FORENSIC MEDICAL ASSESSMENT OF MORPHOLOGICAL CHANGES AT DIFFERENT POSTMORTEM INTERVAL

Purpose: The postmortem interval (PMI) evaluation is one of priorities while performing a forensic medical examination of corpse. To date, there is lack of information of morphological postmortem changes of some internal organs. Considering the persistent need to develop the method for a precise assessment of PMI, postmortem changes in these potentially informative organs were evaluated. The aim of study was to analyze morphological postmortem changes in prostate and uterus. Materials and Methods: histological samples of 40 prostate tissues and 40 uterus (n=80) from corpses of deceased aged 18-75 years. Only cases with known time of death were included to study, the time of death was taken from police reports. Exclusion criteria were cases of violent death, cases of death with massive blood loss, tumors of studied internal organs, cases when diagnosis was not made by a forensic medical examiner. The PMI of studied cases ranged from 1 to 6 days. Histological slides were made with a staining by hematoxylin and eosin, x200 magnification, using Olympus ВХ41 and Olympus ВХ46 microscopes, Olympus SC50 camera. Postmortem morphological changes were evaluated by a calculation of blank spaces percentage in microscopical structures using a JS-based program. Connection between PMI and morphological changes was calculated by the Spearman’s rank correlation. Results: the average percentage of blank spaces in uterus tissues was smaller than in prostate tissues (1,99 and 9,65 relatively). The slower growing of blank spaces was in uterus. In prostate samples, a notable increase of blank spaces was observed between 48 and 72 hours after the death. After this period, the increase slowed down and then an increase was observed again between 120 and 144 hours after the death. In uterus samples, a slight acceleration observed between 72 and 120 hours after the death and then slowing down between 120 and 144 hours after the death. Blank spaces in evaluated histological slides were increasing directly proportional to the PMI, a statistically significant interconnection was defined (p < 0.05). Conclusions: The morphological postmortem changes in prostate and uterus were developing at certain time frames. Blank spaces percentage, in studied histological slides, were increasing directly proportional to the PMI increase, a statistically significant interconnection was defined. Therefore, the results of study show the possibility of the evaluation of a postmortem time interval by assessing such morphological changes in these organs, which could be used in forensic medical cases.

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RELATION OF POSTMORTEM CHANGES DEVELOPMENT AND EXACT POSTMORTEM INTERVAL

Inter Collegas ◽

10.35339/ic.7.2.72-75 ◽

2020 ◽

Vol 7 (2) ◽

pp. 72-75

Author(s):

E. Grygorian ◽

V. Olkhovsky ◽

M. Gubin

Keyword(s):

