1,720,964 research outputs found
Driving under the influence of cannabis: A 5-year retrospective Italian study
Full text linkIntroduction: Cannabis consumption is associated with driving impairment and increased crash risk, endangering road safety. Toxicological analyses play a fundamental role in detecting a recent consumption of psychoactive substances. The aim of this study was to examine the concentration of cannabinoids in blood samples of drivingunder-the-influence (DUI) offenders in order to investigate whether delayed sample collection affects the toxicological assessment of the offenders.Materials and Methods: An observational retrospective study was performed using anonymized toxicological data referring to cannabis-related DUI offenders involved in road traffic accidents (RTA) or apprehended by the police from 1 January 2017-31 December 2021 archived at Legal Medicine and Toxicology Department of the University Hospital of Padova, Italy.Results: In a total sample of 318 drivers, 143 blood samples tested positive for tetrahydrocannabinol (THC) and metabolites 11-hydroxy-A9-tetrahydrocannabinol (11-OH-THC) and 11-nor-A9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH), and 173 blood samples were positive for THC-COOH with THC negative. In the first group, the mean concentrations of THC and THC-COOH were 4.05 ng/mL and 28.29 ng/mL, respectively. In THC-negative cases, the mean THC-COOH concentration was 7.3 ng/mL. The time elapsed between the event and sample collection varied from 15 min to 7 h (mean 2 h 29 min). The average estimated time elapsed after consumption of cannabinoids was 3 h 7 min (Model I) and 2 h 36 min (Model II).Conclusions: The present research discussed the main difficulties in the toxicological evaluation of drivers under the influence of Cannabis. Issues related to the time between RTA and sample collection, the laws and legal limits in force in various Countries were presente
AI and professional liability assessment in healthcare. A revolution in legal medicine?
Full text linkThe adoption of advanced artificial intelligence (AI) systems in healthcare
is transforming the healthcare-delivery landscape. Artificial intelligence may
enhance patient safety and improve healthcare outcomes, but it presents
notable ethical and legal dilemmas. Moreover, as AI streamlines the analysis
of the multitude of factors relevant to malpractice claims, including informed
consent, adherence to standards of care, and causation, the evaluation of
professional liability might also benefit from its use. Beginning with an analysis
of the basic steps in assessing professional liability, this article examines the
potential new medical-legal issues that an expert witness may encounter
when analyzing malpractice cases and the potential integration of AI in this
context. These changes related to the use of integrated AI, will necessitate
efforts on the part of judges, experts, and clinicians, and may require new
legislative regulations. A new expert witness will be likely necessary in the
evaluation of professional liability cases. On the one hand, artificial intelligence
will support the expert witness; however, on the other hand, it will introduce
specific elements into the activities of healthcare workers. These elements will
necessitate an expert witness with a specialized cultural background. Examining
the steps of professional liability assessment indicates that the likely path for AI
in legal medicine involves its role as a collaborative and integrated tool. The
combination of AI with human judgment in these assessments can enhance
comprehensiveness and fairness. However, it is imperative to adopt a cautious
and balanced approach to prevent complete automation in this field
Driving license regranting: Hair EtG, serum CDT, and the role of sociodemographic and medicolegal variables
No full textDriving under the influence (DUI) of alcohol is a road safety problem. Driving license regranting is based on the evaluation of medicolegal and toxicological variables that may include serum carbohydrate-deficient transferrin (CDT) and hair ethyl glucuronide (hEtG).The aim of the study was to compare the diagnostic performance of CDT and hEtG in a population of DUI offenders. Other factors potentially associated with heavy alcohol use were explored. The population included DUI offenders examined during the period of January 1, 2019, through June 30, 2022. Sociodemographic, medicolegal, and toxicological variables were collected. CDT in serum and EtG in head hair were determined in all subjects. Excessive alcohol intake (hEtG >= 30 pg/mg) was considered cause for unfitness to drive. Cohen's kappa coefficient was calculated. Descriptive analyses were performed using chi-square and Mann-Whitney tests. Variables significantly different between the groups were included in a multivariate binary logistic regression model. The sample encompassed 838 subjects (case group: 179, comparison group: 689). CDT exhibited poor agreement (kappa = 0.053) with hEtG as the reference test. Lower education, age at DUI, heavy smoking, and GGT levels associated with heavy alcohol consumption differentiated the two groups. For DUI offenders, the use of CDT to assess heavy alcohol consumption is limited, possibly due to the time-window assessed, the time required for normalization, and the different amount of ethanol needed to reach higher CDT levels, in comparison to hEtG; thus, hEtG assessment is strongly recommended for this population. Heavy smoking, GGT, education, and age could be related to heavy alcohol consumption and higher risk of DUI
Entrapment within an ottoman storage bed: an unusual accidental asphyxial death
Full text linkHerein, we present an uncommon forensic case of death by asphyxia. The victim was a woman whose body at death scene investigation (DSI) was discovered beside an ottoman storage bed. According to the rescue team, who had moved the body before our arrival, the body was originally found in the prone position and stuck with the neck, thorax and arms within the bed. Examination of the body showed hypostasis that was mainly distributed to the face and the lower chest while sparing the neck and the upper chest. The face was markedly swollen, and the eyes were congested with blood. Dissection and histology revealed pulmonary oedema and emphysema of both lungs. Integrating circumstantial, radiology and autopsy data, it was established that the victim, while trapped between the mattress and the edge of the ottoman storage bed, died by mechanical asphyxia due to cervical-thoracic compression and postural asphyxia acting simultaneously
Driving impairment due to psychoactive substances and attention deficit disorder: A pilot study
Full text linkObjective: Attention disorder and substance use disorder are linked to driving impairment and
increased road crash involvement. This study explores attention deficits in a population of drivers
found driving under the influence (DUI) of psychoactive substances.
