Serum biochemical markers in drowning: diagnostic efficacy of Strontium and other trace elements

The aim of our study was to analyse several serum biochemical markers in order to evaluate the discriminant capacity of trace elements individually and jointly in drowning (seawater drowning and freshwater drowning) and their correlation with age, sex, postmortem interval, time in water and concentrations of the trace elements in the drowning medium. Sixty-seven cases of drowning (53 seawater drownings (SWD); 14 freshwater drownings (FWD) and 73 control cases (other asphyxias, n=44, and other causes of death, n=29) were selected according to the scene, cause and circumstances of death, together with autopsy findings. Serum strontium (Sr), magnesium (Mg), sodium (Na), chloride (Cl), calcium (Ca), iron (Fe), urea, creatinine (Cr) and cardiac Troponine T (cTn-T) were measured in the left ventricle (Lv), right ventricle (Rv) and peripheral blood. Lv-Rv differences for each marker and Sr, Mg, Na, Cl, Ca and Fe concentrations in the drowning medium were determinated. Mean concentrations of Sr, Cl and Mg in both ventricles and peripheral serum and Lv-Rv differences and Ca Lv and Na Rv were significantly higher in cases of drowning than for other causes of death. In SWD, Sr, Mg, Ca, Na and Cl were significantly higher in Lv than in Rv as a result of aspirating water. In contrast, haemodilution is evident from the significantly higher levels of Fe and urea in Rv than in Lv in cases of SWD, and from the higher Mg and Cr levels in Rv in FWD. In the case of SWD, serum levels of Sr are confirmed as the best parameter for diagnosis, although other trace elements may also be useful, such as the serum concentrations of Mg and Cl. In the case of FWD, the joint determination of Sr and other biochemical markers, especially Fe, may increase correct diagnosis.     

Aqueous Fluid as a Viable Substitute for Vitreous Fluid in Postmortem Chemistry Analysis

Vitreous fluid sampling for postmortem chemistry analysis is discouraged in pediatric forensic cases involving head trauma due to the risk of introducing retinal artifacts. Aqueous fluid is physically separated from the posterior chamber of the eye, and therefore, unlikely to produce vitreal artifact when sampled. Analysis of aqueous fluid is therefore proposed as a substitute for vitreous. Vitreous and aqueous fluid was sampled concurrently from 28 pediatric and 55 adult decedents, and sodium (Na), potassium (K), chloride (Cl), urea nitrogen (UN), creatinine (Cr), and glucose (Glc) concentrations were compared. Significant correlation existed between all analytes regardless of age or postmortem interval, and linear regression equations were derived. Aqueous concentrations were generally higher than vitreous for Na, K, and Cr and were marginally lower for Cl, UN, and Glc. Assuming vitreous fluid as a standard for correlating postmortem chemistry to antemortem serum values, aqueous may be a viable substitute for vitreous when expected differences are considered.     

Evaluation of the composition of street cocaine seized in two regions of Brazil

This work evaluates cocaine purity and the concentration ranges of adulterants and inorganic constituents for 31 street cocaine samples seized in two different regions of Brazil from July 2008 to May 2010. Cocaine and adulterants, such as caffeine, lidocaine and benzocaine, were quantified by Gas chromatography–mass spectrometry (GC–MS), and the inorganic constituents were determined by Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES) and ion chromatography (IC). The cocaine concentrations in the samples seized in the Amazonas state (AM samples) ranged from 154 to 978 mg g^? 1, and these samples did not contain any of the adulterants studied. The cocaine concentrations in the samples seized in the Minas Gerais state (MG samples) ranged from 63.9 to 753 mg g^? 1. Caffeine was the main adulterant found in 76% of the MG samples, ranging in concentration from 5.5 to 645.3 mg g^? 1. Lidocaine was found in 66.7% of the MG samples, with concentrations ranging from 16.3 to 576.7 mg g^? 1. Benzocaine was found in only one MG sample, at a concentration of 84.8 mg g^? 1. Fourteen elements were identified by ICP-OES, and a wide variation was observed in the concentrations of Ca, Mg, Na, P, Al, Fe, Mn and Zn. Pearson Product–moment Correlations between the analytes allowed the constituents to be associated with the chemicals used in the manufacturing of cocaine and with some common diluents. The study of the purity of cocaine and the presence and concentration of adulterants and inorganic constituents is important because the latter can have deleterious effects on health.     