Rank Correlation ◽

Postmortem Interval ◽

Medical Examiner ◽

Postmortem Changes ◽

Time Interval ◽

Time Of Death ◽

Cross Sectional ◽

Positive Correlation ◽

Total Body Score ◽

Total Body

RELATION OF POSTMORTEM CHANGES DEVELOPMENT AND EXACT POSTMORTEM INTERVAL Grygorian E., Olkhovsky V., Gubin M. Purpose: Precise postmortem interval’s evaluation is crucial in cases when violent types of death are suspected by forensic medical examiner. There are different factors that could affect results of postmortem interval (PMI) evaluation by forensic medical expert. The aim of this study was to study connections between the known postmortem time interval and the degree of particular postmortem changes’ development. Materials and Methods: A cross-sectional analysis of 116 forensic medical examinations of deceased persons (of female persons n = 58, of males n = 58), in cases of non-violent death, was performed. Data about time of death was obtained from police preliminary records provided to the examination - only cases with known time of death prescription were included to study. Postmortem changes were evaluated by Total Body Score (TBS) [1] at equal time interval after death (48 hours ± 3 hours). Interconnection between postmortem changes degree and PMI was estimated using Spearman’s rank correlation. Difference between sexes was evaluated using Mann-Whitney U test. Results: “Thickness of clothes” criterion reached the highest positive correlation coefficient, “ambient temperature” criterion had also a significant positive correlation. The rest of studied criteria had very weak correlation with the development of postmortem changes. Conclusions: Several criteria had significant (p < 0.05), yet week, impact on the postmortem changes’ development. The other criteria were statistically insignificant. Keywords: forensic medicine, forensic medical examination, postmortem interval, thanatology. Резюме. ЗВ’ЯЗОК РОЗВИТКУ ПОСТМОРТАЛЬНИХ ЗМІН І ДАВНОСТІ НАСТАННЯ СМЕРТІ Григорян Е.К., Ольховський В.О., Губін М.В. Мета: Точна оцінка терміну, що пройшов з моменту настання смерті, має вирішальне значення у випадках, коли судово-медичний експерт підозрює насильницькі види смерті. Існують різні фактори, які можуть вплинути на результати оцінки давності настання смерті (ДНС) судово-медичним експертом. Метою даного дослідження було вивчення зв’язку між відомою давністю настання смерті і ступенем розвитку конкретних посмертних змін. Матеріали та методи: Було проведено аналіз 116 судово-медичних експертиз померлих осіб (жінок n = 58, чоловіків n = 58) у випадках ненасильницької смерті. У дослідження були включені тільки випадки з відомим терміном давності настання смерті, дані про час настання смерті були отримані із супровідної документації правоохоронних органів, наданої на експертизу. Посмертні зміни оцінювали за методом Total Body Score (TBS) [1] через однаковий проміжок часу після настання смерті (48 годин ± 3 години). Взаємозв’язок між ступенем посмертних змін і ДНС був оцінений з використанням рангової кореляції Спірмена. Різниця між статями була оцінена з використанням U-критерію Манна-Уїтні. Результати: Критерій «товщина одягу» мав найвищий позитивний коефіцієнт кореляції, критерій «температура навколишнього середовища» також мав значну позитивну кореляцію. Решта вивчених критеріїв мали дуже слабку кореляцію з розвитком посмертних змін. Висновки: Кілька критеріїв мали значний (р <0,05), але слабкий вплив на розвиток посмертних змін. Решта критеріїв були статистично незначущими. Ключові слова: судова медицина, судово-медична експертиза, давність настання смерті, танатологія. Резюме. СВЯЗЬ РАЗВИТИЯ ПОСТМОРТАЛЬНЫХ ИЗМЕНЕНИЙ И ДАВНОСТИ НАСТУПЛЕНИЯ СМЕРТИ Григорян Э.К., Ольховский В.А., Губин Н.В. Цель: Точная оценка срока, прошедшего с момента наступления смерти, имеет решающее значение в случаях, когда судебно-медицинский эксперт подозревает насильственные виды смерти. Существуют различные факторы, которые могут повлиять на результаты оценки давности наступления смерти (ДНС) судебно-медицинским экспертом. Целью данного исследования было изучение связей между известной давностью наступления смерти и степенью развития конкретных посмертных изменений. Материалы и методы: Был проведен анализ 116 судебно-медицинских экспертиз умерших лиц (женщин n = 58, мужчин n = 58) в случаях ненасильственной смерти. В исследование были включены только случаи с известным сроком давности наступления смерти, данные о времени наступления смерти были получены из сопроводительной документации правоохранительных органов, предоставленной на экспертизу. Посмертные изменения оценивали по методу Total Body Score (TBS) [1] через одинаковый промежуток времени после наступления смерти (48 часов ± 3 часа). Взаимосвязь между степенью посмертных изменений и ДНС была оценена с использованием ранговой корреляции Спирмена. Различие между полами было оценено с использованием U-критерия Манна-Уитни. Результаты: Критерий «толщина одежды» имел наивысший положительный коэффициент корреляции, критерий «температура окружающей среды» также имел значимую положительную корреляцию. Остальные изученные критерии имели очень слабую корреляцию с развитием посмертных изменений. Выводы: Несколько критериев оказали значительное (р <0,05), но слабое влияние на развитие посмертных изменений. Остальные критерии были статистически незначимыми. Ключевые слова: судебная медицина, судебно-медицинская экспертиза, давность наступления смерти, танатология.

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Validating Efficacy of Shea Nut Oil Extract in Knee Osteoarthritis Patients

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/147163 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

San-Pei Chen ◽

Sui-Foon Lo ◽

Yu-Chia Wang ◽

Tzu-Yi Chou ◽

Kang-Ming Chang ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Correlation Coefficient ◽

