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BACKGROUND Therapeutic hypothermia following hypoxic ischaemic encephalopathy in term infants was introduced into Switzerland in 2005. Initial documentation of perinatal and resuscitation details was poor and neuromonitoring insufficient. In 2011, a National Asphyxia and Cooling Register was introduced. AIMS To compare management of cooled infants before and after introduction of the register concerning documentation, neuromonitoring, cooling methods and evaluation of temperature variability between cooling methods. STUDY DESIGN Data of cooled infants before the register was in place (first time period: 2005-2010) and afterwards (second time period: 2011-2012) was collected with a case report form. RESULTS 150 infants were cooled during the first time period and 97 during the second time period. Most infants were cooled passively or passively with gel packs during both time periods (82% in 2005-2010 vs 70% in 2011-2012), however more infants were cooled actively during the second time period (18% versus 30%). Overall there was a significant reduction in temperature variability (p < 0.001) comparing the two time periods. A significantly higher proportion of temperature measurements within target temperature range (72% versus 77%, p < 0.001), fewer temperature measurements above (24% versus 7%, p < 0.001) and more temperatures below target range (4% versus 16%, p < 0.001) were recorded during the second time period. Neuromonitoring improved after introduction of the cooling register. CONCLUSION Management of infants with HIE improved since introducing the register. Temperature variability was reduced, more temperature measurements in the target range and fewer temperature measurements above target range were observed. Neuromonitoring has improved, however imaging should be performed more often.

OBJECTIVE To compare rates of a composite outcome of mortality or major morbidity in very-preterm/very low birth weight infants between 8 members of the International Network for Evaluating Outcomes. STUDY DESIGN We included 58 004 infants born weighing

Well defined estimates of mutation rates are a prerequisite for the use of short tandem repeat (STR-) loci in relationship testing. We investigated 65 isolated genetic inconsistencies, which were observed within 50,796 allelic transfers at 23 STR-loci (ACTBP2 (SE33), CD4, CSF1PO, F13A1, F13B, FES, FGA, vWA, TH01, TPOX, D2S1338, D3S1358, D5S818, D7S820, D8S1132, D8S1179, D12S391, D13S317, D16S539, D17S976, D18S51, D19S433, D21S11) in Caucasoid families residing in Austria and Switzerland. Sequencing data of repeat and flanking regions and the median of all theoretically possible mutational steps showed valuable information to characterise the mutational events with regard to parental origin, change of repeat number (mutational step size) and direction of mutation (losses and gains of repeats). Apart from predominant single-step mutations including one case with a double genetic inconsistency, two double-step and two apparent four-step mutations could be identified. More losses than gains of repeats and more mutations originating from the paternal than the maternal lineage were observed (31 losses, 22 gains, 12 losses or gains and 47 paternal, 11 maternal mutations and 7 unclear of parental origin). The mutation in the paternal germline was 3.3 times higher than in the maternal germline. The results of our study show, that apart from the vast majority of single-step mutations rare multi-step mutations can be observed. Therefore, the interpretation of mutational events should not rigidly be restricted to the shortest possible mutational step, because rare but true multi-step mutations can easily be overlooked, if haplotype analysis is not possible.

In the present work, we have evaluated eight reportedly blood-specific mRNA markers (HBB, HBA, ALAS2, CD3G, ANK1, PBGD, SPTB, AQP9) in an attempt to determine the most suitable ones for use in forensic applications based on their sensitivities, specificities and performance with casework samples. While varying levels of expression were observed, all markers were relatively sensitive requiring as little as 1 ng of RNA input into the reverse transcription (RT) reaction. In singleplex reactions, seven of the eight analyzed blood markers (all except AQP9) demonstrated a high degree of specificity for blood. In multiplex reactions, non-reproducible cross-reactivity was observed for several of the mRNA markers, which was reduced and, in most cases, eliminated when less input total RNA was used. Additionally, some cross-reactivity was observed with tissue and animal samples. Despite differences in the observed sensitivity and specificity of the blood markers examined in this study, a number of the candidates appear to be suitable for inclusion in appropriately validated multiplex mRNA-based body fluid identification systems.