Postmortem serum uric acid and creatinine levels in relation to the causes of death

Serum uric acid (UA) and creatinine (Cr) mainly derive from skeletal muscle tissues. Although, remarkable postmortem stability of the serum levels has been reported, there appears to be very poor knowledge of the diagnostic value in investigation of death, except for uremia. The aim of the present study was to evaluate postmortem serum UA and Cr levels using 395 forensic autopsy cases, in comparison with blood urea nitrogen (BUN), for investigation of the pathophysiology of death with special regard to the causes of death involving possible skeletal muscle damage, e.g. due to hypoxia, heat or agonal convulsions. Cr and BUN showed relatively good topographic stability in the cadaveric blood, whereas, UA was often much higher in the right heart blood than in the left heart and peripheral blood, independent of postmortem intervals. Moderate to marked elevation of Cr and BUN accompanied with hyperuricemia was observed in delayed death. In the acute death cases (survival time <30 min), UA, especially in the right heart blood, showed a considerable elevation in mechanical asphyxiation and drowning. The Cr level in fire victims with a lower carboxyhemoglobin (COHb) level (<60%) was significantly higher than in those with the possible fatal level (>60%). A similar elevation of Cr was observed in fatalities from heat stroke and methamphetamine (MA) poisoning. The observations suggested that hyperuricemia in acute death may be indicative of advanced hypoxia and that elevated Cr level may reflect the skeletal muscle damage, especially due to thermal influence.     

Detection of acute fentanyl exposure in fresh and decomposed skeletal tissues part II: The effect of dose–death interval

The effects of dose–death interval on the detection of acute fentanyl exposure in fresh and decomposed skeletal tissues (marrow and bone), by automated enzyme-linked immunosorbent assay (ELISA) are described. Rats (n = 14) were administered fentanyl acutely at a dose of 0 (n = 2) or 60 μg/kg (n = 12) by intraperitoneal injection, and euthanized within 20, 45, 135, or 225 min. Femora and tibiae were extracted from the fresh corpses and marrow was isolated from the femoral and tibial medullary cavities. The remains were then allowed to decompose outdoors to the point of complete skeletonization, and vertebrae, pelvi and miscellaneous (humeri and scapulae) were recovered for analysis. In all cases, bones were cleaned in alkaline solution and then ground into a fine powder. Marrow was homogenized in alkaline solution. Fentanyl was extracted from ground bone by methanolic extraction. Extracts were adjusted to pH 6 and analyzed by ELISA. Perimortem heart blood was also collected and diluted in phosphate buffer prior to screening by ELISA. The effect of tissue type on ELISA response was examined through determination of binary classification test sensitivity and the relative decrease in absorbance (%DA, drug-positive tissues vs. drug-free controls) in each tissue type. Overall, the %DA varied significantly between extracts from different skeletal tissues at a given dose–death interval, according to the general order of marrow > decomposed bone > fresh bone. Binary classification test sensitivity values for fentanyl in marrow, fresh epiphyseal (femoral and tibial) bone, fresh diaphyseal (femoral and tibial) bone, decomposed vertebrae, decomposed pelvic bone, and decomposed miscellaneous bone were 67–100%, 0–33%, 0–33%, 0–67%, 0–67% and 0–33%, respectively, over all dose–death intervals. Although group mean %DA values showed a strong negative correlation with dose–death interval in marrow, fresh epiphyseal bone, decomposed vertebrae, pelvic and miscellaneous bone (r = ?0.989, ?0.930, ?0.955, ?0.903, and ?0.974, respectively), the high variability in both fresh and decomposed bone precluded differentiation of the dose–death intervals based on %DA value alone. Overall, the results suggested that the type of skeletal tissue sampled may not be as important as the amount of residual marrow remaining in skeletonized remains.     

Comparison of the three age estimation methods: Which is more reliable for Turkish children?

BackgroundThree atlases—the GÖK, the Greulich–Pyle (GP), and the Tanner–Whitehouse (TW3)—are used frequently for age determination in Turkey. The purpose of this study was to evaluate the applicability of these three methods related to the skeletal age assessment for Turkish adolescents.Materials and methodsThe conventional roentgenograms of the left hands and wrists, elbows, shoulders, and pelvises of 333 healthy Caucasian children (164 females, 169 males) who fit the study and the criteria of each atlas were obtained. The mean differences (± standard deviation [S.D.] in years) between the chronologic age (CA) and the skeletal age (BA), which were obtained by using each age estimation method, were calculated and tested using t-test.ResultsFor girls, the most accurate method was the TW3 (mean differences (d): ?0.21 (p < 0.05)), following by the GP (d: 0.66 (p < 0.001), and the GÖK (d: 2.99 (p < 0.001)). For boys, the most accurate method was the GP (d: ?0.02 (p > 0.05)), followed by the TW3 (d: ?0.18 (p < 0.05)) and GÖK (d: 1.05 (p < 0.001)).Discussion and conclusionsResults show that the TW3 (for girls) and the GP (for boys) methods are more appropriate than the GÖK atlas for estimating the BA. GÖK could be used for boys aged 11–14 years but it should not be used for girls.     

