The Stability of Synthetic Cathinones and the Study of Potential Intake Biomarkers in the Biological Material from a Case of 3-CMC Poisoning.

The objective of the present study was to identify the metabolites of synthetic cathinone (SC), 3-chloromethcathinone (3-CMC), and to select a potential intake biomarker for this compound. The basis of the experiment was the analysis of blood and urine samples from a case of fatal poisoning with this substance. We also evaluated the stability of 3-CMC and the selected potential biomarker, the dihydro-3-CMC metabolite, depending on the time elapsed since the autopsy as well as the storage conditions of the biological material. Studies have shown that 3-CMC shows low stability in the biological material. However, acidification of the biological material or storage at low temperatures has a great impact on maintaining its stability. It is crucial to monitor the presence of the dihydro-3-CMC metabolite in the biological material during analysis, which showed high stability under all of the given storage conditions. SCs might not be detected in the biological material and, if they are, the determined concentrations at the time of testing may not correspond to the actual concentrations at the time of the event or death. Consequently, the interpretation of the results obtained for 3-CMC and dihydro-3-CMC in terms of assessing their toxicity and possible cause of death is difficult. The area of research into the search for other intake biomarkers of unstable halogen derivatives of SCs remains open.

The various pathological manifestations of a lightning strike exemplified in a single four-fatality incident - A case report and review of a literature.

The lightning strike is one of leading cases of weather-related death worldwide. We present an unusual case of four fatality-lightning strike with various pathological manifestations. All victims died from a single lightning strike in the mountains that also caused injury to 156 other people. All victims had mechanical damage and rock damage that are typical for lightning strikes in the mountainside. Another lesions indicative of lightning strike and electrical damage were, among others: burnt and torn clothes (all cases) current marks (Cases 1, 2 and 3) and Lichtenberg figures along with flashover marks on Case 1. In the review we described the pathophysiological mechanisms of lightning-induced lesions and injuries and epidemiological trends of lightning-strike deaths. Our study exemplifies various manifestations of lightning strikes on forensic examination and underlines the necessity to take lightning strike into consideration when investigating open-air deaths of unclear origin.

Post-aggression suicide under the influence of new psychoactive substances AMB-FUBINACA and U-47700.

The objective of the present study was the development and validation of the method for determining AMB-FUBINACA and its metabolite - AMB-FUBINACA O-desmethyl acid - in blood samples, followed by verification of the method in toxicological judicial and forensic medicine practice employing the example of post-aggression suicide. Most likely in consequence of development of adverse effects resulting in psychotic symptoms, a male being under the influence of the synthetic cannabinoid AMB-FUBINACA and the new synthetic opioid U-47700, mortally wounded his female partner and subsequently committed suicide. Identification and determination of the afore-mentioned xenobiotics in blood samples collected from the male and female victims were performed employing high performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS). The analytes were isolated from blood samples using the solid phase extraction (SPE) method. The blood samples collected from the male and female demonstrated respectively 110 and 196 ng/mL of AMB-FUBINACA O-desmethyl acid metabolite, 1935 and 357 ng/mL of U-47700, 250 and 200 ng/mL of N-desmethyl-U-47700, as well as 410 and 200 ng/mL of N,N-didesmethyl-U-47700. The concentration values of new psychoactive substances (NPS's) in blood samples originating from the male and female were within the ranges encountered in cases of poisoning, including these resulting in death. Nevertheless, the evident signs of exsanguination proof that the woman was alive when she sustained lethal injuries. The presented cases illustrate the difficult to be anticipated effect exerted on the users by NPS's.

Restraint asphyxia. An analysis of the circumstances and mechanism of death in agitated, physically restrained individuals. / Asfiksja restrykcyjna. Analiza okolicznosci i mechanizmu smierci osób pobudzonych psychoruchowo, w trakcie obezwladniania z uzyciem sily.

Recent years saw frequent media reports of young people who die while they are being arrested by the police. Death in these circumstances affects people who are agitated and restrained with the use of force, with their autopsies indicating no unequivocally traumatic cause of death. The goal of this study was to identify the mechanism and circumstances of sudden deaths in agitated individuals who are being restrained. Ten cases evaluated at our center since 2010 were included in this study: nine involved forensic postmortem examination and one involved casefile analysis. In each case there was sudden cardiac arrest or at least a loss of consciousness, and the cardiopulmonary resuscitation proved ineffective. In six cases the cause of agitation was acute psychosis, in four it was an effect of narcotics, usually in high concentration. Conjunctival petechiae were detected in only five cases. The most probable cause of death in the evaluated cases was the combination of physical exertion caused by pathological psychomotor agitation and forcible restraint, hindering the function of the respiratory system. This mechanism is known as restraint asphyxia.

