Voodoo Death: Some New Thoughts on an Old Phenomenon

Criticisms of the validity of the phenomenon of death by suggestion are reviewed and rebutted. Two theories of the mechanism of death by suggestion, proposed by Cannon and Richter, are described, and a new theory is proposed. The new theory is based on Engel's concept of the giving up-given up complex in medically ill patients and is shown to be capable of generating testable predictions about the phenomenon of voodoo death.     

National general practice study of epilepsy: the social and psychological effects of a recent diagnosis of epilepsy.

OBJECTIVES--To determine the nature and extent of psychosocial problems in epilepsy and their associations. DESIGN--A postal survey was used drawing data from prospective consecutive cases. Data on demographic, medical, and social backgrounds were collected. A specially designed, validated attitude questionnaire examined 14 areas of psychosocial adjustment to epilepsy. SETTING--124 primary care general practices. SUBJECTS--Adults (aged over 17) with a recent diagnosis of epilepsy (within previous 36 months). They were registered with the national general practice study of epilepsy and had a confirmed diagnosis according to the usual criteria. 216 subjects were approached for the survey by their general practitioners; 192 returned questionnaires. RESULTS--Problems in at least one area were experienced by 175 (91%) of the 192 subjects. Problems were generally mild, which contrasts strongly with findings in chronic cases. The areas of greatest concern were fear of seizures (80% of cases; 72% moderate or severe) and fear of stigma in employment (69% of cases; 40% moderate or severe). A highly significant relation was found between psychosocial effects and the frequency and recency of seizures. CONCLUSIONS--In the early stages of epilepsy psychosocial effects are closely related to the severity of the medical condition, suggesting that the argument for the stigmatising effect of the diagnosis by itself is less important than previously thought. The findings also suggest that problems may evolve as the condition becomes chronic.     

Fatal attack on an infant by an adult female tonkean macaque

We describe a fatal attack on a 10-month-old female infant by an adult female Tonkean macaque (Macaca tonkeana)in a semi-free-ranging group. During an intense conflict involving many group members, an adult female, the second most dominant in the group, attacked the infant of a lower-ranking female. The attacker remained near the victim for approximately 20 min, grabbing and biting it repeatedly, until the mother retrieved the infant. She died 2 days later. An autopsy revealed no lethal injury;the main cause of death was starvation or dehydration or both. We discuss social conditions under which a fatal attack by an adult female might occur.     

Plant Freezing and Damage

Imaging methods are giving new insights into plant freezingand the consequent damage that affects survival and distributionof both wild and crop plants. Ice can enter plants through stomataand hydathodes. Intrinsic nucleation of freezing can also occur.The initial growth of ice through the plant can be as rapidas 40 mm s^-1, although barriers can limit this growth. Onlya small fraction of plant water is changed to ice in this firstfreezing event. Nevertheless, this first rapid growth of iceis of key importance because it can initiate further, potentiallylethal, freezing at any site that it reaches. Some organs andtissues avoid freezing by supercooling. However, supercooledparts of buds can dehydrate progressively, indicating that avoidanceof freezing-induced dehydration by deep supercooling is onlypartial. Extracellular ice forms in freezing-intolerant as wellas freezing-tolerant species and causes cellular dehydration.The single most important cause of freezing-damage is when thisdehydration exceeds what cells can tolerate. In freezing-adaptedspecies, lethal freezing-induced dehydration causes damage tocell membranes. In specific cases, other factors may also causedamage, examples being cell death when limits to deep supercoolingare exceeded, and death of shoots when freezing-induced embolismsin xylem vessels persist. Extracellular masses of ice can damagethe structure of organs but this may be tolerated, as in extra-organfreezing of buds. Experiments to genetically engineer expressionof fish antifreeze proteins have not improved freezing toleranceof sensitive species. A better strategy may be to confer toleranceof cellular dehydration.Copyright 2001 Annals of Botany Company Freezing, dehydration, infrared video thermography, low temperature scanning electron microscopy, NMR micro-imaging     