Prevalence of blood alcohol in fatal traffic crashes in Shanghai

The objective of this project was to investigate the incidence of alcohol consumption in fatal traffic deaths in Shanghai, one of the largest cities in China. A study was conducted on 803 individuals killed in road accidents during the period 2009–2011, in terms of alcohol-positive rate, mean blood alcohol content (BAC), gender, age, vehicle type, pedestrian alcohol problem, single-vehicle vs multiple-vehicle crashes, and time of day. It was found that 28.9% of the drivers involved had a BAC ≥ 0.20 mg/mL (limit of civil offense) and 21.8% had a BAC ≥ 0.80 mg/mL (limit of criminal offense). The mean BAC of alcohol-positive drivers (with a BAC ≥ 0.20 mg/mL) was 1.51 mg/mL. The vast majority of the drivers involved were males. With regards to age, the largest group was of drivers aged between 40 and 49 years group in both alcohol-negative cases (26.8%) and alcohol-positive cases (26.2%). Motorcycles were most likely to be involved, representing 34.4% of alcohol-negative crashes and 51.6% of alcohol-positive crashes. Very high BACs were common among alcohol-positive pedestrians, yet all female pedestrians were alcohol-negative. Single-vehicle crashes were over-represented in alcohol-positive cases. Alcohol-negative crashes and alcohol-positive crashes most often happened during the time period of 17:00–18:59 and 19:00–20:59, respectively.     

人体死亡后血液中生化指标的变化

目的测定人体死亡后血液中生化指标的变化并进行分析。方法收集81例交通事故死亡后尸体锁骨下静脉血样,并采用罗氏cobasc311全自动生化分析仪检测血液中肝功能（ALT、AST、TBIL、DBIL）、肾功能（UA、Cr）、心功能（CK、CK—MB、LDH）、电解质（K＋、Na＋、Cl-）以及葡萄糖（GLU）13项生化指标的变化,采用SPSS17．0统计学软件进行描述性分析。结果生化指标中ALT、AST、CK、CK—MB、LDH、D数值较活体正常参考值高、波动幅度较大。TBIL、DBIL、UA、Cr、Na＋、Cl-、GLU数值相对稳定、波动幅度较小。结论人体死亡后血液生化指标中肝功能、肾功能、心功能、电解质以及葡萄糖等指标易受溶血、自溶等因素影响,表现为生化指标升高明显,尤以酶类为著,且标准差较大。     

Estimation of legal age using calcification stages of third molars in living individuals

The increased number of adolescents and young adults with unknown or inaccurately given date of birth is a current issue in justice and legal medicine. The objective of this study was to determine the extent to which third molar calcification stages assessed on panoramic X-rays could be useful as additional criteria for forensic age estimation in living individuals, focusing on the legally important ages 17 and 18.In a retrospective multi-center study, the developmental stage of each individual's third molar was analyzed using Demirjian's scale in 2360 cases. Additionally, sex, age and ancestry were assessed.Individuals with the lowest calcification stage of all present molars in stage H were ≥ 18 years with a likelihood of ≥ 99.05% in the female (n = 388), and ≥ 99.24% in the male (n = 482) population.The lowest calcification stage of all present third molars proved to be useful as an additional reliable criterion for the determination of an age ≥ 18 years.     

Experimental forensic studies of the preservation of pollen in vehicle fires

The implications of the recent recommendations of the Law Commission regarding the use of admissibility tests have the potential to be far reaching for forensic disciplines that rely on the expertise of highly qualified expert witnesses. These disciplines will need a concomitant body of peer-reviewed experiments that provides a basis for the interpretations of such evidence presented in court. This paper therefore, presents such results from two experiments which were undertaken to address specific issues that were raised in cases presented in the British courtroom. These studies demonstrate that there is a variability in the persistence of Lily, Daffodil and Tulip pollen when exposed to high temperatures between 0.5 min and 1440 min (24 h). It was possible to identify all three pollen types after 30 min of exposure to 400 °C, and after shorter time frames the threshold for successful identification was 700 °C after 0.5 min for all pollen types tested and 500 °C for Daffodil and Lily after 5 min of heat exposure. Over longer time periods (18 h (1080 min)) the different pollen types were found to persist in a viable form for identification at 300 °C (Lily), 200 °C (Daffodil) and 50 °C (Tulip). These findings, albeit from a small sample of pollen types, provide empirical contextual information that would contribute to such evidence having sufficient scientific weight to meet admissibility criteria and be viable evidence for a court. These studies demonstrate the value in seeking pollen evidence from even such extreme crime scenes as encountered in vehicular fires.     