Bioeconomy development factors in the European Union and Poland.

Bioeconomy is not an autonomous sector of the economy, but rather a complex mechanism involving agriculture, industry, biotechnology, service sectors and consumers. To measure the size of the bioeconomy in European Union (EU) countries, it is necessary to create appropriate indicators that allow it to be monitored with reference to its current state, growth rate and sector description. In many countries, including Poland, there is no complete information or data collection system to monitor bioeconomy development directly, e.g. in the Polish Central Statistical Office. In response to these needs, several groups of indicators related to the circular economy, sustainable development and Europe 2020 were created by the European Commission (EC) in the Eurostat database. These indicators can help monitoring of bioeconomy development in EU countries. The present study discusses factors for bioeconomy development through an analysis of their social, economic and environmental aspects, as well as showing the value of the selected indicators in the EU and Poland. In addition, a separate section is dedicated to public perception of bioeconomy and to legislation regarding genetically modified organisms (GMOs). To date, many research studies have been reported on the public acceptance of bioeconomy issues in the EU, including renewable resources, biofuels, GMOs, bio-based products, food security and climate change. The awareness and perception of society on the bioeconomy, bio-based products and processes, and the sustainable use of resources can contribute to environmental sustainability, but intensified efforts are required to increase public acceptance.

Legal and practical challenges to authorization of gene edited plants in the EU.

According to a predominant interpretation of the C-528/16 judgment of the Court of Justice of the European Union, mutants resulting from gene editing, even those featuring only single nucleotide variants, should be subject to the authorization procedures designed for organisms developed through genetic modification (i.e. insertion of large DNA fragments). In this article, we illustrate practical problems with the authorization of products of gene editing in the EU. On the basis of these problems, we analyze the influence of the current interpretation of EU legislation and judgment on the practical ability to authorize and detect such products on the EU market. We show that the predominant interpretation of the judgment leads to legally unacceptable consequences, in particular to the violation of the principle of proportionality with regard to individuals who wish to develop and market products of gene editing. As a result of our considerations, we show that the C-528/16 judgment did not need to be interpreted in the dominant way.

The Rapeseed Potential in Poland and Germany in the Context of Production, Legislation, and Intellectual Property Rights.

Rapeseed is an essential crop which is used in many different areas as edible oil, biodiesel, lubricant, and feed. It is one of the most popular oil crops in Europe (63% of oilseeds production in 2017). The current study highlights the potential for further rapeseed development in European Union (EU), with special emphasis on Germany (19% of EU production) and Poland (12% of EU production). The study focused on three factors: cultivation area, volume of production and the numbers of Intellectual Property Rights (IPR), particularly patents granted for rapeseed or rapeseed-related inventions and plant variety rights. Possible further obstacles to development, such as current legal framework, were also taken under consideration. The analyzed statistical data shows that both the cultivation area, as well as the volume of production of rapeseed fluctuated in the last decade in both examined countries, while the numbers for European patent publications and Community Plant Variety Rights showed a rising trend, indicating investments in the Research and Development (R&D) of the crop. The data analysis seems to confirm a hypothesis that there is a potential for the development of rapeseed as a versatile, multi-use crop; however, the current EU GMO policies and a legal uncertainty as to the status of products of certain modern gene editing techniques may hamper making optimal use of this potential.

Relation between Headache and Mastication Muscle Tone in Adolescents.

Headache is a common problem in the population, which decreases the quality of life and makes everyday functioning difficult. It often coexists with typical symptoms of temporomandibular disorders. The objective of the study was to clarify whether there is a relationship between the presence of headache in young volunteers and the mastication muscle tone. Material and Method. Volunteers aged 18 years who underwent general dental examination, clinical evaluation, and examination using the dual-axis diagnostic system Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) form in the Polish language version participated in the study. On the basis of the examination results, these individuals were divided into three groups according to RDC results. A group of healthy individuals (axis I value 0), a group of sick individuals (axis I diagnosis Ia, IIa, or IIIa), and a group of individuals suffering from depression (axis II values 1-3) were singled out. Then, volunteers were divided into two groups: group I reporting headache and group II without any pain. In each of these individuals, the contractile activity of the masseter muscles and anterior temporal muscles was recorded bilaterally as the surface electromyographic activity (sEMG) at rest, during swallowing, and maximum clenching. The activity index ranging between +100 (activity of the masseter muscles only) and -100 (activity of the anterior temporal muscles only) was used to indicate the predominance of activity of the study muscles. Results. The statistical analysis of data showed that there was a significant relationship between the presence of headache and a change in the mastication muscle tone, expressed as the predominant activity of the temporal muscles, only in the group of sick individuals during maximum clenching. Summary. The diversity of sEMG results implies that a change in the mastication muscle tone is not a direct consequence of headache, but it has to be modified by other factors.