Zusammenfassung: Der ärztliche Umgang mit Opiaten und Sedativa bei Patienten am Lebensende kann ethische Fragen aufwerfen. Entsprechende Entscheidungen blieben bisher in aller Regel der ärztlichen Berufskunst und -pflicht überantwortet. Heute aber gerät dieser Bereich zunehmend auch in den Blickwinkel des Rechts. Ausdruck davon sind Bestrebungen, die indirekte Sterbehilfe, allenfalls auch die terminale Sedierung gesetzlich zu regeln. Ausgehend von einer Ist-Analyse der ärztlichen Praxis sowie von bereits bestehenden Regulierungen untersucht diese Arbeit die Konsequenzen derartiger Bestrebungen. Es zeigt sich, dass der Versuch, die Thematik der indirekten Sterbehilfe für sich allein, also unter Vermeidung einer Regelung der direkt aktiven Sterbehilfe, zu behandeln, zu großen Schwierigkeiten führen würde. Ernüchternd sind aber auch die Erfahrungen aus den Niederlanden, derartige Fragen im Rahmen eines umfassenden Sterbehilfegesetzes anzugehen. Insgesamt ist somit zu befürchten, dass der Versuch einer detaillierten gesetzlichen Regelung dieses Bereiches mehr neue Grauzonen und Unsicherheiten schafft, als er zu beseitigen vermag

Studienziel: Die Stabilitat der Einstellung Betagter zu lebensverlangernden Masnahmen zu untersuchen. Methode: Personliche Interviews mit Pflegeheimbewohnern im Abstand von drei Jahren (prospektive longitudinale Interviewstudie). Resultate: Bei der Erstbefragung 1997 (n=50) hatten sich 19 Pflegeheimbewohner (38%) im Falle des hypothetischen Szenarios einer akut lebensbedrohlichen Lungenentzundung eine antibiotische Behandlung gewunscht. 15 Befragte (30%) hatten eine solche abgelehnt, weitere 16 (32%) hatten sich ambivalent geausert. Drei Jahre spater konnten 19 Personen nachbefragt werden (28 waren inzwischen verstorben, 3 waren an einer fortgeschrittenen Demenz erkrankt). Von diesen auserten sich 16 zum beschriebenen Szenario gleich oder ahnlich wie vor 3 Jahren (Ubereinstimmung 84,2%, p

Background Plastic bronchitis is an extremely rare disease characterized by the formation of tracheobronchial airway casts, which are composed of a fibrinous exudate with rubber-like consistency and cause respiratory distress as a result of severe airflow obstruction. Bronchial casts may be associated with congenital and acquired cardiopathies, bronchopulmonary diseases leading to mucus hypersecretion, and pulmonary lymphatic abnormalities. In recent years, however, there is growing evidence that plastic bronchitis can also be triggered by common respiratory tract infections and thereby cause atelectasis even in otherwise healthy children. Case presentation We report on 22-month-old monozygotic twins presenting with atelectasis triggered by a simple respiratory tract infection. The clinical, laboratory, and radiographic findings given, bronchial cast formation was suspected in both infants but could only be confirmed after bronchoscopy in the first case. Real-time polymerase chain reaction of the removed cast as well as nasal lavage fluid of both infants demonstrated strong positivity for human bocavirus. Conclusion Our case report is the first to describe two simultaneously affected monozygotic twins and substantiates the hypothesis of a contributing genetic factor in the pathophysiology of this disease. In this second report related to human bocavirus, we show additional evidence that this condition can be triggered by a simple respiratory tract infection in previously healthy infants.