Psychosocial stress and abdominal pain in adolescents

Children and adolescents may express psychiatric symptoms via somatic complaints. Likewise, children with chronic somatic illnesses are likely to experience psychiatric sequelae. We report three cases of adolescents who were admitted to general paediatrics services for abdominal pain and/or nausea and vomiting with a negative medical workup. In each case, a clear psychosocial stressor was evident. It is possible that somatic symptoms without clear medical causes may reflect psychosocial stress, but it is difficult to discern whether the psychosocial issues preceded the somatic complaints or were a result of them. Making an accurate diagnosis is difficult, and broaching such a subject with patients and their families is a delicate matter. More research is needed to determine appropriate screening tools for identifying cases where psychosocial stress may play a relevant role in symptom presentation, as well as potential treatment modalities for such cases.     

Natural and unnatural death: assessment of the manner of death by nursing home physicians and notification to the medical examiner

The assessment of the manner of death by physicians is often a problem due to unclear regulations on this point. By means of a questionnaire we investigated how 40 nursing home physicians assess the manner of death in 14 different hypothetic cases and whether the physicians should report the case to the medical examiner if confronted with similar cases in practice. Some cases of unnatural death would not be reported. Especially in cases of death after a collum fracture the law and medical practice diverge. The reasons to report or not to the medical examiner were also investigated. Death fitting in the 'descending line of life' was most mentioned.     

IMMUNOLOGICAL IDENTIFICATION OF THE ALTERNATIVE OXIDASE IN CHLAMYDOMONAS REINHARDTII (CHLOROPHYTA)1

Using a monoclonal antibody to the alternative oxidase from voodoo lily, we provide evidence that the green alga Chlamydomonas reinhardtii Dang, possesses a protein that is immunologically related to the higher plant alternative oxidase. Mitochondria were isolated from a cell wall-less mutant strain (CW-15), and the presence of cyanide-resistant oxygen consumption was confirmed in these mitochondria. The voodoo lily antibody was used as a probe for immunoblotting of sodium dodecyl sulphate-polyacrylamide gel electrophoresis gels of mitochondrial proteins of C. reinhardtii. The antibody reacted with a protein from C. reinhardtii with the same molecular mass (36 kDa) as the alternative oxidase from voodoo lily and tobacco mitochondria. These results suggest that cyanide-resistant respiration in C. reinhardtii is mediated by a higher plant-type alternative oxidase.     

Violent coalitionary attacks and intraspecific killing in wild white-faced capuchin monkeys (<Emphasis Type="Italic">Cebus capucinus</Emphasis>)

During 12 years of observation, we have observed three confirmed and two inferred lethal coalitionary attacks on adult male white-faced capuchins (Cebus capucinus) by members of two habituated social groups at Lomas Barbudal Biological Reserve, Costa Rica. In one case, an alpha male was badly wounded and evicted from his group, and when later found by his former groupmates he was attacked by several of them and died less than 24 h later. In two other cases, lone extra-group males were mobbed by adult and immature males of a bisexual group. One victim's abdomen was torn open and he died less than 24 h later. A second victim was quite badly bitten but may have escaped. The fourth and fifth cases resulted from intergroup encounters. One victim lost the use of both arms but may have survived, whereas the other died of unknown causes within an hour of the attack. The observed death rate from coalitionary aggression at our site is approximately the same as that reported for eastern chimpanzees. Because at least three of the five observed incidents involved large coalitions attacking lone victims, they support the general hypothesis that imbalances of power contribute to intraspecific killing in primates. However, the occurrence of lethal coalitional attacks in a species lacking fission–fusion social organization poses a challenge to the more specific version of the imbalance-of-power hypothesis proposed by Manson and Wrangham in 1991 to explain chimpanzee and human intergroup aggression.     