Towards Food Security: Current State and Future Prospects of Agrobiotechnology.

The consistent increase in the global population, estimated to reach 9 billion people by 2050, poses a serious challenge for the achievement of global food security. Therefore, the need to feed an increasing world population and to respond adequately to the effects of climate change must be urgently considered. Progress may be achieved by applying knowledge of molecular and genetic mechanisms to create and/or improve agricultural and industrial processes. We highlight the importance of crops (wheat, maize, rice, rapeseed, and soybean) to the development of sustainable agriculture and agrobiotechnology in the EU and discuss possible solutions for ensuring food security, while also considering their social acceptance.

The bioeconomy in Poland within the context of the European Union.

This article outlines the potential of the development of bioeconomy in Poland in the context of the European Union (EU). The analyses take into account the concept of bioeconomy, the overview of documents referring to the bioeconomy in the EU, including policy frameworks and agendas. Many countries including Poland emphasise the importance of bioeconomy, but have not yet developed a complex strategy. The state of bioeconomy in Poland is characterised by the sectors of agriculture, forestry and food production, as well as parts of the chemical, biotechnology and energy industries. In 2014 the global production volume in the Polish bioeconomy amounted to PLN 343 billion with the sector employing almost 3 million staff. However, the structure of the bioeconomy is dominated by traditional sectors, such as agriculture and agro-food industries. This article presents the analysis of research and development activity in Poland from 2009 to 2015. It reports the position of Poland on GMOs and their future development potential. It is worth mentioning that many EU states including Poland have declared themselves as being "GMO-free countries".

The current state of bioeconomy in Poland.

Conversion of scientific achievements to market a product is a key issue and the best description of significance of science for society. In the case of experts in the natural sciences in Poland, we observe a high intellectual potential of researchers and several scientific discoveries. However, Polish inventions are very rarely available on the market and the number of national and international patent applications done by Polish scientists is very limited. For the development of bioeconomy, the progress in biotechnology is critical.

Satisfaction with Life and Social Factors in Decision-Making Proces on Breast Reconstruction in Women after Mastectomy.

The aim of the study was to analyse the correlation between satisfaction with life in women after mastectomy and motivation to undergo breast reconstruction, compared to women who after breast amputation did not decide to undergo reconstructive treatment. MATERIAL AND METHODS: Comparative analysis comprised patients after mastectomy, who decided on breast reconstruction (40) and those who did not undergo reconstructive surgery (40). The study was conducted in the Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Lodz and Department of Oncological surgery and Breast Diseases ICZMP, Lódz, between 2013-2015. In the study the question whether higher satisfaction with life prompts decision on breast reconstruction was investigated. The Satisfaction with Life Scale (SWLS) was used, as well as an original questionnaire. The correlations between statistical parameters were evaluated using the chi-square test. RESULTS: We have demonstrated differences between the level of satisfaction with life in patients who decided to undergo breast reconstruction and those who did not choose reconstructive surgery. The discrepancies may reflect differences in the system of values and level of satisfaction with life before reconstructive treatment and also point to potential effect of these factors on the decision to undergo surgery. CONCLUSIONS: 1. Differences in cognitive structures between 'Amazons' determine the decision on reconstructive treatment. 2. Transfer of information between the therapeutic team and women after mastectomy is not satisfactory. 3. Higher level of satisfaction with life has a positive effect on the decision of breast reconstruction.

Whole-body post-mortem computed tomography angiography of a newborn revealing transposition of great arteries.

