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Background: Torture has traditionally been described in the context of politically motivated abuse. Torture of children in the familial context is a less studied phenomenon, with scholarly articles focused on legal or medical viewpoints. Analysis from a frontline professional's perspective is virtually nonexistent in the literature., Objective: The present study seeks to identify the common features of child torture and assist law enforcement, medical, and child protection agencies in earlier identification and inform more effective investigative and intervention strategies., Participants and Setting: A convenience sampling method was used to identify and collect cases involving severe child maltreatment consistent with torture. The sample included 42 offenders and 35 victims, representing 20 households., Methods: Researchers reviewed and extracted data from law enforcement case files, to include investigative, medical, and child protective services (CPS) reports, as well as recorded law enforcement interviews of offenders/witnesses and child forensic interviews. Descriptive and frequency statistics were generated., Results: Offenders were often female (57 %), most commonly biological mothers (38 %), with a history of violence (57 %). Prior CPS reports were noted in 85 % of cases, less than half of which were substantiated. In over half of the cases (55 %), law enforcement discovered digital documentation of the torture. Over half (54 %) of the victims died as a result of the torture., Conclusions: This study demonstrated how CT is a distinct form of child maltreatment that is especially severe and pervasive. Recognition, assessment and documentation of the unique constellation of physical and psychological abuse are key to an efficient intervention., (Published by Elsevier Ltd.)

Child maltreatment, including medical neglect, is a frequent contributor to the development of asthma as well as a barrier to its proper management. This article aims to review the role of medical neglect as a contributor to poor asthma control. Medical neglect can present as failure of the caretaker to recognize severe asthma symptoms in a child, non-adherence to medical management, failure to prevent chronic exposure to allergens or tobacco smoke, poor child nutrition leading to obesity, and allowing a young child to manage his/her illness without supervision. This article will explore the different factors leading to medical neglect (as illustrated by two cases) and suggest possible interventions aiming to prevent emergency department visits, hospitalizations, and asthma-related deaths., Competing Interests: Disclosure of InterestOn behalf of all authors, the corresponding author states that there is no conflict of interest., (© Springer Nature Switzerland AG 2019.)

Human Immunodeficiency Virus (HIV) causes a chronic illness requiring lifelong medical care to prevent opportunistic infections and death. It is important to identify medical neglect in children that are perinatally exposed to or living with human immunodeficiency virus and to take steps to prevent it. Diagnosis of medical neglect must be considered in the context of the caregivers' understanding of the risks of harm, and the logistical, cultural and social factors that may influence their actions or non-actions. When medical neglect as failure of treatment or prevention of infection is suspected, medical providers should work collaboratively with caregivers to assess and address barriers to adherence and to provide resources and support. Medical neglect may be diagnosed if repeated preventive efforts fail., Competing Interests: Conflict of InterestOn behalf of all authors, the corresponding author states that there is no conflict of interest., (© Springer Nature Switzerland AG 2019.)

We have recently encountered a series of cases where an obese caretaker is juxtaposed to a severely starved, malnourished dependent. The cases described all share a common characteristic: that the primary perpetrator was an obese caretaker who tried to exert absolute control over their victim's daily life in a way that included either a severe restriction or complete denial of food. Because the pathophysiology of both child abuse and obesity are incredibly complex and multifactorial, these cases are presented to encourage further discussion and more rigorous investigation into the validity of a hypothesis that has been derived from this set of cases: that the obesity of a child's caretaker may be an additional risk factor for child maltreatment by starvation.

The term "Big Black Brain" was first coined in 1993 to describe cases of abusive head trauma associated with subdural hematoma(s), brain swelling, and uni- or bilateral hypo-density involving the entire supratentorial compartment on CT scan imaging. This constellation of findings was invariably followed by extensive cerebral parenchymal destruction and a dismal neurological outcome or death. We describe two such cases and review the pathophysiology and differential diagnosis of this entity., (© Springer International Publishing 2017.)

The presence of TSNA has been suggested as a potentially important cancer risk factor for moist smokeless tobacco (MST) products. We describe studies of the impact of tobacco agronomic and production practices which influence TSNA formation. TSNA were measured at points in the MST production chain from the farm to the finished product at the end of shelf life. Analyses were conducted to define points at which TSNA may occur, the factors related to the magnitude of occurrence, and actions which may be taken to mitigate such occurrence. Weather conditions during the curing season can have a dramatic impact on TSNA levels in tobacco, with wet seasons markedly increasing TSNA levels in cured tobacco. TSNA levels in MST do not increase beyond levels in cured tobacco when production practices limit the presence of nitrate reducing bacteria. Therefore, TSNA in such products are a function of the agronomic practices and conditions under which tobacco is produced at the farm level. Regional and annual variation in TSNA levels results from the stochastic nature of agronomic factors related to TSNA formation during tobacco growing and curing., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

This study evaluated the effect of ultimate pH (pHu) of pork on shelf life based upon microbial growth, drip loss, and oxidative rancidity (2-thiobarbituric acid [TBA] procedure) in vacuum-packaged loins stored at 4 degrees C. Glucose and lactate concentrations of the pork loins were also measured. Thirty-six pork loins (pH = 5.56 to 6.57) were collected at a commercial slaughter facility 1-d postslaughter. All pigs were from the same genetic line. Loins were grouped by pH (group: pH range): A: 5.55 to 5.70, B: 5.71 to 5.85, C: 5.86 to 6.00, D: 6.01 to 6.15, and E: > 6.16. They were analyzed at days 0, 6, 14, 24, and 34. For aerobic plate counts, groups A and B were significantly lower than C through E, while psychrotrophic or Enterobacteriaceae counts of groups A and A through C were significantly lower than groups B through E and D and E, respectively. Lactic acid bacteria counts were not significantly influenced by pHu. Group A had higher glucose concentrations than groups C through E and higher lactate concentrations than groups D through E on most sampling days. Group A had a higher TBA value than group E at days 0 and 34. Group A displayed greater drip loss than groups D and E at day 6 and groups B through D on days 24 and 34. Based on the microbial and drip loss results, a pork loin pHu of 5.8 to 5.9 appears to be optimum to provide a vacuum-packaged shelf life of at least 24 d with minimum drip loss.