Morphological Changes ◽

Intraclass Correlation ◽

Rank Correlation ◽

Pain Scale ◽

Thickness Change ◽

Knee Oa ◽

Spearman’S Rank Correlation ◽

Oil Extract

Objectives. To examine and investigate the efficacy of shea nut oil extract (SheaFlex75) in relation to knee osteoarthritis (OA).Methods. Thirty-three patients (age63.6±5.8years) with knee OA were recruited. Real-time ultrasound imaging and surface electromyography were used to objectively assess the morphological changes and the activity of vastus medialis oblique (VMO) muscles during a 16-week intervention of SheaFlex75. The intraclass correlation coefficient (ICC) was calculated to examine the reliability of the interscans. A paired-samplet-test was used to compare the findings in different stages. The Spearman’s rank correlation coefficient was used to examine the relationship between the relevant variables of OA and percentage of thickness change of VMO at different contraction levels.Results. The baseline findings showed strong correlation, suggesting that the reliability of interscans at pretest was high. The ability to contract the muscles of the knee to a 30% contraction level showed significant change between the baseline and after 16-week testing, both in terms of morphological changes and muscle activity. Pain scale reported a significant decrease at the 16th week.Conclusion. The results suggest that SheaFlex75 can relieve the symptoms of knee OA and can result in improvement of muscle control of the knee.

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Ultrastructural changes of renal epithelial cells during postmortem autolysis: Experimental work

Medicinski pregled ◽

10.2298/mpns1002015z ◽

2010 ◽

Vol 63 (1-2) ◽

pp. 15-20

Author(s):

Miodrag Zdravkovic

Keyword(s):

Morphological Changes ◽

Kidney Tissue ◽

The Body ◽

Proximal Tubules ◽

Ultrastructural Changes ◽

Control Group ◽

Time Interval ◽

Time Of Death ◽

Laboratory Rats ◽

Different Temperatures

Introduction. Determination of schedule and certain predictable regularities of ultrastructural changes of proximal tubules epithet of kidney during post mortal interval would be very useful in forensic medicine when it is needed to determine the exact time of death. Material and methods. In this research there were 52 experimental animals, laboratory rats 'Wistar' type, which had been killed by choking. Four animals were selected to be a control group right after death, and 48 rats were divided into three equal groups: The rats were then fended on different temperatures: 8-10?C, 18-20?C, 28-30?C, respectively. In each and every group the rats were divided into four groups based on time interval after death: I, 2, 4 and 6 hours. There were four rats in each of those four subgroups. Preparations were analyzed and photographed using transmission electronic microscope. Results. It was found that pace of ultrastructure changes of proximal tubules epitel the cells of kidney was directly dependable on the duration of autolysis and temperatures that the body was stored at. First changes on nucleus, which are separation of external and internal membranes, occurred during the fourth hour of autolysis. Decomposition of external membrane occurred also during fourth hour on temperatures of 8-10?C and 18-20?C. When the body was stored at 30?C lysised decomposition of both membranes of nucleus and loss of natural nucleus shape were noticeable even during the first hour of autolysis. During the sixth hour nucleus membranes were almost lysised around the perimeter and that led to 'leaking' of chromatin in sarkoplasm. Mitochondria kept their normal shape six hours after death when the body was stored on 8-10?C and 18-20?C, and lysis and fragmentation of cristae were noticeable from the first hour of autolysis. Mitochondria lost their natural shape and inner composition during the first hour when the body was stored at 30?C. So, after the fourth hour only balloon like and light?ened remaining of mitochondria and fragmented pieces of their cristae were noticeable. Conclusion. All of the predictable changes found in morphological changes on subcell level of kidney tissue can be useful to determine very precisely the time of death. They can be also used to determine vital value of tissue and organs.

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APPROACHES TO DETERMINING POST-MORTEM INTERVAL

Theory and Practice of Forensic Science and Criminalistics ◽

10.32353/khrife.2.2020.21 ◽

2020 ◽

Vol 22 (2) ◽

Author(s):

V. Olkhovsky ◽

E. Grygorian ◽

M. Myroshnychenko

Keyword(s):