The number of medico-legal post-mortem examinations referring to newborns is considerably low: In the case of the Chair and Department of Forensic Medicine of the author's origin, the autopsy rate of such cases is less than 1%. Even experienced forensic pathologists can find the technical autopsy procedure of a newborn quite difficult. Post-mortem imaging using unenhanced post-mortem computed tomography (PMCT) gives only a limited opportunity to help in conventional autopsy examination. By adding contrast medium (CA) administration, we can significantly expand diagnostic capabilities. However, the post-mortem computed tomography angiography (PMCTA) technique has already been developed mostly in adult death cases (as considerably much more frequent), and no standardised protocol for examination of children exists. The authors present the dual-phase PMCTA examination of a newborn by manual CA administration using the access to umbilical vessels (vein and artery) unveiling transposition of the great arteries (TGA). The results are presented as multiplanar reformatted (MPR) images and three-dimensional (3D) images by volume/surface-rendered reconstructions, giving a contribution towards proving the value of forensic imaging in post-mortem examinations of heart and vascular malformations in newborns.

Imaging for homicide investigations.

The authors present the opportunities of the application of post-mortem imaging, focusing on post-mortem computed tomography and post-mortem computed tomography angiography in modern forensic investigation of homicide cases. The paper is based on scientific publications related to the subject from ca. the past 10 years, supplemented by the authors' own experiences. The article is illustrated with reconstructions based on the authors' own cases related to homicide due to ballistic/sharp/blunt trauma. As is shown, the results of evaluation of post-mortem computed tomography allow better diagnosis, documentation and visualisation of forensic examinations.

Renal tumors in unselected forensic post-mortem material.

The frequency of clinically evident renal tumors is increasing, due to an actual increase in incidence, but also due to an improvement in detection methods. The aim of the present study was to analyze the incidence of renal tumors in an unselected autopsy series. A search for renal tumors was conducted based on the autopsy reports from the Department of Forensic Medicine. The slides were reviewed and reclassified according to current criteria. Among 14,904 autopsies, 80 renal tumors were found. The most frequent tumor types were clear cell carcinomas (41%), papillary carcinomas (18%) and cortical adenomas (19%). There were 66 males and 14 females. The average age was 57.83 for males and 62.86 for females. The characteristics of the study group were not exactly identical but similar to other autopsy series, and significantly different from surgical series.

Three-dimensional dosimetry of the full and empty bladder in high dose rate vaginal cuff brachytherapy.

OBJECTIVES: The objectives of the study were to assess the bladder doses during vaginal cuff brachytherapy and to examine the effect of bladder filling on normal tissue dosimetry by means of computed tomography. MATERIALS AND METHODS: A total number of 45 women were enrolled in a prospective clinical trial. Patients were treated with the application of a single-line source vaginal cylinder. All the patients were asked to consume 400 mL of water 40 minutes before computed tomography scans were taken. For each patient, 2 treatment plans were performed-one with full bladder and the other one when the bladder was emptied. A dose-volume histogram and the equivalent of 2-Gy dose for full and empty bladder were calculated. Doses to the bowels in 2 states of the bladder were estimated. RESULTS: Thirty-five patients received a lower dose to the empty bladder than to the filled organ. The average dose difference was 0.5 Gy. Ten patients received a lower dose to the full bladder than to the empty one. However, in this case, the difference amounted only to 0.2 Gy on average. Dose parameters (the maximal dose received by 0.1 cm of tissue and the maximal dose received by 2 cm of tissue) were lower in the empty state, but the volumetric parameters (the percent of bladder volume receiving ≥50% of the prescribed dose and the percent of bladder volume receiving ≥80% of the prescribed dose) were higher in the empty state of the bladder. Doses to the bowels seemed to be higher in the empty bladder. However, none of the doses exceeded the limitations. CONCLUSIONS: The results have shown that in most cases, the dose to the empty bladder is lower than when the bladder is full. Simultaneously, the doses to the bowels increase proportionally in the empty state of the bladder comparing to the full organ. Protection of the bowels, which are more radiosensitive, suggests treating the patients in the full state of the bladder. Early and late bowel toxicity should be investigated to establish clear standards of treatment.

Low malignancy risk of thyroid follicular lesion of undetermined significance in patients from post-endemic areas.