Analysis of a mixed biological stain by means of highly polymorphic VNTR systems usually reveals a profile composed of multiple markers. If the victim and one or several suspects match the profile, the evidential strength of the matches has to be very carefully analysed. The appropriate methods for the statistical analysis of DNA profiles advanced recently were limited to cases with no relationship between the tested and non-tested persons. The present paper extends the theory beyond this limitation.

Viele Pflanzen sind in der Lage, organische Verbindungen auszuscheiden, wodurch andere Organismen unterdruckt werden. Dieses als Allelopathie bezeichnete Phanomen lasst sich mit einfachen Versuchen an Kalanchoe-Pflanzen deutlich machen: Durch Messung der Stangel- und Primarwurzel- langen von Kalanchoe-Tochterpflanzchen kann der intra- und interspezifische allelopathische Hemmeffekt in Biotests mit authentischen Allelochemikalien aufgezeigt werden.

Genetic studies on SIDS have been motivated by clinical, epidemiological, and/or neuropathological observations made of SIDS victims. One of the candidate genes is the serotonin transporter (5-HTT) gene, based on decreased serotonergic receptor binding observed in the brain-stems of SIDS victims. Two polymorphisms in the regulatory region of the 5-HTT gene differentially modulate gene expression (promoter, intron 2). The promoter allelic variants long (L) and extra long (XL) and the intron 2 12-repeat allele seem to be associated with SIDS; however, the 5-HTT promoter allele distribution varies widely by ethnicity. We investigated the DNA of 145 Caucasian SIDS cases and 58 controls and could find no significant association between our Caucasian SIDS cases and controls either for the promoter L allele and the intron 2 12-repeat allele, or for the combined L-12 haplotype as well as the L- or 12-containing genotypes.

Analysis of a mixed biological stain by means of highly polymorphic VNTR systems usually reveals a profile composed of multiple markers. If the victim and one or several suspects match the profile the evidential strength of the matches has to be very carefully analysed. It is shown that a treatment to evaluate mixed stains within the scope of a hypotheses testing approach yields a formula identical to one proposed recently by Weir und coauthors. A simple combinatorial proof of this formula is presented. Further, a special computational formula is derived for the cases where the formula of Weir turns out to be cumbersome.

The Swiss federal DNA profile information system (EDNA) has been launched in July 2000 for a test period of 4 years under a temporary legislation. Based on that experience a new law was put in place in January 2005. Furthermore, a new web-based communication platform was implemented, which allows for faster processing and immediate retrieval of the actual state of the workflow.

With reference date 31st December 2004 the 4-year test period of the Swiss DNA database ended. An evaluation of this test period was performed. The database holds DNA profiles of suspects, single stains and also mixed stains. The success rate was excellent: almost every second stain that was entered into the database resulted in a hit. The main crime category was burglary and theft, but also 285 homicides/bodily harm and 161 sexual offence cases could be assigned to a suspect.

The intra-and interspecific acting allelochemicals of Kalanchoe daigremontiana, K. tubiflora and K. pinnata (Crassulaceae) were isolated and could be identified as p-hydroxybenzoic-, protocatechuic-, gallic-, p-coumaric-and coffeic acid. By measuring length of stems and primary roots of Kalanchoe-daughter plants the intra-and interspecific inhibitory activities of authentic compounds could be demonstrated.

(1) The nomenclature of any STR follows from comparison with a control allelic ladder; availability of reference allelic ladders is central to any scheme. The components of an allelic ladder should be sequenced. (2) The DNA commission recommended a nomenclature based upon the number of repeat sequences present in an allele. Whereas this method is suitable for typing simple STRs, complex hypervariable repeats such as ACTBP2 do not conform to a simple repeating structure. We propose that designation of complex STR repeats such as ACTBP2, D11S554 and APOAI1 follows from the size of specific alleles. Because the size is dependant upon the primers utilised, the size is not definitive (it may also be dependent upon the internal structure of the allele), hence designations are prefixed with the term 'type-'. (3) Allelic ladders should span the entire known range of the common alleles of a locus. (4) It is not necessary for every known allele to be represented in the allelic ladder. The common types should be present; alleles intermediate to two common types can be designated by simple extrapolation. If possible, there should be a maximum 4bp gap between allelic ladder markers for tetrameric and dimeric STRs (if the STR repeat is greater than 4bp, then the maximum gap defaults to the size of the repeat). (5) The designation scheme to be used for a given locus is dependent upon the characteristics of the locus itself. If possible the designation should follow the recommendations of the DNA commission unless its allelic structure precludes that option.