Postmortem Interval ◽

Biochemical Changes ◽

Postmortem Changes ◽

Time Interval ◽

Post Mortem ◽

Post Mortem Interval ◽

Laser Polarimetry ◽

Scientific Papers ◽

Temperature Exposure ◽

Medical Examiners

The main approaches and problems that arise when evaluating postmortem interval are defined, ways to avoid such problems are suggested. According to the results of scientific papers analysis on that topic, it was established that in the context of post-mortem changes studies such changes developed differently during a specific period of time passed from the time of death, they also appeared in a variety of forms as a result of environmental factors influence. The factors having a significant impact on postmortem changes were specified. A review of modern methods for determining post-mortem interval was conducted and methods for further improvement of the assessment of postmortem interval were proposed. The use of methods for assessing the PMI by means of the cadaveric phenomena does not always provide for investigating authorities necessary information due to the relatively large time interval in methods based on such changes. Researchers also note the presence of certain shortcomings in the use of existing methods. Current research using laser polarimetry methods have made it possible to establish post-mortem interval with relatively high accuracy. However, high prices and limited availability of equipment used in laser polarimetry methods preclude from using them in everyday practice of forensic medical examiners. When conducting studies on histological and biochemical changes in tissues of internal organs, certain morphological (decrease in optical density) and biochemical (changes in the levels of biochemical markers) changes in the early post-mortal period were identified, which will enable the development of specific tables where such changes would be linked to a specific post-mortem time period during certain short periods of time. Although changes in the conducted research were recognized only in the early post-mortem period and only in muscle tissue, further research on other tissues that are more resistant to post-mortem changes are likely to provide results that would be less affected by ambient temperature, exposure of a corpse to the sun rays, amount of clothing on a corpse, etc.) and also would be more accurate than most existing methods.

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Estimation of Time of Fetal Death in the Second Trimester by Placental Histopathological Examination

Pediatric and Developmental Pathology ◽

10.1007/s10024-003-8089-9 ◽

2003 ◽

Vol 6 (3) ◽

pp. 226-232 ◽

Cited By ~ 16

Author(s):

Suzanne M. Jacques ◽

Faisal Qureshi ◽

Anthony Johnson ◽

Aziz A. Alkatib ◽

David C. Kmak

Keyword(s):

Fetal Death ◽

Histopathological Examination ◽

Morphological Changes ◽

Time Interval ◽

Time Of Death ◽

Second Trimester ◽

Time Intervals ◽

Group I ◽

Short Time ◽

Umbilical Cords

It has been suggested that certain placental histopathological changes may be useful in predicting the time of death in stillborn fetuses. We retrospectively evaluated 36 placentas from therapeutic terminations in which the time interval between fetal death and delivery was relatively short and well-documented to determine the earliest stillbirth-associated changes and the utility of placental examination in timing death in the second trimester. In each case, termination had been initiated by creating fetal asystole with intracardiac KCl injections. The gestational age ranged from 18–23 wk. The time from asystole to placental delivery range was 2.8–52.0 h. Placental groups were categorized by time intervals from asystole to delivery: I,<12h[ n = 4(11%)]; II, 12–24 h [ n = 15 (42%)]; III, 24–36 h [ n = 14 (39%)]; IV, > 36 h [ n = 3 (8%)]. Among eight histopathologic changes involving the umbilical cord or chorionic villi evaluated, only three were present in a significant number of cases and also appeared to be the result of stillbirth. Degeneration of cord vascular smooth muscle was present in 33% of umbilical cords in group I, but was seen in 100% of cords in groups II–IV; the extent of these changes increased significantly with increasing time intervals. Intravascular karyorrhexis was present in villous blood vessels in 75, 73, 64, and 100%, respectively, for groups I–IV. Villous blood vessel luminal abnormalities were seen in 25, 7, 21, and 67%, respectively, for groups I–IV. These findings indicate that these are the earliest morphological changes in stillbirth in second trimester placentas, but they cannot be used to accurately predict time of death in the relatively short time intervals evaluated in this study.

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A Study of the Relationships between Nursing Students’ Meanings of Life, Positive Beliefs, and Well-Being

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i01/02 ◽

2018 ◽

Vol 3 (01) ◽

Author(s):

Fu-Ju Tsai ◽

Cheng-Yu Chen ◽

Gwo-Liang Yeh ◽

Yih-Jin Hu ◽

Chie-Chien Tseng ◽

...

Keyword(s):

