Bridging the gap between academia and practice: Perspectives from two large-scale and niche research projects in Canada.

There is a recognized disconnect in priority and synergy between academic and practitioners in forensic science. In this work, we personally reflect on our experiences in conducting research studies that directly involve academic and practitioner stakeholders. We believe, amongst others, that this "gap" can be mitigated through regular and productive communication. We also emphasize the need to create stronger and national research strategies which identifies the current and pressing needs of enforcement officials in order to bring these needs directly to academia. As part of this, researchers should actively seek to make sure what they study will be relevant within the discipline. Our reflection is geared on direct feedback from an entomological study in large scale sampling of blowflies and workshops in bloodstain pattern analysis using a forensic blood substitute.

Robust estimation for area of origin in bloodstain pattern analysis via directional analysis.

Directional analysis provides quantitative data supporting the three-dimensional estimation of the area of origin for impact bloodstain pattern analysis. The final stage of directional analysis consists of calculating the point of origin via the arithmetic mean of top-view intersecting points and side-view heights of the virtual trajectories of single stains within the impact pattern. Given the sensitivity of the mean to the presence of outliers (droplets that have been influenced by gravitational force and aerodynamic drag), it is natural to ask whether directional analysis can be made more robust by modifying the averaging procedure. In this paper we focus our attention on two robust alternatives to the arithmetic mean: the trimmed mean and a deterministic version of the RANSAC algorithm. Our results suggest that the trimmed mean is a practical robust alternative to the arithmetic mean, whereas the deterministic RANSAC procedure is not. Since there can be no guarantee that stain selection can be free of outliers, the trimmed mean can be used as an aide in their detection. Moreover, our analysis reveals that the trimmed mean can also be used to detect outliers among the points of intersection of trajectories. Outliers of this type occur as the intersection points of trajectories emanating from stains with nearly vertical paths.

[Dermal necrosis as cutaneous manifestation of heparin-induced thrombocytopenia II?]. / Hautnekrose als kutane Manifestation einer heparininduzierten Thrombopenie Typ II?

Most of the rare cases of skin necrosis following heparin injections are associated with the immunologically mediated form of heparin-induced thrombocytopenia II (HIT II). We present a 62-year- old woman who developed a necrotic abdominal lesion seven days after starting daily subcutaneous injections of the low molecular heparin enoxaparin. We detected circulating antibodies against the platelet factor 4-complex but no concomitant thrombocytopenia. An isolated, antibody-mediated thrombosis of dermal vessels is the likely underlying cause of the skin necrosis in HIT II.

[Hyperkeratotic plaques and generalized pruritus in a 47 year-old man]. / Borkenkrusten und generalisierter Juckreiz bei einem 47-jährigen Mann.

A 47-year-old man presented with generalized pruritic lesions that had persisted for 2 years and shown no response to therapy with topical corticosteroids. The identification of numerous mites in the patient's scales led to the diagnosis of crusted scabies. The lesions responded to systemic therapy with Ivermectin (Stromectol) and topical application of Permethrin (InfectoScab). As underlying factors we suspect the immunosuppressive therapy attempts with topical corticosteroids as well as alcohol abuse.

[Hepatitis B virus markers and anti-HCV antibodies in hemodialyzed patients]. / Hepatitis B vírus markerek és az anti-HCV ellenanyag vizsgálata hemodializált betegekben.

Serum samples from 155 patients on haemodialysis were examined for markers of hepatitis B and C. Abbott and Ortho Elisa tests were used for the determinations. ALT levels were analysed at the same time. Of the 345 random blood donors and 366 prisoners examined, 1.44% proved to be anti-HCV antibody positive. 13 medical staff workers of 147 were found to be positive for anti-HCV antibody (19.1%). In patients on chronic haemodialysis 41.29% anti-HCV antibody prevalence was found. The prevalence of anti-HBc and anti-HCV antibodies in correlation with the number of transfusions was examined as well, in serums of chronic uraemic patients. Anti-HBc antibody prevalence was significantly higher in the polytransfused group (p less than 0.01), compared to the group without transfusion. There were no correlation between the number of transfusions and anti-HCV antibody occurrence. ALT values were in correlation with HBV and HCV seropositives. Elevated ALT levels were found in patients with HBV and/or HCV infection. In conclusion, screening for HBV and HCV markers among patients receiving blood, blood donors and medical staff workers seems to be necessary in the future. The results suggest the determination of anti-HBc to be an early and common marker of hepatitis B and C and the frequent occurrence of nosocomial transmission and the importance of prevention at high risk patients.