On the occasion of a study on mutation rates of human STR loci, numerous alleles have been sequenced. Several new sequence or length variant alleles were found.

A 44-year-old woman was almost completely paralysed after a severe brainstem haemorrhage. Even after several years of efforts at rehabilitation, she remained completely dependent on the help of others. However, a special device enabled her to administer (after careful preparation) liquids through the PEG catheter despite her poorly coordinated movements. Four years after the stroke, the woman joined a right-to-die society with the wish to bring her life to an end. A doctor working with this organisation prescribed her a lethal dose of pentobarbital. In the presence of her husband and her companion from the organisation, the woman administered herself the lethal substance by means of the device. On the basis of the fact that she herself had switched the device on this death was classed as (assisted) suicide.

In a collaborative study, we calculated mutation rates at 23 different STR loci after investigation of nearly 24,000 meioses including all Profiler™, Profiler Plus™, COfiler™, SGM Plus™ and Powerplex™ 16 loci except Penta D and Penta E and further loci, of which D12S391, D17S976 and SE33 are the most informative: CD4, CSF1PO, D2S1338, D3S1358, D5S818, D7S820, D8S1132, D8S1179, D12S391, D13S317, D16S539, D17S976, D18S51, D19S433, D21S11, F13A1, F13B, FES, FGA, SE33, TH01, TPOX and VWA. The alleles presumed to be taking part in mutations were sequenced. The possible origin and the possible structural variations of mutational events in microsatellites are discussed.

The number of cells in the cerebrospinal fluid increases after death. It is not clear whether this observation represents a post-mortem or a supravital phenomenon. There is speculation that some of the cells actively enter the cerebrospinal fluid during the first hours after death and that the rest exfoliate from the subarachnoid layer. The post-mortem cell count in cerebrospinal fluid correlates to the time after death and can be described mathematically (polynomial curve of third order).

Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

A collaborative exercise on mRNA profiling for the identification of blood was organized by the European DNA Profiling Group (EDNAP). Seven blood samples and one blood dilution series were analyzed by the participating laboratories for the reportedly blood-specific markers HBB, SPTB and PBGD, using different kits, chemistries and instrumentation. The results demonstrate that HBB is expressed abundantly in blood, SPTB moderately and PBGD significantly less. All but one of the 16 participating laboratories were able to successfully isolate and detect RNA from the dried bloodstains even though a majority of the laboratories had no prior experience with RNA. Despite some expected variation in sensitivity between laboratories, the method proved to be reproducible and sensitive using different analysis strategies. The results of this collaborative exercise support the potential use of mRNA profiling as an alternative to conventional serological tests.

We validated and established an automated method for PCR and capillary electrophoresis setup (CE setup), using the Tecan Freedom EVO® 150 and 75 automated liquid handling workstations powered by Freedom EVOware®. The PCR setup script of the Freedom EVO® 150 was based on the HID EVOlution™ System. However, substantial changes in the HID script were required before putting the system on stream in the routine. The CE setup of the Freedom EVO® 75 was based on a script made by application specialists of Tecan. For internal validation of the two robots, we investigated repeatability, reproducibility and occurrence of contaminations. The analysis of the reproducibility data demonstrated that electropherograms of samples pipetted by the robots had a lower mean size standard peak height, than the hand-pipetted samples, whereas the mean sample peak height did not differ between the two methods. This was mainly due to precision-differences between the robots and the hand-pipetting. The investigation of the occurrence of contaminations showed that with the PCR setup robot no sample got contaminated. The CE setup robot on the contrary revealed carryovers of samples from one well to the subsequent well. After intense examination, we discovered that the tip travel height was set too low, causing the tip to touch the rim of the 96 well plate which led to the carryovers. The contact between rim and tip could not be seen by naked eye, but after increasing the tip travel height, no further contamination was observed. Our validation demonstrates that robots, even when set up by application specialists, need to undergo a proper internal validation before being put on stream in the routine.

