precise diagnosis and differentiation of numerous causes of acute scrotum. The objective of our research was to assess the utility of ultrasonography in the identification and prevalence determination of causes of acute scrotum. Materials and methods Patients with acute scrotal pain referred to the Department of Radiodiagnosis at Great Eastern Medical School & Hospital (GEMS), Srikakulam, India, were added in the research. This is a prospective observational study. High-frequency linear transducer (4-15 MHz) was used for imaging. Grey scale, colour and duplex Doppler were performed routinely. The ultimate diagnosis was established by considering the clinical results, follow-up observations, intraoperative observations and, when accessible, histopathological analysis. For the statistical analysis, IBM SPSS Statistics for Windows, version 22 (released 2013; IBM Corp., Armonk, New York, United States). was used. Descriptive analysis was conducted. The Kendall rank correlation coefficient was used to evaluate the non-parametric association between side and torsion. Results A total of 120 patients were included for statistical analysis. Inflammatory pathology was the most commoncause of acute scrotum, followed by testicular torsion and torsion of testicular appendage. Testicular torsion and side of pain did not show a significant association. Conclusion High-resolution ultrasonography with colour and duplex Doppler sonography is an excellent imaging modality exhibiting exceptional sensitivity and specificity for the accurate diagnosis of acute scrotal diseases. Inflammatory pathology was the most commoncause of acute scrotum, followed by testicular torsion and torsion of the testicular appendage.

Determination of causes of adult deaths using minimally invasive tissue sampling in Gandaki province of Nepal: a multicenter hospital-based study

BackgroundMinimally Invasive Tissue Sampling (MITS) has been successfully used to establish the cause of death in low- and middle-income countries, mostly in stillbirths and neonates. The objective of this study was to determine the causes of death among adults using MITS in the Gandaki province of Nepal and to find out the contribution of MITS to identify the causes of death.MethodsA multicentric hospital-based pilot study was conducted to enroll 100 cases of adult deaths. The specimens of cerebrospinal fluid, blood, brain, lungs, and liver tissue were collected utilizing MITS. These specimens underwent standard histopathological, serological, and microbiological analyses. The findings from MITS, and if available, clinical records and forensic autopsy findings were compiled and the cause of death panel identified the causes of death. The final cause of death allocated to each case was based on the WHO International Medical Certificate of Death.ResultsAmong a total of 100 cases enrolled during the study period, infectious cause attributed to the immediate cause of death in 77 (77%), cardiovascular in 10 (10%), neurological in 8 (8%), malignancy in two (2%), and gastrointestinal and hepatobiliary cause in one (1%) case. The mean age of the cases was 50.8 ± 15.9 years and 76 (76%) were males. MITS established the cause of death in the causal chain of events in 81(81%) cases and identified the cause of death significantly more with infectious than non-infectious causes (p < 0.001).ConclusionsMITS was useful in establishing the cause of death in the majority of adult deaths and the most common cause was infectious disease. Our findings suggest that MITS can be a valuable and alternative tool for mortality surveillance in low-resource settings, where complete diagnostic autopsies are less accepted or less prioritized.

“Somebody Help Me… I’m Stayin’ Alive.” Putting Into Context the Burgeoning of Sudden Cardiac Deaths

The surge in sudden cardiac deaths (SCDs), especially among the young, has become a global concern impacting economies and healthcare systems. In Western societies, SCD accounts for up to 20% of all deaths, while in the United States, it is the primary cause of cardiovascular-related mortality. Sudden Cardiac Arrest (SCA) and SCD, stemming from cardiac activity disruption, necessitate urgent intervention, with defibrillation playing a crucial role. In the Indian context, challenges arise from the incomplete determination of causes of death. The limited application of the Medical Certification of Cause of Death (MCCD) contributes to this issue. A population-based study in India reveals a substantial SCD rate, estimating approximately 700,000 cases annually. India faces a burgeoning cardiovascular crisis, necessitating proactive strategies to prevent heart diseases and SCDs. Prioritizing preventive measures, public awareness, and emergency response are critical components. By embracing these measures and campaigns, such as FIT INDIA and EAT RIGHT, India can pave the way for a healthier future and reduce the burden of cardiovascular diseases and SCDs.

COULD ALZHEIMER'S DISEASE PATHOLOGY BE ASSOCIATED WITH METALS RELEASED FROM TOTAL HIP ARTHROPLASTY?