Health Promotion ◽

Nursing Students ◽

Analysis Of Variance ◽

Rank Correlation ◽

Meaning Of Life ◽

Well Being ◽

Social Health ◽

Cross Sectional ◽

Nursing Educators ◽

Spearman’S Rank Correlation

Background: Nursing educators should train nursing students to pursue physical, psychological, spiritual, and social health promotion. The purpose of this study was to explore relationships between nursing students’ meaning of life, positive beliefs, and well-being. Methods: A cross-sectional correlational study with a quantitative approach was adopted. Purposive sampling was used. A total of 170 nursing students voluntarily participated in this study. A 56-item questionnaire was used to examine nursing students’ meaning of life (1-25 items), positive beliefs (1-11 items), and well-being (1-20 items). The content validity index (CVI) of the study questionnaire was established as 0.95 by seven expert scholars. The reliability values for the three parts of the measure were as follows: meaning of life, Cronbach’s α 0.96; positive beliefs, Cronbach’s α 0.93; and well-being, Cronbach’s α 0.95. Percentages, frequencies, means, SDs, Kruskal-Wallis one-way analysis of variance by rank, Spearman’s rank correlation, one-way analysis of variance, Spearman’s rho correlation, and regression analysis were used for the data analysis. Results: Nursing students had the following mean scores: meaning of life with 4.02 (SD 0.56); positive beliefs with 3.92 (SD 0.62); and well-being with 3.95 (SD 0.57). The results indicate that for all nursing students, meaning of life was positively correlated with positive beliefs, r=0.83 (P<.01); similarly, all nursing students had positive beliefs that were positively correlated with meaning of life, r=0.83 (P<.01). In the results of the study, the nursing students’ background, meaning of life and positive beliefs explained 63% of the variance in well-being (Adjusted R2 squared =0.63, F=33.41, P<.001). Conclusions: Nursing students’ sense of meaning of life and positive beliefs may impact their well-being. Therefore, nursing educators can promote meaning of life and positive beliefs to nursing students as a way to increase their well-being for physical, psychological, spiritual, and social health promotion.

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Deregulation of lncRNA HIST1H2AG-6 and AIM1-3 in peripheral blood mononuclear cells is associated with newly diagnosed type 2 diabetes

BMC Medical Genomics ◽

10.1186/s12920-021-00994-z ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Hui Jiang ◽

Peian Lou ◽

Xiaoluo Chen ◽

Chenguang Wu ◽

Shihe Shao

Keyword(s):

Roc Curve ◽

Multivariate Logistic Regression Analysis ◽

Rank Correlation ◽

Differentially Expressed ◽

Healthy Controls ◽

Biological Functions ◽

Multivariate Logistic Regression ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient

Abstract Background Type 2 diabetes mellitus (T2DM) is mainly affected by genetic and environmental factors; however, the correlation of long noncoding RNAs (lncRNAs) with T2DM remains largely unknown. Methods Microarray analysis was performed to identify the differentially expressed lncRNAs and messenger RNAs (mRNAs) in patients with T2DM and healthy controls, and the expression of two candidate lncRNAs (lnc-HIST1H2AG-6 and lnc-AIM1-3) were further validated using quantitative real-time polymerase chain reaction (qRT-PCR). Spearman’s rank correlation coefficient was used to measure the degree of association between the two candidate lncRNAs and differentially expressed mRNAs. Furthermore, the KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway and GO (Gene Ontology) enrichment analysis were used to reveal the biological functions of the two candidate lncRNAs. Additionally, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. Results The microarray analysis revealed that there were 55 lncRNAs and 36 mRNAs differentially expressed in patients with T2DM compared with healthy controls. Notably, lnc-HIST1H2AG-6 was significantly upregulated and lnc-AIM1-3 was significantly downregulated in patients with T2DM, which was validated in a large-scale qRT-PCR examination (90 controls and 100 patients with T2DM). Spearman’s rank correlation coefficient revealed that both lncRNAs were correlated with 36 differentially expressed mRNAs. Furthermore, functional enrichment (KEGG and GO) analysis demonstrated that the two lncRNA-related mRNAs might be involved in multiple biological functions, including cell programmed death, negative regulation of insulin receptor signal, and starch and sucrose metabolism. Multivariate logistic regression analysis revealed that lnc-HIST1H2AG-6 and lnc-AIM1-3 were significantly correlated with T2DM (OR = 5.791 and 0.071, respectively, both P = 0.000). Furthermore, the ROC curve showed that the expression of lnc-HIST1H2AG-6 and lnc-AIM1-3 might be used to differentiate patients with T2DM from healthy controls (area under the ROC curve = 0.664 and 0.769, respectively). Conclusion The profiles of lncRNA and mRNA were significantly changed in patients with T2DM. The expression levels of lnc-HIST1H2AG-6 and lnc-AIM1-3 genes were significantly correlated with some features of T2DM, which may be used to distinguish patients with T2DM from healthy controls and may serve as potential novel biomarkers for diagnosis in the future.