A second collaborative exercise on RNA/DNA co-analysis for body fluid identification and STR profiling was organized by the European DNA Profiling Group (EDNAP). Six human blood stains, two blood dilution series (5-0.001 μl blood) and, optionally, bona fide or mock casework samples of human or non-human origin were analyzed by the participating laboratories using a RNA/DNA co-extraction or solely RNA extraction method. Two novel mRNA multiplexes were used for the identification of blood: a highly sensitive duplex (HBA, HBB) and a moderately sensitive pentaplex (ALAS2, CD3G, ANK1, SPTB and PBGD). The laboratories used different chemistries and instrumentation. All of the 18 participating laboratories were able to successfully isolate and detect mRNA in dried blood stains. Thirteen laboratories simultaneously extracted RNA and DNA from individual stains and were able to utilize mRNA profiling to confirm the presence of blood and to obtain autosomal STR profiles from the blood stain donors. The positive identification of blood and good quality DNA profiles were also obtained from old and compromised casework samples. The method proved to be reproducible and sensitive using different analysis strategies. The results of this collaborative exercise involving a RNA/DNA co-extraction strategy support the potential use of an mRNA based system for the identification of blood in forensic casework that is compatible with current DNA analysis methodology. © 2011 Elsevier Ireland Ltd. All rights reserved.

To investigate the performance of postmortem magnetic resonance imaging (pmMRI) in identification and characterization of lethal myocardial infarction in a non-invasive manner on human corpses.Before forensic autopsy, 20 human forensic corpses were examined on a 1.5-T system for the presence of myocardial infarction. Short axis, transversal and longitudinal long axis images (T1-weighted; T2-weighted; PD-weighted) were acquired in situ. In subsequent autopsy, the section technique was adapted to short axis images. Histological investigations were conducted to confirm autopsy and/or radiological diagnoses.Nineteen myocardial lesions were detected and age staged with pmMRI, of which 13 were histologically confirmed (chronic, subacute and acute). Six lesions interpreted as peracute by pmMRI showed no macroscopic or histological finding. Five of the six peracute lesions correlated well to coronary pathology, and one case displayed a severe hypertrophic alteration.pmMRI reliably demonstrates chronic, subacute and acute myocardial infarction in situ. In peracute cases pmMRI may display ischemic lesions undetectable at autopsy and routine histology. pmMRI has the potential to substantiate autopsy and to counteract the loss of reliable information on causes of death due to the recent disappearance of the clinical autopsy.

The incidence of morphologic variations (MVs) was investigated in 180 infants who died unexpectedly and suddenly and in 180 age-matched nonsuddenly deceased infants. The same person (G.M.) performed a full postmortem and histologic examination on all of the infants, none of whom had significant malformations. The test group (TG) consisted of 146 infants whose death was unexplained, whereas group 3 (G3) consisted of 34 infants with adequately determined causes of death. The principal findings in the control group were prematurity, inflammatory and metabolic diseases, tumors, and traumatic lesions. MVs were present in 62% of the TG infants, in 47% of the G3 children, and in 22% of the controls. The differences between the TG and G3 on the one hand and the controls on the other are statistically significant (p < 0.001 and 0.05, respectively). In the TG, anomalies were twice, dysplasias three times, and dysmorphisms four times as common as in controls; in G3, four times as many dysplasias and dystropics were found as in controls. In the TG, 23% of the MVs were multiple as compared with 9% in G3 and 5% in controls. The pattern of distribution was not confined to certain organs. Among the relative high percentage of dysplasias, the large number of neuroblastomas is striking.