Medical management of canine and feline dystocia

When dystocia is diagnosed in the bitch or queen, two forms of treatment exist: medical or surgical therapy. Medical management of dystocia has the advantage of aiding completion of the parturition process without surgery or anesthesia. However, since not all cases of dystocia can be managed medically, educated and careful decision making is required prior to instituting medical management in cases of dystocia. Improper medical treatment, especially when surgical management is clinically indicated, can result in compromise and even death of the dam and fetuses. This paper focuses on the decision making necessary prior to instituting medical management for cases of dystocia in both bitches and queens, and describes available therapeutics.     

Dysphagia in acute stroke.

A prospective study was undertaken to define the incidence, duration, and consequences of dysphagia in an unselected group of 91 consecutive patients who had suffered acute stroke. The site of the present lesion and of any previous stroke was determined clinically and was confirmed by computed tomography of the brain or necropsy in 40 cases. Of 41 patients who had dysphagia on admission, 37 had had a stroke in one cerebral hemisphere. Only seven patients showed evidence of lesions in both hemispheres. Nineteen of 22 patients who survived a stroke in a hemisphere regained their ability to swallow within 14 days. Dysphagia in patients who had had a stroke in a cerebral hemisphere was associated in this study with a higher incidence of chest infections, dehydration, and death.     

Tryptase, CD15 and IL-15 as reliable markers for the determination of soft and hard ligature marks vitality

In forensic practice, it is required to distinguish between suicidal or accidental hanging and simulated hanging. Conventional macroscopic and histological findings may be unreliable; vital signs are often absent, and they can be produced postmortem. The application of immunohistochemical techniques opened up a new field of investigation in the issue of ligature marks. We investigated the immunohistochemical expression of a panel of cytokines and inflammatory cells in skin specimens in autopsy cases of death due to hanging, to discuss their significance in assessing whether hanging mark and signs occurred before or after the death of the victim. We selected 21 cases in which broad, soft and yielding materials were used and 28 cases in which materials used for hanging were hard. The control group included the following 21 cases: 14 cases of sudden cardiac death and 7 cases of post-mortem hanging (suspension) of bodies (drug overdose or suffocation as cause of death in all the cases). An immunohistochemical investigation of skin samples was performed utilizing antibodies anti- tryptase, fibronectin, TNFa, IL-6, IL-8, IL-10, MCP-1, IL-15, IL-1?, CD45, CD4, CD3, CD8, CD68, CD20, CD15. We conclude that tryptase, IL-15, and CD15 appear to be reliable parameters in the determination of ligature marks' vitality with the accuracy needed for forensic purposes. This fact especially applies to soft marks which are particularly difficult to evaluate on the basis of gross examination and of conventional histological studies.     

Sequence of occurring damages in yeast plasma membrane during dehydration and rehydration: Mechanisms of cell death

Yeasts are often exposed to variations in osmotic pressure in their natural environments or in their substrates when used in fermentation industries. Such changes may lead to cell death or activity loss. Although the involvement of the plasma membrane is strongly suspected, the mechanism remains unclear. Here, the integrity and functionality of the yeast plasma membrane at different levels of dehydration and rehydration during an osmotic treatment were assessed using various fluorescent dyes. Flow cytometry and confocal microscopy of cells stained with oxonol, propidium iodide, and lucifer yellow were used to study changes in membrane polarization, permeabilization, and endocytosis, respectively. Cell volume contraction, reversible depolarization, permeabilization, and endovesicle formation were successively observed with increasing levels of osmotic pressure during dehydration. The maximum survival rate was also detected at a specific rehydration level, of 20 MPa, above which cells were strongly permeabilized. Thus, we show that the two steps of an osmotic treatment, dehydration and rehydration, are both involved in the induction of cell death. Permeabilization of the plasma membranes is the critical event related to cell death. It may result from lipidic phase transitions in the membrane and from variations in the area-to-volume ratio during the osmotic treatment.     