Methods: A case-control study was conducted comparing subjects with a previous DUI episode
(cases) to subjects who were negative for DUI offenses (controls). Personal, socio-demographic,
and DUI data were collected for both groups. All subjects were administered the Continuous
Performance Test–third edition (CPT-3), which measures dimensions of attention, including
inattentiveness, impulsivity, sustained attention, and vigilance. Possible associations with a
previous DUI episode, the use of illicit substances or excessive alcohol use, and road crash
involvement were analyzed statistically.
Results: Overall, the study included 147 subjects (100 cases, 47 controls). The parameter distributions
of detectability, probability of ADHD, and inattentiveness indicated statistical differences
between the two groups. No attention deficits predicted substance use disorder or excessive
alcohol consumption. Inattentiveness was an independent risk factor for previous road collision
involvement.
Conclusions: The results suggest that alterations exist in some attention dimensions in a population
of DUI subjects who were users of alcohol or other psychoactive substances and involved in road
traffic crashes. The CPT-3 had successfully distinguished between the two study groups, and after
validation, it could be useful in the process of reinstating a driver’s license. Future research
should expand the study sample to better understand the relevance of the proposed methodological
approach in terms of prevention, rehabilitation, and the monitoring of subjects evaluated
for driving eligibility requirements
Sex differences and driving impairment related to psychoactive substances
No full textObjective: The first aim of the study was to identify sex differences in the use of psychoactive substances among subjects with a previous driving under the influence (DUI) episode. The secondary objective was to propose specific strategies for medico-legal improvements. Methods: This was a retrospective observational study that took place between June 1, 2019, and August 31, 2023. It was conducted on DUI subjects examined for reinstatement of their driver's license using an integrated medico-legal and toxicological approach. Ethyl glucuronide (EtG) and illicit psychoactive substances were determined from hair samples. We performed descriptive statistical analyses for the entire sample as well as separately by sex. Additionally, we conducted binary logistic regression analyses separately for males and females to identify protective/risk factors associated with previous road accidents and judgments of unfitness to drive due to excessive alcohol consumption (EtG ≥ 30 pg/mg). Results: The study included 2,221 subjects, comprising 1,970 men and 251 women. Men exhibited a higher prevalence of tobacco, alcohol, and illicit psychoactive substance use. Women were more frequently co-users of alcohol and psychoactive substances and involved in road accidents at the time of DUI. Among the men, being married or having a partner was found to be a protective factor concerning past traffic accidents. For both sexes, a DUI episode with a blood alcohol concentration (BAC) exceeding 1.5 g/L or the co-ingestion of alcohol and drugs was identified as a risk factor for road accident involvement. For men, smoking more than 20 cigarettes per day and, for women, having a DUI episode with a BAC over 1.5 g/L were the main factors indicating unfitness to drive, as determined through high hair EtG levels (> 30 pg/mg). Women with a previous history of road accidents were less likely to have EtG levels of 30 pg/mg or more. Conclusions: The study confirmed sex differences in subjects with a previous DUI episode. A BAC exceeding 1.5 g/L or the simultaneous use of alcohol and drugs at the time of DUI necessitate careful assessment of both men and women seeking driver's license reinstatement. In women, a BAC exceeding 1.5 g/L is considered a risk factor for a subsequent judgment of unfitness to drive. The medico-legal assessment should also involve a thorough investigation of smoking habits in men, as these habits could be related to an increased risk of excessive alcohol consumption
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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