Both total joint arthroplasty (TJA) and Alzheimer's Disease (AD) are prevalent in elderly populations. It is the goal of this study to determine if the presence of implant metals originating from TJA correlates with the onset with higher implant metal content in the brain and AD pathology.Tissue samples from four brain regions of 701 (229 with TJA) participants from an ongoing longitudinal cohort study (Rush Memory and Aging Project) was analyzed including the inferior-temporal-cortex (ITC), which is associated with early onset of AD. Implant metal (Co, Cr, Mo, Ti, Al) content was determined by ICP-MS. Comparisons were conducted between the no-TJA-group and a TJA group. Due to the higher likelihood of Co release the TJA group was further differentiated in a THA (N=146) and a TKA/TSA (N=83) group. Diffuse and neuritic amyloid plaques and phosphorylated tau were assessed and summarized as standard measures of AD pathology. We used separate linear regression models adjusted for age, sex, education, and APOɛ4-status for the associations of all metals (log-transformed) with global AD pathology, amyloid plaques, and phosphorylated tau.The THA group had higher cobalt content across all brain regions (p=0.003) and within the ITC (p=0.051) compared to the no-TJA group, whereas the TKA/TSA group did not. Across all tissue samples, Co was associated with higher amyloid load (β=0.35, p=0.027), phosphorylated tau (β=0.47, p=0.011), and global AD pathology (β=0.19, 0.0004) in the ITC. The presence of TJA itself was not associated with AD pathology.We showed that only Co content was higher within the ITC in persons with THA. We found among all tested metals that Co was consistently associated with AD pathology. Although we found an association of cobalt with AD pathology, the cross-sectional nature of this study does not allow the determination of cause and effect.

Оценка влияния биологически агрессивной среды на прочностные характеристики и структурно-фазовый состав бетона

The article points out the lack of radically effective worldwide methods of anti-biocorrosion protection. The author considers the role of microorganisms on concrete corrosion, describes the mechanisms of biological effect and biofilm formation on concrete surface. The article focuses on the determination of causes and peculiarities of cement concrete biocorrosion in conditions of high humidity. According to the author, biocorrosive impact reduces strength characteristics of concrete and causes its fast destruction. The author has revealed changes in structural-phase composition of concrete during surface biofouling. Although there are available methods to increase the bio-resistance of cement-based concretes, it is problematic to guarantee their preservation because bio-destructors have the ability to adapt to the work environment. The paper attempts to assess and predict the resistance of a building material in a biologically aggressive environment properly

Neural tube defects as a cause of death among stillbirths, infants, and children younger than 5 years in sub-Saharan Africa and southeast Asia: an analysis of the CHAMPS network

Neural tube defects are common birth defects resulting in severe morbidity and mortality; they can largely be prevented with periconceptional maternal intake of folic acid. Understanding the occurrence of neural tube defects and their contribution to mortality in settings where their burden is highest could inform prevention and health-care policy. We aimed to estimate the mortality attributed to neural tube defects in seven countries in sub-Saharan Africa and southeast Asia. This analysis used data from the Child Health and Mortality Prevention Surveillance (CHAMPS) network and health and demographic surveillance systems from South Africa, Mozambique, Bangladesh, Kenya, Mali, Ethiopia, and Sierra Leone. All stillbirths and infants and children younger than 5 years who died, who were enrolled in CHAMPS, whose families consented to post-mortem minimally invasive tissue sampling (MITS) between Jan 1, 2017, and Dec 31, 2021, and who were assigned a cause of death by a determination of cause of death panel as of May 24, 2022, were included in this analysis, regardless the cause of death. MITS and advanced diagnostic methods were used to describe the frequency and characteristics of neural tube defects among eligible deaths, identify risk factors, and estimate the mortality fraction and mortality rate (per 10 000 births) by CHAMPS site. Causes of death were determined for 3232 stillbirths, infants, and children younger than 5 years, of whom 69 (2%) died with a neural tube defect. Most deaths with a neural tube defect were stillbirths (51 [74%]); 46 (67%) were neural tube defects incompatible with life (ie, anencephaly, craniorachischisis, or iniencephaly) and 22 (32%) were spina bifida. Deaths with a neural tube defect were more common in Ethiopia (adjusted odds ratio 8·09 [95% CI 2·84-23·02]), among female individuals (4·40 [2·44-7·93]), and among those whose mothers had no antenatal care (2·48 [1·12-5·51]). Ethiopia had the highest adjusted mortality fraction of deaths with neural tube defects (7·5% [6·7-8·4]) and the highest adjusted mortality rate attributed to neural tube defects (104·0 per 10 000 births [92·9-116·4]), 4-23 times greater than in any other site. CHAMPS identified neural tube defects, a largely preventable condition, as a common cause of death among stillbirths and neonatal deaths, especially in Ethiopia. Implementing interventions such as mandatory folic acid fortification could reduce mortality due to neural tube defects. Bill & Melinda Gates Foundation.