Sequence of occurring damages in yeast plasma membrane during dehydration and rehydration: mechanisms of cell death

Yeasts are often exposed to variations in osmotic pressure in their natural environments or in their substrates when used in fermentation industries. Such changes may lead to cell death or activity loss. Although the involvement of the plasma membrane is strongly suspected, the mechanism remains unclear. Here, the integrity and functionality of the yeast plasma membrane at different levels of dehydration and rehydration during an osmotic treatment were assessed using various fluorescent dyes. Flow cytometry and confocal microscopy of cells stained with oxonol, propidium iodide, and lucifer yellow were used to study changes in membrane polarization, permeabilization, and endocytosis, respectively. Cell volume contraction, reversible depolarization, permeabilization, and endovesicle formation were successively observed with increasing levels of osmotic pressure during dehydration. The maximum survival rate was also detected at a specific rehydration level, of 20 MPa, above which cells were strongly permeabilized. Thus, we show that the two steps of an osmotic treatment, dehydration and rehydration, are both involved in the induction of cell death. Permeabilization of the plasma membranes is the critical event related to cell death. It may result from lipidic phase transitions in the membrane and from variations in the area-to-volume ratio during the osmotic treatment.     

Rationale and design of the CAREFUL study

Background. Sudden cardiac death (SCD) in the young (1-45 years) is a strong risk factor for the presence of inherited cardiac diseases in surviving first-degree relatives. Postmortem investigation of the victim and cardiogenetic evaluation of the first-degree relatives is indicated to detect inherited cardiac diseases and treat relatives at an early stage to prevent SCD. In the Netherlands, postmortem investigation is often not performed and relatives of SCD and sudden unexplained death (SUD) victims are rarely evaluated for inherited cardiac diseases. Methods. A prospective population-based follow-up study carried out in two intervention regions and two control regions. In the intervention regions a comprehensive intervention (stimulate autopsy and storage of victims DNA and the referral of first-degree relatives for cardiogenetic evaluation) is applied in a ‘top down’ and ‘bottom up’ mode. In each region, young sudden death victims are registered and for all cases performance of autopsy and evaluation of relatives in a cardiogenetics outpatient clinic will be determined. Expected results. The study will provide information on the incidence of sudden death in the young and the proportion of diagnosed inherited cardiac diseases. Moreover, the additional value of the introduction of two different preventive strategies directed at early detection of inherited cardiac diseases in first-degree relatives to usual care will be evaluated. Conclusion. The CAREFUL study will help to set a new standard of care in the evaluation of young sudden death victims and their relatives to identify the presence of inherited cardiac diseases, in order to prevent sudden death. (Neth Heart J 2010;18:286-90.)     

Effects of acute stress on lateralization of lipid peroxidation in the brain depend on the behavioral typology of rats

Using the "emotional resonance test" albino mongrel male rats were separated for their preference to light or dark space during the cry of a "victim" rat receiving footshock. Rats avoiding the cry of a "victim" by moving to the light space were characterized by higher levels of lipid peroxidation (LPO) products. A short footshock resulted in a dramatic LPO decrease in both hemispheres in the brain of all rats under study, but in rats not avoiding the cry of a "victim" (preferring dark space) "left" asymmetry of LPO increased.     

Validation of the symptom pattern method for analyzing verbal autopsy data

Background

Cause of death data are a critical input to formulating good public health policy. In the absence of reliable vital registration data, information collected after death from household members, called verbal autopsy (VA), is commonly used to study causes of death. VA data are usually analyzed by physician-coded verbal autopsy (PCVA). PCVA is expensive and its comparability across regions is questionable. Nearly all validation studies of PCVA have allowed physicians access to information collected from the household members'' recall of medical records or contact with health services, thus exaggerating accuracy of PCVA in communities where few deaths had any interaction with the health system. In this study we develop and validate a statistical strategy for analyzing VA data that overcomes the limitations of PCVA.