Initial clinical experience with centrifugal pumps coated with the Carmeda process.

From September 5 to November 4, 1991, four consecutive patients placed on centrifugal ventricular assist devices (VADs) for cardiac failure were supported with Biomedicus pumps coated with the Carmeda bioactive surface. The study included three men and one woman aged 52-65 years. Two patients were supported with a right VAD, one with a left VAD, and one with a biventricular VAD. Support ranged from 35.5 to 65.75 hr, and VAD flows ranged from 1.0-5.5 L/min. Three patients were weaned from the VADs, and two survived. At explant, all four systems had clots adherent to the surface of the tubing and connectors on the pump outflow side of the circuit. Two patients had clots in the pump. Some of the clots were firmly adherent, whereas others dislodged easily after being rinsed with saline. All patients received heparin for insertion, and in three patients, heparin was reversed with protamine. Two patients received no further anticoagulation, and two received continuous heparin within 24 hr of implant to maintain activated clotting times of 140-150 sec. All patients had bleeding complications before and after VAD placement, necessitating multiple blood product transfusions. One patient who was weaned and survived had multiple thromboembolic strokes. These data suggest that clots can form on surfaces coated with the Carmeda process, even if a low dosage of heparin is used.

[Incidence of the anti-N-like antibodies in the serum of patients dialyzed for chronic uremia]. / Az anti-N-szerü ellenanyag elöfordulása krónikus uraemiás dializált betegek szérumában.

The authors examined the serum of 164 hemodialysed chronic uremic patients for the detection of anti-N-like antibodies in two time intervals (in 1982 and 1988). The hemodialysis treatment was done in both intervals with regenerated, formaline-sterilized capillary dialysers. In 1982 antibodies could be detected in 5 out of 44 patients (11.3%) while in 1988 the ratio was 3 out of 120 (2.5%). The control group consisted of 40 healthy blood donors and 27 such dialysed patients who were treated only with new, ethylene oxide-sterilized single use capillary dialysers. The special cold agglutinine was not detectable in the serum of the subjects of the control group.

Prevalence of antibody to hepatitis C virus in blood donors, high-risk groups and patients with liver diseases in Hungary. A multicentre study using ABBOTT EIA test and a comparison with an ORTHO ELISA test system.

Serum samples from 1185 individuals (blood donors, health-care workers, patients on haemodialysis, those from other high-risk groups and those suffering from non-A, non-B hepatitis or other liver diseases) were examined for antibody to a recombinant HCV antigen. An ABBOTT HCV EIA system was used throughout and in addition a parallel study with ORTHO HCV ELISA was done in 380 of the samples to compare the two anti-HCV tests. A confirmatory neutralizing ABBOTT ELISA probe was also performed in 45 cases. The anti-HCV test was positive in 1.60% of the healthy blood donors and in 9% of subjects excluded from donation for elevated aminotransferase. In patients on haemodialysis 47%, in other high-risk-group subjects 33% anti-HCV prevalence was found. Patients with acute and chronic post-transfusion NANB hepatitis showed 40% and 70% prevalence, respectively. The two ELISA tests revealed 95% agreement in the parallel determinations. Serial end-point-dilution studies of anti-HCV-positive sera suggest that the ABBOTT test was of superior sensitivity. The results of the confirmatory test suggest that reactive (positive) samples of low optical density near to the cut-off value, required a confirmation with the naturalization test. HCV infection seems to be a common aetiological factor in PT-NANB hepatitis in Hungary, therefore, screening of blood donors for anti-HCV may be justified.