Distribution Loss Analysis of NEA, Nepal

Nepal Electricity Authority (NEA) is facing the problems in supply chain of electricity that causes the loss of energy which results in loss of economy. NEA has planned to extend the distribution network throughout the country so that every household can have access of Electrical Energy (EE) by 2023. NEA is also working in the sector of maximizing the sales in order to increase its revenue. In order to achieve such goals NEA must enhance its distribution system infrastructure. In this article, distribution losses are to be analyzed for enhancing and upgradation of existing electrical network if any. Some of the electrical components that cause electrical loss in distribution sector are also to be analyzed. This helps on determination of causes of losses. As NEA is importing electrical energy from India, consumer’s sales energy should be analyzed. At present calibration of area specific electricity consumption pattern that too on Time of Day (TOD) basis is not possible. This research paper will determine the process that helps in identifying area specific consumption pattern thus aid operators in laying reliable supply chain infrastructure to meet the demand of electricity. Electrical loss to be minimized by enhancing distribution network as per consumer demand.

Operationalizing the structural vulnerability profile within the medical examiner context

The medicolegal death investigation process in the United States, historically focused on personal identification and determination of cause and manner of death, has evolved in recent decades to include space for advocacy centered around public health. Particularly, in the domain of forensic anthropology, practitioners have begun to incorporate a structural vulnerability perspective on human anatomical variation, with the goals of articulating the social determinants of ill health and early death and ultimately influencing public policy. This perspective has explanatory power far beyond the anthropological sphere. In this piece, we argue that biological and contextual indicators of structural vulnerability can be incorporated into medicolegal reporting with potentially powerful impacts on policy. We apply theoretical frameworks from medical anthropology, public health, and social epidemiology to the context of medical examiner casework, highlighting the recently proposed Structural Vulnerability Profile developed and explored in other articles in this special issue. We argue that: 1. Medicolegal case reporting provides a valuable opportunity to record a faithful accounting of structural inequities in the annals of death investigation, and 2. Existing reporting infrastructure could, with limited modifications, provide a powerful opportunity to inform State and Federal policy with medicolegal data, presented within a structural vulnerability framework.

EXPLORING THE POTENTIAL OF AUGMENTED REALITY FOR FORENSIC CRIME SCENE RECONSTRUCTION: A REVIEW

This paper explores the applications of Augmented Reality (AR) and Virtual Reality (VR) technologies in forensic science, specifically in crime scene investigation and the judiciary system. AR and VR offer immersive and interactive experiences that aid in crime scene reconstruction, evidence collection, and visualization. These technologies have the potential to transform courtroom proceedings by enabling virtual courtrooms, enhancing evidence presentation, and facilitating virtual crime scene reconstructions. AR and VR also have implications in legal research, judicial training, and access to justice. The importance of crime scene investigation and reconstruction in forensic science is highlighted, emphasizing their role in evidence preservation, identification, and the determination of cause and manner of death. The intricacies of conventional crime scene reconstruction, such as evidence collection, interpretation, and reconstruction limitations, are discussed. AR and VR technology can overcome these challenges by providing virtual crime scene tours, training simulations, and interactive courtroom presentations. Overall, AR and VR have the potential to enhance forensic science practices and the judiciary system, offering new tools and capabilities for investigators, legal professionals, and the public.

