[Died from or with dementia? The relationship between dementia and cause of death]. / Verstorben an oder mit Demenz? Die Beziehung zwischen demenzieller Erkrankung und Todesursache.

Specifying a singular specific cause of death or an appropriate causal chain in the death certificate can be challenging, especially in cases of elderly, multimorbid deceased persons.The German cause of death statistics suggest that mental illnesses, including dementia, are beneath the most frequent causes of death. But when looking at death certificates in the context of dementia considerable information gaps and a lack of plausibility in the causal chain can be observed quite regularly.In this article we give recommendations for the correct designation of the cause of death and underlying diseases in the death certificate. These recommendations are not only to be seen against an academic background. The correct registration of dementia in the causes of death statistics may be a basis for decision making in health politics and is hence in the interest of optimal patient care.

Molecular and morphological findings in a sample of oral surgery patients: What can we learn for multivariate concepts for age estimation?

It has already been proposed that a combined use of different molecular and morphological markers of aging in multivariate models may result in a greater accuracy of age estimation. However, such an approach can be complex and expensive, and not every combination may be useful. The significance and usefulness of combined analyses of D-aspartic acid in dentine, pentosidine in dentine, DNA methylation in buccal swabs at five genomic regions (PDE4C, RPA2, ELOVL2, DDO, and EDARADD), and third molar mineralization were tested by investigating a sample of 90 oral surgery patients. Machine learning models for age estimation were trained and evaluated, and the contribution of each parameter to multivariate models was tested by assessment of the predictor importance. For models based on D-aspartic acid, pentosidine, and the combination of both, mean absolute errors (MAEs) of 2.93, 3.41, and 2.68 years were calculated, respectively. The additional inclusion of the five DNAm markers did not improve the results. The sole DNAm-based model revealed a MAE of 4.14 years. In individuals under 28 years of age, the combination of the DNAm markers with the third molar mineralization stages reduced the MAE from 3.85 to 2.81 years. Our findings confirm that the combination of parameters in multivariate models may be very useful for age estimation. However, the inclusion of many parameters does not necessarily lead to better results. It is a task for future research to identify the best selection of parameters for the different requirements in forensic practice.

Ophthalmologic examinations under the acute influence of alcohol.

Alcohol is the most widely used recreational drug in Western countries. It affects the psychophysical performance in different ways, e.g. by reducing cognitive functions, causing coordination disturbances or impairing vision. Visual impairments both concern oculomotor and visual sensory functions, such as decreased mesopic vision, decreased field of vision and an increase of saccadic eye movements. During cycling trials with alcoholised test persons, repeated measurements of (1.) the time needed to read a 50-word text, (2.) the time to perform a swing test by tenfold touching the moving fingertip of the examiner, and (3.) the amplitude of fusion were carried out. The results of these tests were further evaluated to test the hypothesis that impaired vision is significantly correlated to reduced cycling performances of alcoholised persons. In a second step, it was examined which test is most useful to identify alcohol intoxicated cyclists. The ophthalmologic examination results of the groups of best and worst cycling-performing test persons at blood alcohol levels between 0.10% and 0.15% were set into relation to the documented allocated demerits. Additionally, the individual results of these persons were compared to the state of soberness. The time needed to read a 50-word text significantly correlated with the cycling performance. As this is an easy and objective test, it might contribute to a synoptic evaluation of the psychophysical performance of a drunken cyclist.

Diagnostic value and forensic relevance of a novel photorealistic 3D reconstruction technique in post-mortem CT.

OBJECTIVES: Evaluation of performance and forensic relevance of a novel, photorealistic, 3D reconstruction method (cinematic rendering, (CR)) in comparison with conventional post-mortem CT (PMCT) and volume rendering (VR) technique for visualization of traumatic injuries. METHODS: 112 pathologies (fractures, soft tissue injuries and foreign bodies) from 33 human cadavers undergoing whole body PMCT after traumatic death were retrospectively analyzed. Pathologies were reconstructed with CR and VR techniques. Fractures were classified according to their dislocation. Images were evaluated according to their expressiveness and judicial relevance by two forensic pathologists using a five-level Likert-scale (1: high expressiveness, 5: low expressiveness). They decided whether CR reconstructions were suitable for judicial reviews. The detection rate of pathologies was determined by two radiologists. RESULTS: CR was more expressive than VR for all three trauma categories (p < 0.01) and than conventional CT when used for fractures with dislocation (p < 0.001), injuries of the ventral body surface (p < 0.001), and demonstration of foreign bodies (p = 0.033). CR and VR became more expressive with a higher grade of fracture dislocation (p < 0.001). 20% of all pathologies in the CR and VR reconstructions were not detectable by radiologists. CONCLUSION: CR reconstructions are superior to VR regarding the expressiveness. For fractures with substantial dislocation, soft tissue injuries, and foreign bodies in situ, CR showed a significantly better expressiveness than conventional PMCT. CR and VR have significant limitations in cases of fractures with minor dislocations and covered soft tissue injuries. ADVANCES IN KNOWLEDGE: CR is a helpful tool to present pathologies found in PMCT for judicial reviews.

Lactones from the Sponge-Derived Fungus Talaromyces rugulosus.

The marine-derived fungus Talaromyces rugulosus isolated from the Mediterranean sponge Axinella cannabina and cultured on solid rice medium yielded seventeen lactone derivatives including five butenolides (1-5), seven (3S)-resorcylide derivatives (6-12), two butenolide-resorcylide dimers (13 and 14), and three dihydroisocoumarins (15-17). Among them, fourteen compounds (1-3, 6-16) are new natural products. The structures of the isolated compounds were elucidated by 1D and 2D NMR (Nuclear Magnetic Resonance) spectroscopy as well as by ESI-HRMS (ElectroSpray Ionization-High Resolution Mass Spectrometry). TDDFT-ECD (Time-Dependent Density Functional Theory-Electronic Circular Dichroism) calculations were performed to determine the absolute configurations of chiral compounds. The butenolide-resorcylide dimers talarodilactones A and B (13 and 14) exhibited potent cytotoxicity against the L5178Y murine lymphoma cell line with IC50 values of 3.9 and 1.3 µM, respectively.