Determination of amphetamine-type stimulants,ketamine and metabolites in fingernails by gas chromatography–mass spectrometry

A gas chromatography–mass spectrometry (GC–MS) method was developed and validated for the simultaneous qualification and quantification of methamphetamine (MA), amphetamine (AP), 3,4-methylenedioxy-N-methylamphetamine (MDMA), 3,4-methylenedioxy-N-amphetamine (MDA), ketamine (KET) and norketamine (NKT) in fingernails. Fingernail samples (20 mg) were washed with distilled water and methanol, digested with 1.0 M sodium hydroxide at 95 °C for 30 min, and then extracted with ethyl acetate. Extract solutions were evaporated to dryness, derivatized using heptafluorobutyric anhydride (HFBA) at 60 °C for 30 min, and analyzed by GC–MS. The linear ranges were 0.1–20.0 ng/mg for AP, MDMA and NKT, 0.2–20.0 ng/mg for MA and MDA, and 0.4–20.0 ng/mg for KET, with the coefficients of determination (r² ≥ 0.9989). The intra- and inter-day precisions were within 7.1% and 10.6%, respectively. The intra- and inter-day accuracies were ?10.9% to 0.8% and ?4.3% to 4.5%, respectively. The limits of detections (LODs) and the limits of quantifications (LOQs) for each analyte were lower than 0.094 ng/mg and 0.314 ng/mg, respectively. The recoveries were in the range of 72.3–94.9%. The average fingernail growth rates of two subjects for three years and six subjects for two months were 3.12 mm/month and 3.16 mm/month, respectively. The method proved to be suitable also for the simultaneous detection and quantification of MA, MDMA, KET and their metabolites in fingernails.     

Evaluation of postmortem serum calcium and magnesium levels in relation to the causes of death in forensic autopsy

There appears to be very poor investigation of postmortem serum calcium (Ca) and magnesium (Mg) for diagnostic evidence to determine the cause of death. The aim of the present study was a comprehensive analysis of the serum levels in relation to the causes of death in routine casework. Autopsy cases (total, n=360; 5-48 h postmortem), including blunt injury (n=76), sharp injury (n=29), asphyxiation (n=42), drownings (n=28: freshwater, n=11; saltwater, n=17), fire fatalities (n=79), methamphetamine (MA) poisoning (n=8), delayed death from traumas (n=37), and acute myocardial infarction/ischemia (AMI, n=61), were examined. In total cases, there was no significant postmortem time-dependent rise in serum Ca and Mg. Both Ca and Mg levels in the heart and peripheral blood were significantly higher in saltwater drowning compared with those of the other groups. In addition, a significant elevation in the Ca level was observed in freshwater drowning and fire fatalities, and in the Mg level in fatal MA intoxication and asphyxiation. Topographic analyses suggested a rise in serum Ca and Mg due to aspirated saltwater in drowning, that in serum Ca in freshwater drowning and fire fatalities of peripheral skeletal muscle origin and that in serum Mg in MA fatality and asphyxiation of myocardial and/or peripheral origin. These markers may be useful especially for diagnosis and differentiation of salt- and freshwater drownings and may be also helpful to determine the causes of death involving skeletal muscle damage, including burns and MA intoxication.     

Predicting the postmortem interval using human intestinal microbiome data and random forest algorithm

Gradual changes in microbial communities in a human body after death can be used to determine postmortem interval (PMI). In this study, gut microflora samples were collected from the vermiform appendix and the transverse colon of human cadavers with PMIs between 5 and 192 h. The results revealed that the appendix might be an excellent intestinal sampling site and the appendix flora had an inferred succession rule during human body decomposition. Firmicutes, Bacteroidetes, and their respective subclasses showed a predictable succession rule in relative abundance over time. A Random Forest regression model was developed to correlate human gut microbiota with PMI. We believe that our findings have increased the knowledge of the composition and abundance of the gut microbiota in human corpses, and suggest that the use of the human appendix microbial succession may be a potential method for forensic estimation of the time of death.     