Methods and Findings

We propose and validate a method that combines the advantages of methods proposed by King and Lu, and Byass, which we term the symptom pattern (SP) method. The SP method uses two sources of VA data. First, it requires a dataset for which we know the true cause of death, but which need not be representative of the population of interest; this dataset might come from deaths that occur in a hospital. The SP method can then be applied to a second VA sample that is representative of the population of interest. From the hospital data we compute the properties of each symptom; that is, the probability of responding yes to each symptom, given the true cause of death. These symptom properties allow us first to estimate the population-level cause-specific mortality fractions (CSMFs), and to then use the CSMFs as an input in assigning a cause of death to each individual VA response. Finally, we use our individual cause-of-death assignments to refine our population-level CSMF estimates. The results from applying our method to data collected in China are promising. At the population level, SP estimates the CSMFs with 16% average relative error and 0.7% average absolute error, while PCVA results in 27% average relative error and 1.1% average absolute error. At the individual level, SP assigns the correct cause of death in 83% of the cases, while PCVA does so for 69% of the cases. We also compare the results of SP and PCVA when both methods have restricted access to the information from the medical record recall section of the VA instrument. At the population level, without medical record recall, the SP method estimates the CSMFs with 14% average relative error and 0.6% average absolute error, while PCVA results in 70% average relative error and 3.2% average absolute error. For individual estimates without medical record recall, SP assigns the correct cause of death in 78% of cases, while PCVA does so for 38% of cases.

Conclusions

Our results from the data collected in China suggest that the SP method outperforms PCVA, both at the population and especially at the individual level. Further study is needed on additional VA datasets in order to continue validation of the method, and to understand how the symptom properties vary as a function of culture, language, and other factors. Our results also suggest that PCVA relies heavily on household recall of medical records and related information, limiting its applicability in low-resource settings. SP does not require that additional information to adequately estimate causes of death.     

Disposal of the body after murder committed by juvenile offender

Disposal of the body by setting in concrete or sealing with bricks represents relatively rare form of corpse hiding after crime. We report a unique case of juvenile offender who killed his father and subsequently concealed the body. The victim had been reported missing by members of his family but the body was not found until 12 months later. Hidden in concrete body was well preserved allowing not only identification of the victim but also determination of the cause of death.     

36 例心源性猝死尸检的临床病理学研究*

目的:分析心源性猝死的临床病理学特征,为心源性猝死的诊断和预防提供理论依据。方法:收集36例心源性猝死病例的尸检解剖资料,进行病理组织学检查。结果:36例心源性猝死者中,冠心病21例,占心源性猝死者总数的58.33%;心律失常性右心室心肌病猝死者3例,占心源性猝死者总数的8.33%。结论:科学系统的尸检可以明确猝死原因,为医疗纠纷鉴定提供可靠依据,同时,对提高医疗质量,早期诊断、治疗心血管系统疾病和减少猝死发生起有重要作用。     

Dancing between the devil and deep blue sea: the stabilizing effect of enemy-free and victimless sinks

Theoretical and empirical studies have shown that enemy–victim interactions in spatially homogenous environments can exhibit diverging oscillations which result in the extinction of one or both species. For enemy–victim models with overlapping generations, we investigate the dynamical implications of spatial heterogeneity created by enemy-free sinks or victimless sinks. An enemy-free sink is a behavioral, physiological or ecological state that reduces or eliminates the victim's vulnerability to the enemy but cannot sustain the victim population. For victims that move in an ideal-free manner, we prove that the inclusion of an enemy-free sink shifts the population dynamics from diverging oscillations to stable oscillations. During these stable oscillations, the victim disperses in an oscillatory manner between the enemy-free sink and the enemy-occupied patch. Enemy-free sinks with lower mortality rates exhibit oscillations with smaller amplitudes and longer periods. A victimless sink, on the other hand, is a behavioral, physiological or ecological state in which the enemy has limited (or no) access to its victims. For enemies that move in an ideal-free manner, we prove that victimless sinks also stabilize diverging oscillations. Simulations suggest that suboptimal behavior due to information gathering or learning limitations amplify oscillations for systems with enemy-free sinks and dampen oscillations for systems with victimless sinks. These results illustrate that the coupling of a sink created by unstable enemy–victim interactions and a sink created by unsuitable environmental conditions can result in population persistence at the landscape level.