BackgroundUntil now there has been a reported lack of systematic reports and scientific evaluations of rescue missions during terror attacks. This however is urgently required in order to improve the performance of emergency medical services and to be able to compare different missions with each other. Aim of the presented work was to report the systematic evaluation and the lessons learned from the response to a terror attack that happened in Wuerzburg, Germany in 2016.MethodsA team of 14 experts developed a template of quality indicators and operational characteristics, which allow for the description, assessment and comparison of civil emergency rescue missions during mass killing incidents. The entire systematic evaluation process consisted of three main steps. The first step was the systematic data collection according to the quality indicators and operational characteristics. Second was the systematic stratification and assessment of the data. The last step was the prioritisation of the identified weaknesses and the definition of the lessons learned.ResultsFive important “lessons learned” have been defined. First of all, a comprehensive concept for rescue missions during terror attacks is essential. Furthermore, the establishment of a defined high priority communication infrastructure between the different dispatch centres (“red phone”) is vital. The goal is to secure the continuity of information between a few well-defined individuals. Thirdly, the organization of the incident scene needs to be commonly decided and communicated between police, medical services and fire services during the mission. A successful mission tactic requires continuous flux of reports to the on-site command post. Therefore, a predefined and common communication infrastructure for all operational forces is a crucial point. Finally, all strategies need to be extensively trained before the real life scenario hits.ConclusionAccording to a systematic evaluation, we defined the lessons learned from a terror attack in 2016. Further systematic reports and academic work surrounding life threatening rescue missions and mass killing incidents are needed in order to ultimately improve such mission outcomes. In the future, a close international collaboration might help to find the best database to report and evaluate major incidents but also mass killing events.

The genus Duboisia (Solanaceae) is indigenous to Australia and comprises three species. D. myoporoides R. Br. and D. leichhardtii F. Muell are tropane alkaloids-yielding plants which have commercial value (1). Later, a hybrid between these two plants was selected and cultivated commercially (2). Cultivation studies on the Duboisia hybrid and D. myoporoides had been done in Australia (2, 3) and Japan (4, 5). Monthly analyses of alkaloid content were made in two consecutive years. Both studies showed similar results i.e. there was a drop in hyoscine content during winter time.Metabolic studies on the Duboisia hybrid suggested correlation between transpiration rate, the rate of stem in hyoscine metabolism and the hyoscine content in leaves.Therefore, during cool weather, when transpiration rate was reduced, hyoscine accumulated in the leaves (6). Experiments on glasshouse plants grown under controlled temperature showed stable hyoscine contents (3). Thailand is a tropical country in a Monsoon area with 3 seasons: summer (Feb-Apr), rainy season (May-Oct), and winter (Nov-Jan). The temperature range in central Thailand was between 18 to 39°C. The range was not as broad as in Australia or Japan, therefore, it was expected that there would not be much variation in alkaloid content. The Duboisia hybrid was only grown on fertile volcanic soil while D. myoporoides was less selective.The leaf and stem explants of D. myoporoides were subjected to callus initiation. Shoot differentiation was induced from callus under light and regenerated plants were obtained after a transfer to high auxin containing media. Fresh cuttings of Duboisia hybrid were introduced from Australia and kept under mist for 6 weeks. Alter root strike the plants were hardened off in Bangkok for 2 weeks before growing in the field.The regenerated plants of D. inyoporoides grew vigorously at the average rate of 15-37 cm per month. Frequent pruning and sufficient soil water were essential to keep vigorous plants. The juvenile plants showed fleshy leaves, branches and stem. The mature plants developed a corky stem, the branches and leaves were less fleshy. There were also some somaclonal variations observed in leaf size, shape and colour, plant structure, growth rate and alkaloid content. At the beginning the hybrid plants grew at a slower rate than the regenerated plant of D. inyoporoides. Later the vigorous plants grew at the rate of ca. 39cm per month. The plants developed a corky stem early which made the plants more robust. Frequent pruning was not necessary. The plantation of hybrid plants was homogeneous in general morphology but the different growth rate was not unexpected in some plants.The leaf samples were taken monthly and analysed by GLC. Some analyses have been done showing the maximal hyoscine content to be 1.93% for D. myoporoides and 2.76% for Duboisia hybrid. Interpretation of all analytical results will be made in correlation with seasons and age of the plants. References Intern. Trade Centre UNCTAD/GArI' (1982) Markets for selected medicina...

Introduction Pathologies of the amygdala and the hippocampus have been argued to be critically involved in autism as well as in sadomasochism. In line with Kluver and Bucy syndrome, clinical observations, animal models and a few case reports emphasize that temporal brain changes are important for the etiopathogenesis of sexual deviant behaviour. In particular, the amygdalohippocampal region has been linked to hypersexuality, transvestitism and fetishism. While cases and studies are rare, the impact of amygdalohippocampal changes in criminal behaviour remains unclear so far. Aim To demonstrate the impact of subcortical neurobiological changes in the etiopathogenesis of autism and sadomasochism. Methods We report on a forensic psychiatric inpatient due to murderer with autism and sadomasochism who had amgdalohippocampal abnormalities bilaterally. Studies on the neurobiological underpinnings of autism and of sadomasochism are reviewed in particular regarding amygdalohippocampal region. Results In this patient, MRI scan showed hypointensities in amygdala-hippocampal complex bilaterally medial to both cornua inferiores corresponding to an amygdalo-hippocampal atrophy. Conclusions In line with the literature, this case report links autism and sadomasochism to amygdalohippocampal pathology emphasising its impact in the etiopathogenesis of both disorders. Further research is needed to elucidate the interaction of amygdalohippocampal changes, disturbed emotion precessing and sex offenses.

There is an important need to systematically evaluate rescue missions after mass killing incidents. In this study we report a template of parameters and quality indicators in order to systematically evaluate mass violence events. The presented template is the result of an expert consensus process and may serve as a basis for further development and research.

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