OBJECTIVE: New classification of the thyroid fine-needle aspiration biopsy (FNAB) results tries to stratify the risk of malignancy of thyroid follicular lesions using 'follicular lesion of undetermined significance' (FLUS) subcategory. Clinical significance of this category in the endemic (or post-endemic) areas has not been clearly established. DESIGN: The aim of the study was to determine the risk of malignancy for FLUS as well as to evaluate ultrasound (US) malignancy risk features (MRF) in such nodules in comparison with 'suspicious for neoplasm' (SFN) and 'benign lesions' (BL). METHODS: The US images and cytological diagnoses of 589 thyroid follicular lesions were analysed from January 2010 to July 2012. Cytological follow-up was assessed in 110 cases and surgical one in 100 cases. RESULTS: FLUS was diagnosed in 340 cases (3.8% of all cytological diagnoses and 57% of thyroid follicular lesions). Altogether, clinical and/or surgical follow-up revealed thyroid cancer in 3.2% patients with FLUS nodules. Repeat FNAB led to more specific diagnosis in 74.4% of FLUS (3.5%, papillary cancers or their suspicion; 2.3%, SFN; 68.6%, BL). The histopathological examination showed thyroid cancer in 6.4% cases of FLUS and 7.0% of SFN and follicular adenoma in 8.5% of FLUS and 11.6% of SFN (NS, FLUS vs SFN). FLUS showed MRF of intermediate values between BL and SFN; SFN more often than FLUS showed at least two MRF (53 vs 30%, P<0.0001). CONCLUSIONS: The risk of cancer in FLUS in areas with recently corrected iodine supply is low. In such areas, repeated biopsy leads to more precise cytological diagnosis in about 3/4 cases.

Weapon identification using antemortem computed tomography with virtual 3D and rapid prototype modeling--a report in a case of blunt force head injury.

A frequent request of a prosecutor referring to forensic autopsy is to determine the mechanism of an injury and to identify the weapons used to cause those injuries. This task could be problematic in many ways, including changes in the primary injury caused by medical intervention and the process of healing. To accomplish this task, the forensic pathologist has to gather all possible information during the post-mortem examination. The more data is collected, the easier it is to obtain an accurate answer to the prosecutor's question. The authors present a case of head injuries that the victim sustained under unknown circumstances. The patient underwent neurosurgical treatment which resulted in alteration of the bone fracture pattern. The only way to evaluate this injury was to analyze antemortem clinical data, especially CT scans, with virtual 3D reconstruction of the fractured skull. A physical model of a part of the broken skull was created with the use of 3D printing. These advanced techniques, applied for the first time in Poland for forensic purposes, allowed investigators to extract enough data to develop a hypothesis about the mechanism of injury and the weapon most likely used.

The influence of fine-needle aspiration biopsy of the thyroid gland on the size of the examined nodule and its ultrasound image.

INTRODUCTION: The aim of the study was to assess the influence of thyroid fine-needle aspiration biopsy (FNAB) on the size and ultrasound (US) features of the lesions and to examine whether the possible effects are persistent. MATERIAL AND METHODS: One hundred and fifty biopsied and 50 control thyroid nodules underwent two US examinations, 10-20 days and 8-10 weeks after the biopsy. The study took into account lesion volume alterations, both absolute and relative (with reference to its initial value), and the presence of US features of malignancy: hypoechogenicity, microcalcifications, internal blood flow, irregular or blurred margins and suspicious shape of the lesions. The analysis covered only those nodules which immediately after FNAB did not change their appearance owing to cyst fluid evacuation or intranodular hemorrhage. RESULTS: The increase of the lesion volume was more frequent in the group of biopsied lesions than the control one (58.0% vs. 24.0%, p < 0.0001) with the highest increase of 61.5%. The mean change percentage, however, was determined below 5% and a tendency of the lesions to resume their initial volume was noticeable. Neither a persistent increase in nodule volume of above 50% nor significant changes in the presence of malignancy suggestive US features were observed after FNAB. None of the biopsied nodules developed any microcalcifications, irregular or blurred margins, internal blood flow, or suspicious shape. CONCLUSIONS: Fine-needle aspiration biopsy does not cause permanent changes in the US image of biopsied lesions, provided that the sampling technique is appropriate and there are no significant changes observed during the biopsy.

[Validity of post-mortem computed tomography angiography (PMCTA) in medico-legal diagnostic management of stab and incised wounds]. / Przydatnosc posmiertnego badania tomografii komputerowej z angiografia (PMCTA) w sadowo-lekarskiej diagnostyce przypadków ran klutych i cietych.

The report presents an analysis of results of multi-phase post-mortem computed tomography angiography (MPMCTA) scans performed at the Chair of Forensic Medicine, Jagiellonian University Medical College, in cases of stab wounds and incised wounds, as confronted with the results of conventional medico-legal autopsies. The analysis of the material points to a validity of PMCTA scans as supplementing post-mortem medico-legal examinations and being capable of providing significant data that affect final conclusions and adding new quality to recording post-mortem observations.