The aim of the present study was a refined analysis of neuroinflammation including TMEM119 as a useful microglia-specific marker in forensic assessments of traumatic causes of death, e.g., traumatic brain injury (TBI). Human brain tissue samples were obtained from autopsies and divided into cases with lethal TBI (n = 25) and subdivided into three groups according to their trauma survival time and compared with an age-, gender-, and postmortem interval-matched cohort of sudden cardiovascular fatalities as controls (n = 23). Brain tissue samples next to cortex contusions and surrounding white matter as well as samples of the ipsilateral uninjured brain stem and cerebellum were collected and stained immunohistochemically with antibodies against TMEM119, CD206, and CCR2. We could document the highest number of TMEM119-positive cells in acute TBI death with highly significant differences to the control numbers. CCR2-positive monocytes showed a significantly higher cell count in the cortex samples of TBI cases than in the controls with an increasing number of immunopositive cells over time. The number of CD206-positive M2 microglial cells increased survival time-dependent. After 3 days of survival, the cell number increased significantly in all four regions investigated compared with controls. In sum, we validate a specific and robustly expressed as well as fast reacting microglia marker, TMEM119, which distinguishes microglia from resident and infiltrating macrophages and thus offers a great potential for the estimation of the minimum survival time after TBI.
Background
The last 10 years have seen an increase in the number of suicides in the US Armed Forces. Accordingly, the topic of suicides in the German military has received a lot of attention in media and science alike.
Methods
This study retrospectively examined all suicides (N = 107) committed by active, nonretired German military personnel from 2010 to the end of 2014, analyzing archived medical records. In a second step, these data were compared to a representative German Armed Forces survey conducted in 2012 (N = 1,549).
Results
The following risk groups for suicide were identified: male (OR = 9.6), single (OR = 7.8), aged over 45 years (OR = 4.0), short period of service (<2 years; OR = 2.7), and low level of education (OR = 2.2). Surprisingly, military personnel with little experience in deployments abroad (<2 missions) showed double the risk (OR = 2.0) compared to those who had been deployed more than once.
Discussion
Multiple robustness checks show that being single, aged over 45 years, and having obtained a low level of education exhibit the most robust effects on suicide risk.
Conclusion
Efforts should be made to develop and evaluate risk group‐focused prevention programs. We conclude, that further studies should be initiated to show differences of risk groups between lethal and nonlethal suicidal behavior.
Ende 2014 kehrt die Bundeswehr mit einem großen Teil ihrer Truppen aus Afghanistan zurück. Sie hat sich verändert. Wie kein anderer Einsatz zuvor prägt der Afghanistaneinsatz die Bundeswehr als Gesamtorganisation, "nicht allein die Strukturen, sondern auch die Organisationskultur und das Selbstverständnis einer Generation von Soldatinnen und Soldaten, die die Bundeswehr meist nur noch als Einsatzarmee kennen". 2 Als die Bundeswehr Ende 2001 ihren Einsatz in Afghanistan begann, besaß sie erst wenige Jahre Erfahrung mit Auslandseinsätzen. Ähnlich wie in den ersten größeren Einsätzen der Bundeswehr auf dem Balkan lautete der Auftrag des deutschen ISAF-Kontingents, die afghanische Regierung bei der Aufrechterhaltung der Sicherheit zu unterstützen und den Aufbau des Landes militärisch abzusichern. Was in den Anfangsjahren noch recht erfolgreich war, änderte sich 2006 zunächst im Süden und Osten Afghanistans und ab 2007 sukzessive dann auch im deutschen Verantwortungsbereich im Norden des Landes. Immer häufiger gerieten Soldatinnen und Soldaten der Bundeswehr in Hinterhalte und in Gefechte. Ab 2009 war die Bundeswehr in Afghanistan erstmalig in ihrer Geschichte buchstäblich in ____________________ 1 Der Beitrag ist eine Erweiterung und Aktualisierung bereits erschienener Aufsätze, siehe Anja Seiffert, Generation Einsatz-Einsatzrealitäten, Selbstverständnis und Organisation, in: dies.
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