Pressing need for national governmental recognition of forensic anthropology in South Africa as illustrated in a medico-legal case

Forensic anthropology in South Africa is well developed in the higher education sector, with advanced training and research programmes. Despite this and decades of academic involvement in casework, forensic anthropology still lacks a defined framework and mandate at a governmental level. Therefore, the involvement of forensic anthropologists’ expertise varies markedly between cases, provinces, and among various stakeholders within the country, to the detriment of dispensation of social and criminal justice. The lack of clearly defined guidelines for the rendering of the service was exemplified and demonstrated through a recent forensic case. Here, contextual information was absent, and the remains posed a challenge to analyse, ostensibly due to missing information. Numerous questions were raised during the analysis of the remains, and broader concerns about the investigative involvement of a forensic anthropologist within South African casework were brought to the fore. Through the analysis of this case, we describe the deductive processes that led to the formation of an opinion that the skeletal linear defects were the result of taphonomic changes. In addition, we highlight how these efforts where constrained and each step in the process unnecessarily hindered. Finally, we demonstrate the capacity and willingness of forensic anthropology practitioners to be involved, and how, without governmental support, it is a great potential lamentably untapped.     

Genetic variation in a Japanese population,using the multiplex 24 STRs analysis system

Allele frequency distributions for 24 short tandem repeat (STR) loci were determined using the PowerPlex^R Fusion System (Promega) in 407 Japanese samples. The most informative locus among the 22 STR loci, excluding Amelogenin and DYS391, was Penta E (power of discrimination (PD) = 0.98), while the least informative was TPOX(PD = 0.831). The 22 loci combined matching probability (MP) was calculated to be 4.13 × 10⁻²⁶. These parameters indicated the usefulness of this 24 STR analysis in forensic personal identification and parentage testing among Japanese population.     

Age estimation by pulp/tooth area ratio in canines: Cameriere's method assessed in an Indian sample using radiovisiography

Age estimation of an individual whether living or dead is an intimidating task in forensic investigations. Since teeth are more resistant to most peri- and post-mortem changes, they are frequently used for identification and age estimation when skeletal remains are in poor condition. However, most methods are destructive and warrant extraction of teeth which is not feasible in living individuals. Cameriere's et al. put forth a radiographic method of age estimation by pulp to tooth area ratio (AR) in canines and revealed a linear regression between age and the AR. In the present study, we estimated the AR in 456 canines (upper, lower and both) in an Indian sample (114 males and 114 females) using radiovisiography technique. Linear regression equations were derived for upper canine, lower canine and both using the AR to estimate chronological age. Additionally, the efficacy of these equations was also evaluated in younger age group (<45 years). The formulas derived, i.e., age = 96.795 ? 513.561x₁ (Eq. (1)) for upper canine, age = 88.308 ? 458.137x₂ (Eq. (2)) for lower canine and age = 99.190 ? 283.537x₁ ? 306.902x₂ + 400.873x₁x₂ (Eq. (3)) for both the canines were applied to predict the chronological age. The mean value of residuals using these regression equations ranged from 4.28 to 6.39 years with upper canine equation generally giving a precise result. When these equations were applied for younger ages (<45 years), the regression equation derived from both canines gave a better result (mean residual 2.70 years). Overall these equations were better able to predict the age in younger ages, i.e., up to 45 years.     

Quantitative analysis of glasses used within Australia

An initial 134 glasses have been collected from eleven classifications of glass used within Australia. These include both local and imported glasses. Quantitative elemental analyses of the glasses have been determined using a scanning electron microscope equipped with an energy dispersive X-ray spectrometer. The current program provides for an elemental analysis for Na, Mg, Al, Si, P, S or Pb, Cl, K, Ca, Ba or Ti, V, Cr, Fe, Mn and Zn expressed as oxides, and has a sensitivity down to approximately 0.1%. The data for the six most commonly occurring elements, namely, Na, Mg, Al, Si, K and Ca, together with the refractive index are presented for each class of glass in terms of their mean value and standard deviation from the mean, and also in histogram form.     

Multiple murder and criminal careers: A latent class analysis of multiple homicide offenders

PurposeTo construct an empirically rigorous typology of multiple homicide offenders (MHOs).MethodThe current study conducted latent class analysis of the official records of 160 MHOs sampled from eight states to evaluate their criminal careers.ResultsA 3-class solution best fit the data (?2LL = ?1123.61, Bayesian Information Criterion (BIC) = 2648.15, df = 81, L² = 1179.77). Class 1 (n = 64, class assignment probability = .999) was the low-offending group marked by little criminal record and delayed arrest onset. Class 2 (n = 51, class assignment probability = .957) was the severe group that represents the most violent and habitual criminals. Class 3 (n = 45, class assignment probability = .959) was the moderate group whose offending careers were similar to Class 2.ConclusionA sustained criminal career with involvement in versatile forms of crime was observed for two of three classes of MHOs. Linkages to extant typologies and recommendations for additional research that incorporates clinical constructs are proffered.