mRNA profiling is a promising new method for the identification of body fluids from biological stains. In this study we aimed to establish a multiplex RT-PCR protocol for the detection and differentiation of sperm and seminal plasma. The Agilent Bioanalyzer and Nanodrop spectrophotometer were shown not to be suitable for assessing RNA quality and quantity of forensic stains. Semen specificity of the mRNA markers was successfully confirmed with singleplex PCR. Our data indicated that semen samples down to 0.1μl and up to 20-year-old could be identified with mRNA profiling. With the semen multiplex, including 2 sperm markers (PRM1, PRM2) and 2 novel seminal plasma markers (SEMG1, PSA), samples from azoospermic men (absence of sperm in semen) are clearly distinguishable from those of normozoospermic men (having a normal sperm production). We think that our multiplex RT-PCR protocol is a reliable and sensitive method for the identification of semen in forensic samples.

mRNA profiling is a new method for the identification of body fluids. We evaluated the specificity of the two supposedly vaginal secretion specific mRNA-markers HBD1 and MUC4 and the cross-reactivity with other mucous membranes. Both mRNA-markers reliably detect vaginal secretions from women of all ages (14–82 years), but they cross-react with other mucous membranes like buccal cells, or diverse mucous membranes taken from corpses.

Non-physician volunteers of Exit, the largest right-to-die organization in Switzerland, play an important role in assisted suicide. They conduct assessments and deliver lethal medications for a member to self-administer. This study analyses the content of 114 intake sheets (checklists) of Exit members whose requests for assisted suicide were granted in an effort to examine the frequency of depression and whether their relatives agreed with the member's decision to commit suicide (2 questions that can help increase the likelihood that the member's decision was both informed and voluntary). Exit's paperwork indicated that depression was found to exist in 27% of the cases, was more common among those under 65, and relatives explicitly disagreed with the member's decision in 5% of the cases.

mRNA profiling is a promising new method for the identification of body fluids from biological stains. Major advantages of mRNA profiling are the possibility of detecting several body fluids in one multiplex reaction and of simultaneously isolating DNA without loss of material. A reverse transcription endpoint polymerase chain reaction (PCR) method and a realtime PCR assay were established for the identification of blood, saliva, semen, vaginal secretions and menstrual blood, and were compared to conventional enzymatic and immunologic tests. The results for specificity, sensitivity and suitability to biological stains were satisfying and mRNA stability was demonstrated for up to 2-year-old stains. Two novel multiplex assays were created with the endpoint PCR primers: multiplex 1 amplifies two markers for each of the above mentioned body fluids and is suited for screening; multiplex 2 was designed for the detection of blood, vaginal secretions and menstrual blood. The results demonstrate that both endpoint PCR and realtime PCR are suitable for the identification of body fluids in forensic stains and represent an effective alternative to conventional enzymatic and immunologic tests.

mRNA profiling is a promising new method for the identification of body fluids from biological stains. A multiplex reverse transcription endpoint PCR method was adapted for the identification of blood, saliva, semen, vaginal secretions and menstrual blood. For specificity, sensitivity and suitability to biological stains the endpoint PCR method was satisfying. Up to 15 months old stains were shown to be suitable for mRNA profiling. In addition a realtime PCR assay was tested for sensitivity with blood and semen samples, providing comparable results to endpoint PCR or enzymatic tests.

