An assessment of Raman spectroscopy for the estimation of postmortem interval from skeletonised remains

Upon the detection of human remains, the postmortem interval (PMI), which is the time elapsed since death, is one of the most substantial particulars necessitating investigation in forensic case work. Due to the resilient nature of bones, skeletonised remains are more likely to persist during decomposition than other biological tissue, making their examination invaluable in the calculation of PMI. To date, attempts at the development of an accurate method for PMI estimation in the later stages of decomposition have not been successful. In recent times, research on benchtop and portable Raman spectroscopy has demonstrated their potential in the calculation of PMI from skeletal remains, yet, at this point, their application for this purpose has not been established. The present study aimed to optimise the method for the analysis of bone samples collected from pig carcasses with PMI ranging from 12-30 months using benchtop and portable Raman instrumentation, and analyse spectral data of diagenetic patterns in decomposing bone. The present study demonstrated that bone scraping is a more effective solution to problematic fluorescence than chemical bleaching. Furthermore, due to the inability to collect usable data at 785 nm excitation, the research exhibited that testing of bone samples at 1064 nm produced high quality spectral data. Additionally, analysis of femora was preferred over other bone classifications. Results obtained using the optimised parameters demonstrated visual differences in peak intensity in spectra from bones with varying PMI, particularly in amide I and amide III, which exhibited a gradual pattern of decrease in peak size and distortion in shape in some spectra. This is likely related to the reduction of collagen in bone samples as PMI increases. Through the optimisation of Raman spectroscopic analysis of bone samples, the study provides the necessary methodology for the characterisation of diagenetic patterns of decomposing bone and preliminary baseline data on which further research and potentially future forensic case work can rely. The study recognises that further inquiry into the diagenesis of forensically relevant skeletal remains can provide substantial information which is crucial to the design of a reliable technique capable of accurately estimating PMI from bone material within the Hawkesbury region in NSW, and producing evidence that is admissible in courts of law

The Role of Personal Therapy for Music Therapists: A Survey

The purpose of this study was to examine the attitudes toward and prevalence of use of personal therapy among music therapists. An online survey was conducted with a sample of 132 music therapists working per diem, part-time, and full-time in the Unites States. A total of 130 surveys were analyzed using quantitative methods. The study examined the prevalence of use of personal therapy among music therapists, the ways music therapists seek to increase their personal development, the reasons and importance of receiving personal therapy, and the benefits of receiving personal therapy. Prevalence of use of non-music personal therapy was 33.6%, at the time of the survey, while 60.3% had participated in personal therapy at some time during their career. Personal therapy was most often sought out by the participants to increase their personal development. It was considered by 96.3% of participants to be a valuable and beneficial experience for personal and professional growth; among the reasons cited were that it enables a music therapist to increase self-awareness, work through issues, and develop coping skills. Implications and future research are discussed

Computer simulation clarifies mechanisms of carbon dioxide clearance during apnoea

BackgroundApnoeic oxygenation can come close to matching the oxygen demands of the apnoeic patient but does not facilitate carbon dioxide (CO2) elimination, potentially resulting in dangerous hypercapnia. Numerous studies have shown that high-flow nasal oxygen administration prevents hypoxaemia, and appears to reduce the rate of increase of arterial CO2 partial pressure (PaCO2), but evidence is lacking to explain these effects.MethodsWe extended a high-fidelity computational simulation of cardiopulmonary physiology to include modules allowing variable effects of: (a) cardiogenic oscillations affecting intrathoracic gas spaces, (b) gas mixing within the anatomical dead space, (c) insufflation into the trachea or above the glottis, and (d) pharyngeal pressure oscillation. We validated this model by reproducing the methods and results of five clinical studies on apnoeic oxygenation.ResultsSimulated outputs best matched clinical data for model selection of parameters reflecting: (a) significant effects of cardiogenic oscillations on alveoli, both in terms of strength of the effect (4.5 cm H2O) and percentage of alveoli affected (60%), (b) augmented gas mixing within the anatomical dead space, and (c) pharyngeal pressure oscillations between 0 and 2 cm H2O at 70 Hz.ConclusionsCardiogenic oscillations, dead space gas mixing, and micro-ventilation induced by pharyngeal pressure variations appear to be important mechanisms that combine to facilitate the clearance of CO2 during apnoea. Evolution of high-flow oxygen insufflation devices should take advantage of these insights, potentially improving apnoeic gas exchange

Superexploração da força de trabalho, uma categoria em disputa

This work is focused on exhibition and the context of the work of Ruy Mauro Marini, especially with regard to the formulation of the Marxist Theory of Dependency, which involves, in particular, the concept of overexploitation of labor power. The historical context in which the author developed his theory has significant relevance in the work and will be addressed primarily by the emergence of the Economic Commission for Latin America and the Caribbean (Cepal) and the Brazilian Communist Party (PCB), major builders and debaters of social theories in Latin America. From this exposure, the work aim to establish the importance of the legacy of Ruy Mauro Marini, pointing to several studies of his work for the present time.O presente trabalho está focado na exposição e na contextualização da obra de Ruy Mauro Marini, especialmente no que concerne à formulação da Teoria Marxista da Dependência, o que envolve, particularmente, a conceituação de superexploração da força de trabalho. O contexto histórico em que o autor desenvolveu sua teoria tem expressiva relevância no trabalho e será abordado, principalmente, pelo surgimento da Comissão Econômica para a América Latina e Caribe (Cepal) e do Partido Comunista Brasileiro (PCB), importantes artífices e debatedores de teorias sociais na América Latina. A partir dessa exposição, o trabalho trata de estabelecer a importância do legado de Ruy Mauro Marini, apontando para os diversos estudos acerca da superexploração da força de trabalho na atualidade.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016