The definitive indefinite cause of death Case series based Evaluation and discussion of Negative and Obscure Autopsy

Medicolegal autopsies are routinely done by forensic pathologist to fulfil the objectives of autopsy and to solve the dilemma of investigating agencies. But the medicolegal autopsy is not always concluding the main objective of it which is cause of death and such autopsies are categorised as obscure and negative autopsy. Acknowledgement of incidence of negative autopsy to the practicing forensic pathologist is necessary. We are discussing here some autopsies conducted by the author(s) after which the final scientific cause of death could not be ascertained. The algorithm-based approach toward the determination of cause of death and importance of other circumstantial evidences has been discussed.

Reported mortality of Griffon VultureGyps fulvusin central Italy and indications for conservation and management

SummaryVultures are long-lived species sensitive to human-caused mortality that has already determined a widespread collapse in Asian and African populations. They provide significant ecosystem services (regulatory and cultural) consuming livestock carcasses and saving greenhouse gas emissions, favouring nutrient recycling, environmental sanitation, and providing financial revenue. Appraising the incidence and causes of mortality could help to improve management and conservation actions. We compiled records of reported mortalities for the reintroduced Griffon VultureGyps fulvuspopulation of the central Apennines in Italy (123 cases, July 1994–December 2020). The average mortality was 4.69 vultures per year (± 1.14 SE), with no significant temporal trend. The peak of mortality events, estimated by harmonic regression analysis, was in March, while the minimum occurred in October. No differences were found among age classes and sex ratio mortality was established at 1.43:1 (M:F,N= 68). Out of 103 (83.7%) vultures which underwent a post-mortem and toxicological screening, 53% were poisoned, mainly by carbamates, and 27% died of unknown causes. Overall, direct or indirect anthropogenic mortality caused 67% of deaths. Even considering an inherent bias associated with reported mortality as to the prevalence of causes of death and estimation of mortality rates, the overwhelming relevance of poisoning highlights that existing anti-poisoning efforts should be refined and incorporated into a coordinated multidisciplinary strategy. A standardised approach, from vulture carcass discovery to post-mortem procedures and toxicological analysis, should be applied to reduce uncertainty in the determination of causes of death, increasing effectiveness in the prosecution of wildlife crimes. As most of the poisoning cases affecting the Griffon Vulture population in the central Apennines likely represent a side (though illegal) effect of retaliatory efforts to defeat livestock predators, effective strategies in reducing human–wildlife conflicts should be applied.

Pathological and etiological characterization of cases of bovine abortion due to sporadic bacterial and mycotic infections.

Opportunistic bacteria and fungi are commonly reported causes of bovine abortion in a small percentage of fetal losses of infectious etiology in cattle. The objective of this study was to characterize the pathological and etiological findings in fetuses aborted due to secondary bacterial and fungal infections submitted for postmortem examination between 2004 and 2019 in the State of Rio Grande do Sul, Brazil. Nineteen cases of bacterial etiology and five cases of fungal etiology were assessed. In cases of bacterial etiology, gross changes were uncommon and two different microscopic patterns were observed: (1) primary bronchopneumonia with occasional dissemination in cases of Staphylococcus sp., Streptococcus sp., and Mannheimia haemolytica infections; and (2) systemic disease with sepsis in cases of Escherichia coli and Listeria sp. infections. Aspergillus sp. was the main fungal agent identified, and cases of mycotic abortion were characterized by placentitis, dermatitis, and pneumonia. Fetal membranes were available for examination in less than half of the submissions (11/24), and placental lesions were observed in all cases. This study reaffirms the importance of postmortem examinations in the determination of causes of fetal loss in cattle and highlights pathological findings commonly observed in fetuses aborted due to sporadic bacterial and fungal agents.

Reception of the writings of Martyrius-Sahdona in several confessions

The article deals the problem of reception in several confessions of the writings of the ascetic writer and bishop of the Church of the East Martyrius-Sahdona (o. ~650). The question about his confessional orientation is not clear now. There are saved a few manuscripts with his writings in syriac (the date of the earliest is 837), as well as in arabic (one manuscript of 1492) and georgian translations (a few manuscripts, the date of the earliest is 925). Analysis of the manuscript tradition of his writings permited to establish that the literary tradition, on which drew the writer and which was the base of his ascetical teaching, became essential factor of reception of his writings by orthodox in the most extent, while the other confessions saved only small fragments of these. The determination of causes of the popularity of the writings of Martyrius-Sahdona in several confessions is contribution in solution of the question of his confession, which is unclarified aspect of the biography of this church doer and representant of the East Syrian ascetic literature.