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Magnetic resonance cisternography imaging findings related to the leakage of Gadolinium into the subarachnoid space

Japanese Journal of Radiology ◽

10.1007/s11604-021-01137-1 ◽

2021 ◽

Author(s):

Rei Nakamichi ◽

Toshiaki Taoka ◽

Hisashi Kawai ◽

Tadao Yoshida ◽

Michihiko Sone ◽

...

Keyword(s):

Magnetic Resonance ◽

Subarachnoid Space ◽

Area Under The Curve ◽

Rank Correlation ◽

Predictive Performance ◽

Roc Curves ◽

Imaging Findings ◽

Spearman’S Rank Correlation ◽

Sagittal Sinus ◽

Magnetic Resonance Cisternography

Abstract Purpose To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.

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Predicting presenteeism using measures of health status

Quality of Life Research ◽

10.1007/s11136-021-02936-9 ◽

2021 ◽

Author(s):

Cheryl Jones ◽

Katherine Payne ◽

Alexander Thompson ◽

Suzanne M. M. Verstappen

Keyword(s):

Health Status ◽

Online Survey ◽

Activity Index ◽

Work Productivity ◽

Rank Correlation ◽

Ordinary Least Squares ◽

Statistical Correlation ◽

Least Squares Regression ◽

Mapping Algorithm ◽

Spearman’S Rank Correlation

Abstract Objectives To identify whether it is feasible to develop a mapping algorithm to predict presenteeism using multiattribute measures of health status. Methods Data were collected using a bespoke online survey in a purposive sample (n = 472) of working individuals with a self-reported diagnosis of Rheumatoid arthritis (RA). Survey respondents were recruited using an online panel company (ResearchNow). This study used data captured using two multiattribute measures of health status (EQ5D-5 level; SF6D) and a measure of presenteeism (WPAI, Work Productivity Activity Index). Statistical correlation between the WPAI and the two measures of health status (EQ5D-5 level; SF6D) was assessed using Spearman’s rank correlation. Five regression models were estimated to quantify the relationship between WPAI and predict presenteeism using health status. The models were specified based in index and domain scores and included covariates (age; gender). Estimated and observed presenteeism were compared using tenfold cross-validation and evaluated using Root mean square error (RMSE). Results A strong and negative correlation was found between WPAI and: EQ5D-5 level and WPAI (r = − 0.64); SF6D (r =− 0.60). Two models, using ordinary least squares regression were identified as the best performing models specifying health status using: SF6D domains with age interacted with gender (RMSE = 1.7858); EQ5D-5 Level domains and age interacted with gender (RMSE = 1.7859). Conclusions This study provides indicative evidence that two existing measures of health status (SF6D and EQ5D-5L) have a quantifiable relationship with a measure of presenteeism (WPAI) for an exemplar application of working individuals with RA. A future study should assess the external validity of the proposed mapping algorithms.

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Electrocution Stigmas in Organ Damage: The Pathological Marks

Diagnostics ◽

10.3390/diagnostics11040682 ◽

2021 ◽

Vol 11 (4) ◽

pp. 682

Author(s):

Gelsomina Mansueto ◽

Mario Di Napoli ◽

Pasquale Mascolo ◽

Anna Carfora ◽

Pierluca Zangani ◽

...

Keyword(s):

Morphological Changes ◽

Organ Damage ◽

Pathological Findings ◽

Internal Organs ◽

Histological Changes ◽

Morphological Findings ◽

Starting Point ◽

Autopsy Series ◽

Golden Standard ◽

Wide Variability

Background: Diagnostic criteria for electrocution related death are still a challenge in forensic pathology and it seems that the electrical mark is the only reliable evidence. Methods: A comparison of histological and morphological findings of skin and internal organs from an autopsy series of electrocution deaths with those mostly reported in literature as representative for electrocution. Results: The morphological changes of heart, brain and other main internal organs are still unspecific. Organ’s damage observed in electrocution deaths shows a wide variability, not reliable for a certain diagnosis of electrocution. The electrical mark is still the golden standard for diagnosis of electrocution. Conclusions: In electrocution related deaths, pathological findings of the main internal organs are not enough evidence to support with certainty a post-mortem diagnosis that a victim suffered an electrical damage. Although the organ histological changes are undoubtedly the starting point for a better understanding of the fatal even, the diagnosis of death from electrical damage is still a dark and unsolved chapter. The electrical mark still represents a fundamental indicator above all in the medical-legal field, but the identification of pathognomonic elements and signs not limited to the skin alone could be a valid help in the future, especially in unclear cases.

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