Investigation Between the S377G3 GATA-4 Polymorphism and Migraine

Migraine is a common and painful neurological disorder, with genetic and environmental components. Several conditions have been shown to be comorbid with migraine, notably a cardiac malformation affecting the interatrial septum and leading to patent foramen ovale (PFO). Mutations in the development regulatory gene GATA-4, located on human chromosome 8p23.1-p22, have been found to be responsible for some cases of congenital heart defects including PFO. To determine whether the GATA-4 gene is involved in migraine, the present study performed an association analysis of a common GATA-4 variant that results in a change of amino acid (S377G), in a large case/control population (275 unrelated Caucasian migraineurs versus 275 control individuals). The results showed that there was no significant association for this polymorphism between migraine and controls (χ² = 0.84, P = 0.66). Thus it appears that the GATA-4 (S377G) mutation does not play a significant role in common migraine susceptibility

Predicting 30-day mortality in patients with sepsis: an exploratory analysis of process of care and patient characteristics

Background Sepsis represents a significant public health burden, costing the NHS £2.5 billion annually, with 35% mortality in 2006. The aim of this exploratory study was to investigate risk factors predictive of 30-day mortality amongst patients with sepsis in Nottingham. Methods Data were collected prospectively from adult patients with sepsis in Nottingham University Hospitals NHS Trust as part of an on-going quality improvement project between November 2011 and March 2014. Patients admitted to critical care with the diagnosis of sepsis were included in the study. In all, 97 separate variables were investigated for their association with 30-day mortality. Variables included patient demographics, symptoms of systemic inflammatory response syndrome, organ dysfunction or tissue hypoperfusion, locations of early care, source of sepsis and time to interventions. Results A total of 455 patients were included in the study. Increased age (adjOR = 1.05 95%CI = 1.03–1.07 p < 0.001), thrombocytopenia (adjOR = 3.10 95%CI = 1.23–7.82 p = 0.016), hospital-acquired sepsis (adjOR = 3.34 95%CI = 1.78–6.27 p < 0.001), increased lactate concentration (adjOR = 1.16 95%CI = 1.06–1.27 p = 0.001), remaining hypotensive after vasopressors (adjOR = 3.89 95%CI = 1.26–11.95 p = 0.02) and mottling (adjOR = 3.80 95%CI = 1.06–13.55 p = 0.04) increased 30-day mortality odds. Conversely, fever (adjOR = 0.46 95%CI = 0.28-0.75 p = 0.002), fluid refractory hypotension (adjOR = 0.29 95%CI = 0.10–0.87 p = 0.027) and being diagnosed in surgical wards (adjOR = 0.35 95%CI = 0.15–0.81 p = 0.015) were protective. Treatment timeliness were not significant factors. Conclusion Several important predictors of 30-day mortality were found by this research. Retrospective analysis of our sepsis data has revealed mortality predictors that appear to be more patient-related than intervention-specific. With this information, care can be improved for those identified most at risk of death

In Silico Modeling of Coronavirus Disease 2019 Acute Respiratory Distress Syndrome: Pathophysiologic Insights and Potential Management Implications

Objectives: Patients with COVID-19 Acute Respiratory Distress Syndrome (CARDS) appear to present with at least two distinct phenotypes: severe hypoxemia with relatively well-preserved lung compliance and lung gas volumes (Type 1) and a more conventional ARDS phenotype displaying the typical characteristics of the ‘baby lung’ (Type 2). We aimed to test plausible hypotheses regarding the pathophysiological mechanisms underlying CARDS, and to evaluate the resulting implications for ventilatory management. Design: We adapted a high-fidelity computational simulator, previously validated in several studies of ARDS, to (a) develop quantitative insights into the key pathophysiologic differences between CARDS and conventional ARDS, and (b) assess the impact of different PEEP, FiO2 and tidal volume settings. Setting: Interdisciplinary Collaboration in Systems Medicine Research Network. Subjects: The simulator was calibrated to represent CARDS patients with both normal and elevated body mass indices undergoing invasive mechanical ventilation. Measurements and Main Results: An ARDS model implementing disruption of hypoxic pulmonary vasoconstriction and vasodilation leading to hyperperfusion of collapsed lung regions failed to replicate clinical data on Type 1 CARDS patients. Adding mechanisms to reflect disruption of alveolar gas-exchange due to the effects of pneumonitis, and heightened vascular resistance due to the emergence of microthrombi, produced levels of V/Q mismatch and hypoxemia consistent with data from Type 1 CARDS patients, while preserving close to normal lung compliance and gas volumes. Atypical responses to PEEP increments between 5 and 15 cmH2O were observed for this Type 1 CARDS model across a range of measures: increasing PEEP resulted in reduced lung compliance and no improvement in oxygenation, while Mechanical Power, Driving Pressure and Plateau Pressure all increased. FiO2 settings based on ARDSnet protocols at different PEEP levels were insufficient to achieve adequate oxygenation. Incrementing tidal volumes from 5 to 10 ml/kg produced similar increases in multiple indicators of ventilator induced lung injury in the Type 1 CARDS model to those seen in a conventional ARDS model. Conclusions: Our model suggests that use of standard PEEP/ FiO2 tables, higher PEEP strategies, and higher tidal volumes, may all be potentially deleterious in Type 1 CARDS patients, and that a highly personalized approach to treatment is advisable