Background Two 3D surface scanners using collimated light patterns were evaluated in a new application domain: to document details of surfaces similar to the ones encountered in forensic skin pathology. Since these scanners have not been specifically designed for forensic skin pathology, we tested their performance under practical constraints in an application domain that is to be considered new. Methods Two solid benchmark objects containing relevant features were used to compare two 3D surface scanners: the ATOS-II (GOM, Germany) and the QTSculptor (Polygon Technology, Germany). Both scanners were used to capture and process data within a limited amount of time, whereas point-and-click editing was not allowed. We conducted (a) a qualitative appreciation of setup, handling and resulting 3D data, (b) an experimental subjective evaluation of matching 3D data versus photos of benchmark object regions by a number of 12 judges who were forced to state their preference for either of the two scanners, and (c) a quantitative characterization of both 3D data sets comparing 220 single surface areas with the real benchmark objects in order to determine the recognition rate's possible dependency on feature size and geometry. Results The QTSculptor generated significantly better 3D data in both qualitative tests (a, b) that we had conducted, possibly because of a higher lateral point resolution; statistical evaluation (c) showed that the QTSculptor-generated data allowed the discrimination of features as little as 0.3 mm, whereas ATOS-II-generated data allowed for discrimination of features sized not smaller than 1.2 mm. Conclusion It is particularly important to conduct specific benchmark tests if devices are brought into new application domains they were not specifically designed for; using a realistic test featuring forensic skin pathology features, QT Sculptor-generated data quantitatively exceeded manufacturer's specifications, whereas ATOS-II-generated data was within the limits of the manufacturer's specifications. When designing practically constrained specific tests, benchmark objects should be designed to contain features relevant for the application domain. As costs for 3D scanner hardware, software and data analysis can be hundred times as high compared to high-resolution digital photography equipment, independent user driven evaluation of such systems is paramount. Index terms Forensic pathology, Rough surfaces, Surface Scanning, Technology Assessment

Objective To investigate the safety and short term outcome of high dose recombinant human erythropoietin (rhEpo) given shortly after birth and subsequently over the first 2 days for neuroprotection to very preterm infants. Study design Randomized, double masked phase II trial. Preterm infants (gestational age 26 0/7-31 6/7 weeks) were given rhEpo (n t = 229; 3000 U/kg body weight) or NaCl 0.9% (n c = 214) intravenously at 3, 12-18, and 36-42 hours after birth. Results There were no relevant differences between the groups for short-term outcomes such as mortality, retinopathy of prematurity, intraventricular hemorrhage, sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia. At day 7-10, we found significantly higher hematocrit values, reticulocyte, and white blood cell counts, and a lower platelet count in the rhEpo group. Conclusions Early high-dose rhEpo administration to very premature infants is safe and causes no excess in mortality or major adverse events. Trial registration ClinicalTrials.gov: NCT00413946.

To investigate attitudes to end-of-life decisions, and the influence of cultural factors and of doctors' personal characteristics on these attitudes.As part of a European research project (EURELD), a study on attitudes towards medical end-of-life decisions was conducted among doctors in the German-, French- and Italian-speaking areas of Switzerland. A written questionnaire was sent to a random sample of nine different types of specialist; it presented 14 statements on end-of-life decisions and doctors were asked whether they agreed or disagreed with them.The response rate was 64%. 1360 questionnaires were studied. The results show general agreement with statements on the alleviation of pain and other symptoms with possible life-shortening effect, as well as on non-treatment decisions. The language region was a strong determinant of agreement on some attitudes towards end-of-life decisions. Agreement on the use of lethal drugs and alleviation of pain and other symptoms with possible life-shortening effect was higher among French-speaking than among German- and Italian-speaking doctors. For nontreatment decisions, agreement was higher in the German-speaking region than in the French- and Italian-speaking regions of the country. Italian-speaking doctors were strongly opposed to any kind of end-of-life decision. Religious believers and those who attended a larger number of terminal patients tended to disagree more often with end-of-life decisions than the other doctors.In end-of-life decision-making, Switzerland represents "Europe in miniature". The impact on end-of-life decisions of cultural factors and the number of terminal patients attended needs further consideration.