Overturned abusive head trauma and shaken baby syndrome convictions in the United States: Prevalence, legal basis, and medical evidence.

BACKGROUND: Media reports and the Innocence Network assert that wrongful Abusive Head Trauma (AHT)/Shaken Baby Syndrome (SBS) convictions pervade the United States (U.S.) criminal justice system. Yet, no empirical evaluation of overturned AHT/SBS convictions has been conducted. OBJECTIVE: To evaluate the prevalence, legal basis, and characteristics of appellate rulings of AHT/SBS convictions. PARTICIPANTS AND SETTING: U.S. appellate cases in a legal database, Westlaw. METHODS: Retrospective review of AHT/SBS convictions that had appellate rulings from January 2008 through December 2018. Multiple search terms ensured all potential AHT/SBS cases were included. A mixed-methods analysis was conducted on overturned AHT/SBS convictions. RESULTS: We identified a total of 1431 unique AHT/SBS criminal convictions that had appellate rulings since 2008. Of those, 49 convictions (3%) were overturned, and 1382 (97%) were affirmed/upheld. Of those overturned, 20 cases (1% overall) were overturned on medical evidence-related grounds. The most common themes from the medical evidence-related reversals were controversy over the AHT/SBS diagnosis (n = 12) and accidental injury mechanism (n = 11). After being overturned on appeal, upon retrial, 42% of defendants either re-plead guilty to or were convicted again of the same offense. CONCLUSION(S): AHT/SBS convictions are rarely overturned on medical evidence-related grounds. When overturned, medical evidence-related themes seldom reflect new scientific or clinical discoveries, but rather are alternative or differing medical opinions from those offered at the original trial. Our data tends to support the concerns of other authors regarding irresponsible communication of medical information in AHT/SBS cases.

How Do the Etching Mode and Thermomechanical Loading Influence the Marginal Integrity of Universal Adhesives?

OBJECTIVE: This study evaluated the effect of etching mode and thermomechanical loading on universal adhesives. METHODS AND MATERIALS: Two universal adhesives, Peak Universal and Adhese Universal, were used in two etching modes as the experimental groups: Peak Universal etch-and-rinse (PER), Peak Universal self-etch (PSE), Adhese Universal etch-and-rinse (AER), and Adhese Universal self-etch (ASE). Two adhesives considered gold standards were used as control groups: OptiBond FL (OER) was used as a control group for the etch-and-rinse (ER) mode, and Clearfil SE Bond (CSE) was used as a control group for the self-etch (SE) mode. Standardized class V cavities were created on the buccal and lingual surface in 30 extracted caries-free human third molars. Each adhesive and resin composite was applied according to the manufacturer's instructions. The specimens were subjected to thermomechanical loading (TML) immediately after the fillings were placed. Before and after TML, replicas and photographs of the fillings were performed and evaluated quantitatively and qualitatively. The Mann-Whitney U-test or Kruskal-Wallis test was used for quantitative analyses, and Fisher exact test was used for qualitative analysis. RESULTS: Adhese Universal achieved a significantly higher percentage of continuous margin in the enamel than Peak Universal for the two types of etching both before and after TML (except for the SE group after TML). In dentin, the greatest percentage of continuous margin was achieved for Adhese Universal in the ER group (100%) before TML and for both universal adhesives in the SE groups (61%) after TML. For both etching modes and both time points, Adhese Universal had a greater percentage of continuous margin than Peak Universal for the whole margin. For the ER approach, significant differences were observed both before and after TML, and for the SE approach, significant differences were observed before TML. TML did not cause a significant decrease in the percentage of continuous margin in the enamel, but the results were the opposite in dentin. A qualitative assessment using World Dental Federation criteria did not show statistically significant differences between the groups. CONCLUSIONS: Scanning electron microscope assessment of marginal integrity showed that the evaluated factors such as etching mode and TML significantly influenced the marginal integrity of the universal adhesives. The replica method shows that laboratory and clinical assessment methods complement each other and give a broader view of marginal integrity.

[Uterine myoma complicated by cavernous lymphatic angioma of the liver]. / Miesniaki macicy powiklane naczyniakiem jamisto-chlonnym watroby.

In the article we present the case of fibroids complicated by a tumor derived from the left subcostal area and reached the corpus of uterus. The unquestionable diagnosis of tumor character and its origin could not be stated. Impossibility of laparoscopic examination caused decision of laparotomy. The tumor derived from the left liver lobe with dimensions of 26-31-11 cm and weight of 3.76 kg was discovered. The whole tumor was removed. Hist-path, evaluation of the tumor was: liver cavernosus angioma. The whole uterus with adnexa was removed.